January 7, 2016

How Long Insulin Lasts

If you are using insulin, hopefully you know about how long an insulin vial lasts based on your usage. I know and I have had CDEs tell me otherwise and I have to wonder where they received their information. A vial contains 1,000 units of insulin and one insulin lasts 10.5 days and the other insulin varies from 11 to 13 days depending on the needs and occasionally I can get 14 days.

Again, the newsletter from Diabetes-in-Control has another problem with insulin that does not make sense and in this case, we are not given all the facts and readers should be wondering where the problem lies. If the there was a problem with the amount of insulin used, no mention was made about the A1c or blood glucose levels that should have possibly accompanied the problem of insulin usage.

The patient said he used 50 units of Levemir two times per day and threw out the vial after 30 days with some insulin remaining. Granted the shelf life of Levemir is 42 days once the vial is opened. It is obvious that the insulin is not being used correctly, but as readers, we are not given information to be sure it is dose being used or whether it is half a syringe that is being mistaken for 50 units. Know the latest A1cs could have been useful.

Lessons Learned:
  • Inform patient about how long an insulin vial or pen should last. Inform the patient how long an insulin vial or pen should last once opened. This stresses the importance of proper expiration once opened versus shelf life.
  • Explore with the patient not only what he or she is verbally telling you, but ask how often they use a new vial or pen, and if they have extras at home. If so, how many?
  • Always perform a demonstration and ask for a return demonstration, and make sure the return demonstration is done correctly before discharge.

These are all things that should be done, but seldom are done. Even I was deprived of this, but at the time, I had a neighbor that is a nurse and I did ask several questions of her for several months until I was comfortable with both the amount I was using and that I was injecting in the correct areas.

1 comment:

Ila East said...

I use A Levemire pen. The last two years I have reached the Medicare doighnut hole. A neighbor had this problem for the first time this year. She did some research and discovered that vials were less expensive than pens, as far as what is changed against the allowable. I'm considering changing, and being able to figure out how many units you can get from specific pens and vials would be so helpful.