# Insulin and fridges



## EmmyBuzz (Feb 19, 2016)

Bit of a newbie question but I have just gone to take my night time lantus and realised the pen I have in use hasn't got enough insulin in for my dose - I remember the diabetic nurse telling me that I needed to wait for it to warm up a bit but how long should I be waiting?

Whilst on the subject of insulin and fridges - I keep all my new pens in the fridge but my pens that are in use I keep out on my dressing table as in the hospital they were just left on my table so I have been doing the same at home - they will be ok won't they? as long as I use them within the 4 weeks since they came out of the fridge and it's not super warm (and I'd imagine its best to keep them in the fridge in summer?) - I'm taking novorapid and lantus for reference incase different ones vary!


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## Mini-Vicki (Feb 19, 2016)

Hiya,
I'm on Lantus too, and Humalog during the day. 
I've used my Lantus after about 10 minutes of having it out of the fridge, and haven't had any problems yet. 
Insulin that you're using can safely be kept out of the fridge for 28 days, so no worries there  
I only started insulin in September, so haven't had to deal with summer yet, I'm sure someone more experienced will be along soon with advice for that! But I have invested in a couple of frio pouches, which have gel activated with water to keep insulin cool if you're going somewhere you're worried it will get too warm


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## Matt Cycle (Feb 19, 2016)

Hi

I would imagine it's because the insulin is cold and you can feel it going in so it's more for personal comfort.  I've used it straight from the fridge plenty of times without problems. 

 The pens will be fine to keep out when in use.  It rarely gets hot enough in this country to have any effect.  I've never bothered with frio wallets and haven't had any issues with insulin 'going off', again as it never really gets hot enough for long enough.


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## EmmyBuzz (Feb 19, 2016)

Thank you both! I was thinking I might have to leave it an hour or so! Given it over half an hour so should be fine! (I'm good at worrying!) Might look into the pouches if I am going to be travelling at all they sound useful


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## Mini-Vicki (Feb 20, 2016)

No problem  
I'm good at worrying too, so I completely understand!


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## Sally71 (Feb 20, 2016)

If you are worried about using the insulin straight from the fridge you could always warm it in your hands / down your bra / anywhere else next to your skin for a few minutes!  But I agree that I think it is more for personal comfort that they tell you to always use it at room temperature.

And I think that insulin is tougher than people think, it should be fine at room temperature as long as it isn't in direct sunlight or right next to a radiator etc.  We just keep our in use one in a cupboard, we're pumping though so don't need to get at it every day; I think my mum keeps her pens on a shelf in the bathroom.


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## Amberzak (Feb 20, 2016)

All it is is that it hurts like hell if you inject with cold lantus. 

As for the warm weather, don't worry. Just keen it out of direct sunlight. I ran a fair with the brownies during a heatwave a few years ago, sitting in the middle of a field where it was very warm, with my insulin in my bag. It was fine. 

And now I'm on the insulin pump, I keep my pump (with insulin) in my pocket so it gets very very hot. 

The only time my insulin stopped working was when I put it in my step dad's fridge when I was on holiday. He keeps his fridge very cold (something like 1 degree) and the cold ruined the insulin. We think it froze the insulin. Frozen insulin is far worse that over heated. 

Obviously if you were planning a holiday to the equator, that's a different thing. 

If you're concerned though (which is totally understandable, this is our life after all), get a frio pack for the really really warm days. 

I know people who have left their insulin on the dashboard of the car and not had problems, though I wouldn't advise that. Ha ha. 

You'll be fine. And keep asking questions.


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## TheClockworkDodo (Feb 20, 2016)

I think the one time I forgot to de-fridge my Lantus, I just held it in my hand for about half an hour before injecting and it was fine.

As far as summer is concerned, Lantus is supposed to be OK up to 25 degrees and Novorapid up to 30.  Our house gets over that in the summer so I use a Frio wallet:  http://friouk.com/1119
The only time I've been dubious about overheated insulin was when I had some in the boot of a hot car all day (didn't expect it to be hot so wasn't in wallet).


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## trophywench (Feb 20, 2016)

What everyone else said - it tends to hurt but it won't harm you and works fine when it's cold.

However when you fill a pump reservoir it needs about 20 mins at room temp - otherwise you seem to get more 'champagne' bubbles.


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## SB2015 (Feb 20, 2016)

Hi Emmy, as you have recently started with insulin you might be on quite low doses.  I found that the insulin in my pens lasted more than the 28 days.  I kept it out of the fridge once in use with no problems, and I just put a sticky label on the cartridge when I put it in my pen with the discard date on it, and then changed the cartridge when I got to that date. I wasted a bit each time, but that was fine.

Keep asking


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## TheClockworkDodo (Feb 20, 2016)

Sticky label on pen is a brilliant idea, SB2015 - think I will adopt that too.  I normally keep a record of discard date in the back of my diary but I sometimes forget to write it down and have to guess.  I'm on a tiny amount of Lantus.


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## AlisonM (Feb 20, 2016)

I make a note on my moby which is always with me and change pens when the reminder goes off.


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## EmmyBuzz (Feb 20, 2016)

Thanks everyone for the input - I feel less worried that its just a comfort thing! Its also good to know insulin is more resistant to high temperatures than I expected! I may look into the wallets in the summer time for days out - if we ever get any actual warm weather!



SB2015 said:


> Hi Emmy, as you have recently started with insulin you might be on quite low doses.  I found that the insulin in my pens lasted more than the 28 days.  I kept it out of the fridge once in use with no problems, and I just put a sticky label on the cartridge when I put it in my pen with the discard date on it, and then changed the cartridge when I got to that date. I wasted a bit each time, but that was fine.
> 
> Keep asking





AlisonM said:


> I make a note on my moby which is always with me and change pens when the reminder goes off.



Both of these are really useful ideas! I know my pens from the hospital expire 4 weeks from my discharge date but for future ones I will definitely consider these ideas as I would forget my head if it wasn't attached sometimes! Might try what I do with things I open in my fridge and write on them with a permanent marker too!


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## Ayesha (Feb 23, 2016)

hey, reading on the above comments ive actually been naughty and left my non used insulin in its box on my dressing table and not put it in the fridge. is this okay? how do you know if insulin has gone "bad"?


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## DeusXM (Feb 23, 2016)

How long have you left it out for? Insulin lasts for at least 28 days at room temp. But you should put it in the fridge straight away. It's not really ok at all to leave unused insulin at ambient temperature because you reduce the lifespan of the insulin. If it's been left out for a week, then when you do eventually use it, you'll have to chuck it if it's not used up within three weeks.

Gone-off insulin may be discoloured or have bits in it. Usually though, the only way you can tell is that it doesn't work as effectively as it should.


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## Ayesha (Feb 23, 2016)

Wooopsie it's for sure been longer than 28days


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## SB2015 (Feb 23, 2016)

Once you have left it out of the fridge, I think even if you put it in now it may be too late.
I think it will be best to talk to your nurse and just tell them what has happened.  
It is a lesson learnt, and someone should have made it clear to you that it needed to be in the fridge.

I am sure that it won't be the first time this has happened


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## Austin Mini (Feb 24, 2016)

Heres what I do when its getting a little low. I do my Lantus injection and before putting it down just turn the dose screw anticlockwiswe and it will stop when it wont turn anymore. Just check thats enough for tomorrow plus a couple of clicks for priming. If not enough take a new Lantis out of the fridge.


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## Amberzak (Feb 24, 2016)

When I was younger I didn't have a fridge (long story short, lived with horrid family who had two flats on the council so I was made to stay in one flat but still regularly called down to the other to clean it and look after them all and such). When my nurse found out I didn't have a fridge, she bought me one because she said it's very important to store my insulin in there (horrid abusive family wouldn't let me store my insulin in their fridge in other flat). 

She is a lovely nurse.


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## Robin (Feb 24, 2016)

Austin Mini said:


> Heres what I do when its getting a little low. I do my Lantus injection and before putting it down just turn the dose screw anticlockwiswe and it will stop when it wont turn anymore. Just check thats enough for tomorrow plus a couple of clicks for priming. If not enough take a new Lantis out of the fridge.


What sort of a pen are you using? You can't turn the dose screw on mine ( Autopen 24) without then injecting the contents, i.e.it won't turn back again until you've pressed the plunger, so your idea wouldn't work for mine.


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## Austin Mini (Feb 24, 2016)

EmmyBuzz is using Lantus which is a disposable pen which can be turned back if you dial too big a dose.


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## Robin (Feb 24, 2016)

Austin Mini said:


> EmmyBuzz is using Lantus which is a disposable pen which can be turned back if you dial too big a dose.


Ah, thank you Austin Mini, I'd missed that. I get my Lantus in cartridges for use in a permanent pen.


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## Austin Mini (Feb 24, 2016)

Oh yes I remember now, I was asked if I wanted disposable pens or cartridges. I chose the disposable pens freeing up a Humapen as a spare.


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## EmmyBuzz (Feb 24, 2016)

The turning thing is a good idea, I have turned it too much and turned it back before and had considered it but I didn't know if it would cause problems (?) I did well predicting when I would need a new novorapid just completely forgot the lantus the night I posted this! I'm working on the whole 'I'd forget my head if it wasn't attached' aspect of my personality!


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## TheClockworkDodo (Feb 24, 2016)

If you have disposable pens it won't cause problems to turn it round and back, don't worry.  If you ever get cartridges to put in a reuseable pen it will cause problems because turning it back expels the insulin (but you can get round that by pulling and holding the pen apart so the plunger doesn't connect with the cartridge and then turning as if you're injecting).  That is, assuming all reuseable pens are the same as mine!


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## Robin (Feb 25, 2016)

TheClockworkDodo said:


> If you have disposable pens it won't cause problems to turn it round and back, don't worry.  If you ever get cartridges to put in a reuseable pen it will cause problems because turning it back expels the insulin (but you can get round that by pulling and holding the pen apart so the plunger doesn't connect with the cartridge and then turning as if you're injecting).  That is, assuming all reuseable pens are the same as mine!


Depends on the make of pen. My NovoPen echo, you can dial up to see, then twist back, like a disposable. My Autopen, which I suspect came out of the  Ark, will happily let you dial up as much insulin as you want, but then when you inject, it gets so far, and if it's empty it grinds to a halt. So it will helpfully tell you it only delivered three of your proposed ten units - just what you wanted to hear! It's not a problem for me, because I take so little Lantus that I always dispose of the cartridge partly used after 28 days.


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## TheClockworkDodo (Feb 25, 2016)

Ah, thanks Robin.  Mine is a Novopen 3 Demi.  You can dial up and turn back, but if you turn back it ejects insulin, and it also does the same thing as your Autopen in terms of dialing up insulin that's not there and just grinding to a halt when it's empty.  So it's doubly annoying!


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## Mini-Vicki (Feb 25, 2016)

I have reusable pens for Humalog and Lantus, and these can be dialled up and back down without any wastage... Not sure what make they are though!


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## Northerner (Feb 26, 2016)

Robin said:


> Depends on the make of pen. My NovoPen echo, you can dial up to see, then twist back, like a disposable. My Autopen, which I suspect came out of the  Ark, will happily let you dial up as much insulin as you want, but then when you inject, it gets so far, and if it's empty it grinds to a halt. So it will helpfully tell you it only delivered three of your proposed ten units - just what you wanted to hear! It's not a problem for me, because I take so little Lantus that I always dispose of the cartridge partly used after 28 days.


Ugh! Get rid of your Autopen and replace it with a 'Juniorstar' from Sanofi - see Mike's blog:

http://www.everydayupsanddowns.co.uk/2014/08/half-unit-lantus-insulin-pen-free-on.html


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## Robin (Feb 26, 2016)

Northerner said:


> Ugh! Get rid of your Autopen and replace it with a 'Juniorstar' from Sanofi - see Mike's blog:
> 
> http://www.everydayupsanddowns.co.uk/2014/08/half-unit-lantus-insulin-pen-free-on.html


I keep meaning to get round to it, but last time I needed a new pen, (when I swapped to  the NovoPen echo) my surgery made such a pigs ear of it, I nearly lost the will to live.


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## Northerner (Feb 26, 2016)

Robin said:


> I keep meaning to get round to it, but last time I needed a new pen, (when I swapped to  the NovoPen echo) my surgery made such a pigs ear of it, I nearly lost the will to live.


I know what you mean - when I needed a single unit lantus pen they got it wrong three times before I got the right one!   Worth doing though, those Autopens are horrid


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