Some Side Effects Can Be Serious If You Experience These Symptoms Call Your Doctor Immediately Or Get Emergency Treatment:
- rash, hives, or itching all over the body
- swelling of the eyes, face, lips, tongue, or throat
- swelling of ankles or feet
- shortness of breath
- vision changes
Insulin glargine products may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
Using An Insulin Pump
If you use an insulin pump, you may be able to substitute another insulin for your usual insulin . Check the instructions for your pump to see which insulin types will work. The guidance also explains which insulin types you can use instead of your usual insulin if you need to switch from using your pump to using injectable insulin .
Why Insulin Should Be Refrigerated
Firstly, insulin is effectively proteins dissolved in liquid. So, like any other protein, insulin can spoil. This is why it needs to be refrigerated to keep it from spoiling. Think of insulin as a form of meal. If you keep it out for long enough, its going to spoil.
More clearly, what exactly happens within insulin kept outside is that bacteria starts growing. This bacterial growth will break down the protein. So, by keeping it cool through refrigerating, its easier to prevent bacterial growth. When dealt with in this way, the potency of the insulin will be retained.
Insulin kept out of the refrigerator will not poison you or even make you sick. It just means that your insulin will not work as well or deliver its full potential dose.
In simple terms, if your blood sugar is high, and you use the insulin that has been kept out, your blood sugar may not be lowered. You may still find the blood sugar higher than you expect even after taking the injection at the right amount at the right time.
That being said, its important to remember that keeping your insulin refrigerated doesnt mean it can be used for any period. Insulin has a lifespan, and it will expire after its lifespan regardless of refrigerating.
The next common question that comes with refrigerating is the temperature. So, lets focus next on refrigerating temperatures for insulin.
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Storage And Transport Of Insulin When In Use
For PwD, the insulin in-use is a daily companion, and therefore, is exposed to numerous environmental factors. The average ambient temperature in many regions can be much higher than the recommended 30°C in summer or can drop below 2°C in winter. Package leaflets, in addition to a temperature range, recommend keeping insulin away from sunlight and do not freeze.
There is little research on how insulin is transported when in-use and its quality at the moment of administration. Observational data from users of the insulin pen cap Insulclock showed that during a study period in Spain in summer, injections were performed at an average temperature of 27°C , with 11.7% above 30°C up to 41°C . There are also a few documented cases of diabetic ketoacidosis of pump users, whose insulin had stopped working because of exposure to heat or freezing.,
Important Storage Tips For All Insulin:
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Why Insulin Ought To Be Refrigerated
Primarily, insulin is efficiently proteins dissolved in liquid. Therefore, like any other protein, insulin may spoil. That is the reason it has to be refrigerated to keep it from spoiling. Consider insulin as a type of meal. Should you keep it outside for long enough, then it is likely to spoil.
More obviously, what happens in insulin stored outside is that germs begin to grow. This bacterial growth tends to melt the protein.
Thus, by keeping it cool during refrigerating, it is simpler to stop bacterial growth. When dealt with in this manner, the potency of the insulin is going to be kept.
Insulin stored from the fridge wont poison you or make you ill. It merely means your insulin wont operate too or provide its total potential dose.
If your blood glucose is elevated, and you also utilize the insulin stored outside, your blood glucose might not be lowered. You might still discover the blood glucose greater than you anticipate even after accepting the shot at the ideal level in the ideal moment.
That was having been said. It is important not to forget that keeping your glucose doesnt imply it may be utilized for almost any period. Insulin has a life span, and itll expire after its lifespan no matter refrigerating.
The upcoming frequent question which is included with refrigerating is the fever. Thus, let us focus on refrigerating temperatures for your insulin.
Yes Insulin Does Expire
Medical insulin breaks down over time, which is why all insulin has an expiration date, says Maria Fernandez de Fiore, RN, a diabetes care and education specialist and Inpatient Diabetes Program Coordinator for Riverside University Health System in Moreno Valley, California.
“The expiration date means that the insulin will start to degrade after this date,” Fernandez de Fiore says. “It will go bad because it won’t be effective to manage blood glucose levels anymore.”
Specifically, this is because insulin proteins break down over time. Expired insulin won’t make you sick, but it will be less effective, and it can be dangerous to use.
“When it comes to insulin, we have to make sure it works at its full potency, or the blood glucose levels can go dangerously high,” Fernandez de Fiore says.
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Response From Novo Nordisk
Thank you for sharing this letter regarding insulin storage guidelines. Novo Nordisk shares the commitment of health care professionals that insulin storage and handling should be appropriate to maintain consistent and predictable glycemic effects. We agree that storage and handling guidelines are essential for the patient to use insulin safely and effectively on a daily basis, in a variety of situations. We offer the following information regarding proper use of insulin formulations manufactured by Novo Nordisk.
All Unopened Insulin Should Be Kept In The Refrigerator
It typically has an expiration date of 1 year from the date of purchase. But dont store your insulin in the back of the fridge , and be sure your fridge is at a normal setting of 35°F to 40°F. And double-check the setting when you store insulin temporarily in a friends fridge or at a hotel.
How Long Can Basaglar Be Unrefrigerated
Once removed from refrigeration, the Basaglar KwikPen should be discarded within 28 days, even if it has not been opened and even if it still contains insulin.
Subsequently, question is, what happens if insulin is not refrigerated? If you keep it out for long it’s going to get spoiled. More clearly, what exactly happens within insulin kept outside is that bacteria starts growing. This bacterial growth will break down the protein . So, by keeping it cool through refrigerating, it’s easier to prevent bacterial growth.
Subsequently, one may also ask, how long can insulin be unrefrigerated before it goes bad?
Insulin products contained in vials or cartridges supplied by the manufacturers may be left unrefrigerated at a temperature between 59°F and 86°F for up to 28 days and continue to work.
How long does Basaglar last in the body?
insulin glargine , lasts up to 24 hours.
Target Temps By Insulin Brand
Do different insulins have different recommended temperatures for safe storage? Starting with Novo Nordisk, the company that makes more kinds of insulin than anyone else, heres the official word on product storage:
Long-acting insulin Levemir, should be kept in a refrigerator at that sweet spot between 36° and 46° Fahrenheit.
Well, the problem may be that Novo Nordisk is a Danish company, and its cooler in Denmark than in Phoenix, Arizona, or lots of other places. Their official safe room temp for insulin no hotter than 86° F. Meanwhile, open in-use pens and vials, must NOT be stored in a refrigerator , and have the same 42-day life that unopened room temp Levemir has.
Fast-acting insulin Novolog has the same temperature ranges, for both unopened or in use, but a shorter room temperature lifespan: 28 days. It also has an additional interesting note: Six-days max life in an insulin pump reservoir, unless exposed to temperatures in excess of 98.6° F, in which case it needs to be pitched out.
Pumpers: Dont snuggle up with someone running a mild fever.
OK, and what about the newest insulin formulations from Novo? Are they more robust than our old standbys? Nope. Ultra fasting-acting Fiasp has the exact same recommendations as Novolog. Ultra long-acting basal insulin Tresiba has the same temps and rules as Levemir, except it apparently lasts a full 56 days at Danish room temps.
Still, just for fun, lets look at old-school insulin. Was pioneer insulin tougher?
Response From The Ada
Thank you for asking the ADA to respond to Dr. Grajowers letter. He raises several very important points regarding the storage of insulins and its possible effects on blood glucose control. His specific comments regarding the various insulins and what their manufacturers state regarding storage and product expirations will need to be addressed by the manufacturers themselves. If their guidelines were only evidence based, then they would have that data. I will comment on the general topic of insulin use as regards the guidelines that come from our 2003 Clinical Practice Recommendations. In general, patients are instructed that once opened, an insulin vial need not be refrigerated and can be kept at room temperature for 1 month. Extremes of temperature should be avoided because these can lead to significant changes in insulin action. How long an insulin can be stored while unopened is based on the expiration date.
What Happens If Lantus Gets Hot
A: Insulin you are not using should be kept between 36 degrees and 46 degrees Fahrenheit. If it gets colder than that it can freeze. If it gets warmer than that, it will be good for a while, but eventually it will start to break down. Room temperature is defined as between 59 degrees and 86 degrees Fahrenheit.
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Can Insulin Go Bad If Not Refrigerated
Yes, it surely can but if preserved correctly it can survive. Never use insulin that went bad and make sure you replace it on time.
Insulin cannot withstand too high or too low a temperature. It then quickly loses its effectiveness. Too high temperatures can easily develop if your medication is exposed to full sun or a tropical warm environment. You should also avoid freezing temperatures.
If you want to check if your medication is still working you can check the time it takes to become active and also check the quality of it. Some insulins are naturally clear, others are milky-cloudy because they are mixtures of two types, or because they are mixed with an agent that extends the duration of action. If your insulin looks different than usual it may have been too hot, too cold, or too old. You throw those vials or pens away.
Short-acting insulin lowers the amount of blood sugar after only 10 to 30 minutes the effect lasts 2 to 8 hours. The medium varieties work after 1 to 2 hours and the effect lasts for 16-24 hours. Long-acting insulin has a continuous effect throughout the day when used as directed.
Whats The Best Temperature To Store Insulin
The three major insulin makers Eli Lilly, Novo Nordisk, and Sanofi tell us that refrigeration temperatures between 36° and 46°F are maintained for insulin products during the manufacturing process and that remains the recommended range. They also warn strongly against putting insulin in the freezer, or directly adjacent to the refrigerator cooling element, as freezing renders insulin immediately ineffective.
According to Consumer Reports, the sweet spot for a kitchen fridge is 37° F apparently ideal for keeping veggies like lettuce free of ice crystals, while suppressing the spread of bacteria. But thats pretty close to the bottom of the ideal insulin temp range, so we need to be careful.
Many people with diabetes have a habit of taking their insulin directly from the pharmacy to the kitchen fridge. While this is generally good enough, its important to be alert to colder corners and know that the overall temperature of a full fridge can be lower than the temperature in a nearly empty one. The butter compartment generally remains a good choice of fridge placement for insulin, as it turns out.
Now lets turn to the specific insulin you may be using.
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Last On The Subject Of Hot Weather
The insulin that has already been injected into your body needs to be considered when youre in extremely hot temps, too. Dehydration raises the concentration of sugar in your bloodstream because theres simply less water in your blood, too. This results in high blood sugar levels, and means you either need more insulin or you need to keep yourself more hydrated…likely both! Water, water, water!
How Can You Tell If Insulin Has Gone Bad
If your insulin looks cloudy or discolored in any way, dont use it. If it has clumps or what look like little strings in it, its probably not safe to use. The second way to know your insulin is not working properly is unexplained high blood sugars, as mentioned above.
When Should You Throw Away An Open Insulin Vial Or Pen
Many insulin pens can last outside of the refrigerator for 7-28 days, in some cases even more.
Here are some specific recommendations for insulin storage that you can follow. As always, check the instructions inside the box for specific guidance.
New insulins are coming to market at a rapid pace, and the instructions may vary slightly with different formulations and brands.
- Insulin lispro injection : Pen and vial, throw away after 28 days
- Insulin glulisine injection : 28 days
- Insulin glargine injection : 28 days
- Insulin glargine injection : 28 days
For questions about a particular brand of insulin, problems, or concerns about product stability, contact the manufacturer for help , and in some cases, ask for a replacement.
Insulin Storage And Syringe Safety
Although manufacturers recommend storing your insulin in the refrigerator, injecting cold insulin can sometimes make the injection more painful. To avoid this, many providers suggest storing the bottle of insulin you are using at room temperature. Insulin kept at room temperature will last approximately one month.
Remember though, if you buy more than one bottle at a time to save money, store the extra bottles in the refrigerator. Then, take out the bottle ahead of time so it is ready for your next injection.
Here are some other tips for storing insulin:
- Do not store your insulin near extreme heat or extreme cold.
- Never store insulin in the freezer, direct sunlight, or in the glove compartment of a car.
- Check the expiration date before using, and don’t use any insulin beyond its expiration date.
- Examine the bottle closely to make sure the insulin looks normal before you draw the insulin into the syringe.
If you use regular, check for particles or discoloration of the insulin. If you use NPH or lente, check for “frosting” or crystals in the insulin on the inside of the bottle or for small particles or clumps in the insulin. If you find any of these in your insulin, do not use it, and return the unopened bottle to the pharmacy for an exchange and/or refund.
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Guidelines Labels And Leaflets
When a pharmaceutical manufacturer wants to bring a new product to market, they need to provide a huge amount of data. From clinical findings, proof of efficacy and safety, side effect warnings and dosing guidance down to storage recommendations.
For these, they do extended stability testing at different temperatures with their insulin pens, vials and so on, over months and years, to finally say: If you follow this, your medication stays safe, effective and at optimal quality. Great!
This info is publicly available at your national health authoritys website, eg FDA for the US and EMA for the EU. These authorities are not joking around, and if theres changes to a label, there must be a reason for it! The first time Do not refrigerate popped up was in 2003. Take Lillys Humalog for example, heres the label from 14-years ago, with the new changes highlighted in green.