Does HOT weather screw up Insulin???

[UltiMica06]

OK...I dont understand WHY this is happening..

Ever since its been getting Majorly HOT here in SoCal.

I've had to "increase" my Insulin Units before eating!....Even that doesn't keep my Glucose level under 130 when testing!...WTF!

I have NOT changed the stuff I eat either SAME stuff before it got Hot.

Does anyone know if the Hot Weather messed up my INsulin or something????......Just Frustrated in not being able to maintain a stable level through the day!!!!

[kgm0612]

What insulin are you injecting?

Here's a good read regarding Humalog, but I imagine it would apply to other insulins as well.

Humalog insulin and heat (http://www.diabetesnet.com/diabetes_treatments/insulin_humalog_heat.php)

Karen

[UltiMica06]

Thanks...

I use Novolog Flexpen as the Daily.


Its like ****...I been having to almost double my Insulin it seems like...Sometimes...when I do...I come too low too!!

[genie86333]

Yes, insulin needs to be kept at a reasonable temp.

However, the heat may be affecting *you* as well, so it's not necessarily the insulin that isn't heat-resistant. :)

[kgm0612]

Prior to pumping I also used the Novolog Pens and found, especially in the Summer months, that I could only use it for 14-17 days and not the entire month.

Karen

[Subby]

Hi Ultima...

just to follow up on the idea it might be you not the insulin... I have to increase my basal insulin by up to 30% on hot days, due to insulin resistance in my body. This is consistent and has occurred for me for many years.

Just like stress can affect us and how effective our insulin is, so, it seems, temperature can affect us too. So, just understand that this does happen to other people.

How to tell if it's your insulin or you? I guess, be sure your insulin is relatively fresh and see if it still occurs. By relatively fresh, I mean that it would definitely have to be really really hot (or be left in sunlight) for the insulin to be affected within a few days of being taken out of the fridge.

[UltiMica06]

Thanks Subby....good info!

Never thought about that!...I never leave my Insulin in sunlight or heated areas.....

prob. have the same summer month probs as you!..Guess I need to Increase Insulin Units when its hot....Ugh!!!

Well we shall see....

Hi Ultima...

just to follow up on the idea it might be you not the insulin... I have to increase my basal insulin by up to 30% on hot days, due to insulin resistance in my body. This is consistent and has occurred for me for many years.

Just like stress can affect us and how effective our insulin is, so, it seems, temperature can affect us too. So, just understand that this does happen to other people.

How to tell if it's your insulin or you? I guess, be sure your insulin is relatively fresh and see if it still occurs. By relatively fresh, I mean that it would definitely have to be really really hot (or be left in sunlight) for the insulin to be affected within a few days of being taken out of the fridge.

[Jonathan_R]

I hope hot weather does not affect insulin. The last few days its been 109 to 113. This is quite typical for us ths time of year. When going out, I always keep my insulin between ice packs in the lunch bag to keep the insulin cool. This keeps until the end of the day. So from about 7 or 8 am to about 5 or 6 pm.

[genie86333]

Johnathan, if you're keeping it cool, that's all that matters.

[BUFORDHWY]

Hot weather only effects insulin to the extent it's responsible for bringing the insulin temperature out of the recommended storage range (often called storage conditions). It can be hot out, but if you keep the insulin in a cooler, it should be fine, and not lose its ability to work. However, if you sit it out on the table, and it's 100F outside, and the insulin temp becomes 100F - I'd toss it in the trash! Manufacturers assay/test the insulin under a range of storage conditions to assign a 'shelf-life'. For example, the expiration date on the bottle is based on keeping the insulin at recommended storage conditions (that is, cold). Why does raising the insulin temperature effect its ability to work (also called potency)? Insulin is a peptide linked with disulfide bonds that give it a defined structure. High temps denature that structure (i.e. break it down).

Bottom line - insulin IS NOT stable outside the recommended temp, which is cold.

To verify - grab a fresh bottle from the fridge, and try it.

Best

[Subby]

Hot weather only effects insulin to the extent it's responsible for bringing the insulin temperature out of the recommended storage range (often called storage conditions). It can be hot out, but if you keep the insulin in a cooler, it should be fine, and not lose its ability to work. However, if you sit it out on the table, and it's 100F outside, and the insulin temp becomes 100F - I'd toss it in the trash! Manufacturers assay/test the insulin under a range of storage conditions to assign a 'shelf-life'. For example, the expiration date on the bottle is based on keeping the insulin at recommended storage conditions (that is, cold). Why does raising the insulin temperature effect its ability to work (also called potency)? Insulin is a peptide linked with disulfide bonds that give it a defined structure. High temps denature that structure (i.e. break it down).

Bottom line - insulin IS NOT stable outside the recommended temp, which is cold.
t

This is not correct. The recommended temp for insulin to be at when using it, is room temperature, not "cold". To quote the pharmaceutical notes for my Novorapid:

"The Novorapid that your are using in your insulin delivery system, or that you are carrying as a spare, should not be kept in a refrigerator. You can use it up to 4 weeks below 30c (86f) after taking it out of the refrigerator. Discard Novorapid Penfill after 4 weeks even if there is still some Novorapid left in it."

Of course, when it comes to really hot weather, the parameter of one month before degradation, may well be shortened. At that time, keeping it cooler than ambient temperature might be a good idea. I use a frio, but I also insulate the insulin somewhat to prevent it being "cold", rather just back in a sub 30c, room temperature area.

[owlyn]

This is not correct. The recommended temp for insulin to be at when using it, is room temperature, not "cold". To quote the pharmaceutical notes for my Novorapid:

"The Novorapid that your are using in your insulin delivery system, or that you are carrying as a spare, should not be kept in a refrigerator. You can use it up to 4 weeks below 30c (86f) after taking it out of the refrigerator. Discard Novorapid Penfill after 4 weeks even if there is still some Novorapid left in it."

Of course, when it comes to really hot weather, the parameter of one month before degradation, may well be shortened. At that time, keeping it cooler than ambient temperature might be a good idea. I use a frio, but I also insulate the insulin somewhat to prevent it being "cold", rather just back in a sub 30c, room temperature area.

I did some research into this some time ago, and read a lot of white papers by the pharmas. What is not stated on the inserts is this: Insulin likes stable conditions. It doesn't like frequent temperature changes and it doesn't like to be dropped. These things cause it to degrade more quickly, but not as much as temperatures above 30c/86f. But, the point is, that's why they tell you not to refrigerate it after you start using it. While in theory, keeping it cold would prolong its life, they know that once you use it, they have no idea how long and how often it will be in and out of the fridge, so the best option is to keep it out of the fridge, figuring that this will provide a more stable temperature range. The other part of the 28 day limitation is bacteria growth. It was found by all the manufacturers that after the 28 day after first use point (note that this is not 28 days after coming out of the fridge) the level of bacteria starts to become unacceptable. The 28 day point is not for temperature purposes.

[DannyK]

I keep my Lantus vial in the butter section of the fridge door. I draw and inject 8 units 2x daily (9am & 9 pm). One vial lasts me just over 2 months.

As far as my bolus, I use Humalog and when on the pens, I keep unused in the fridge until the first use, then at room temp. until used up (usually about 1 month).

Here in Tx., it's been unusually hot with not much rain (still humid, in the Houston area) and although I have not changed my basal, I find I need bolus fewer units for meals.

[dbaratta]

[QUOTE=UltiMica06;476549]OK...I dont understand WHY this is happening..

Ever since its been getting Majorly HOT here in SoCal.

I've had to "increase" my Insulin Units before eating!....Even that doesn't keep my Glucose level under 130 when testing!...WTF!

130 is a good reading for me.....why the upset? Diabetes is progressive, could be you are just getting a little worse? Or is your insulin older than 28 days out of the fridge? I still would not fret over that reading, but that is just me.:T

[dbaratta]

OOOOOOOOOHHHHHH that evil pen. Just an experience of mine. That pen jammed on me many times. I contacted the company and everything! It happened so many times I just quit using the pens and went to the vials! What happened was it appeared as if I was getting a dose and I was not, how did I find out? I clicked it up to ten, then hit the trigger in the garbage can and nothing came out!!! I had 5 pens out of 4 scripts mess up on me, that was it. I was not going to work so hard on my disease to have the pen mess me up.

That is just my experience........I hate the pens.

[dbaratta]

[QUOTE=DannyK;478404]I keep my Lantus vial in the butter section of the fridge door. I draw and inject 8 units 2x daily (9am & 9 pm). One vial lasts me just over 2 months.

I do the same thing with my lantus. So I need to know more about this 2-time daily with the lantus. I take it once a day and it works okay, not great, do you guys think 2-times a day (asking doc first of course) would work better?

[owlyn]

OOOOOOOOOHHHHHH that evil pen. Just an experience of mine. That pen jammed on me many times. I contacted the company and everything! It happened so many times I just quit using the pens and went to the vials! What happened was it appeared as if I was getting a dose and I was not, how did I find out? I clicked it up to ten, then hit the trigger in the garbage can and nothing came out!!! I had 5 pens out of 4 scripts mess up on me, that was it. I was not going to work so hard on my disease to have the pen mess me up.

That is just my experience........I hate the pens.

I've been using disposable pens since they came out. Never had a problem.

[Subby]

I did some research into this some time ago, and read a lot of white papers by the pharmas. What is not stated on the inserts is this: Insulin likes stable conditions. It doesn't like frequent temperature changes and it doesn't like to be dropped. These things cause it to degrade more quickly, but not as much as temperatures above 30c/86f. But, the point is, that's why they tell you not to refrigerate it after you start using it. While in theory, keeping it cold would prolong its life, they know that once you use it, they have no idea how long and how often it will be in and out of the fridge, so the best option is to keep it out of the fridge, figuring that this will provide a more stable temperature range. The other part of the 28 day limitation is bacteria growth. It was found by all the manufacturers that after the 28 day after first use point (note that this is not 28 days after coming out of the fridge) the level of bacteria starts to become unacceptable. The 28 day point is not for temperature purposes.

Heat will break down the preservatives. So length of time spent in extreme temperatures is very topical. I'd be interested in the source for your final conclusion.

[UltiMica06]

MAN.... F my L.

I dont understand why my Body is NOT reacting to my Insulin now.

I've had to Double my Dose of Units of Insulin something that isn't even Enough and my Levels are HIGH!!!!....I dont get it.

Even my Levemair shot at Night Time is being screwed up now!...Waking up w/ a Higher than normal reading now...Ugh!!!

I dont understand WHY all of a sudden this happened now.

Maybe it is the Temperture???.....

[misha09]

I thought I was crazy but I had the same thing happen to me with my Novolog pens. A month of having horrible highs and not knowing why, thinking the pen was left out too long until one day I tried injecting into the air and sure enough nothing came out. I now have to shoot into the air every time I use them. Sometimes something comes out, sometimes it takes three or more tries. THEY SUCK!!!! I hate those things, never had this problem with any other pen.

[owlyn]

I thought I was crazy but I had the same thing happen to me with my Novolog pens. A month of having horrible highs and not knowing why, thinking the pen was left out too long until one day I tried injecting into the air and sure enough nothing came out. I now have to shoot into the air every time I use them. Sometimes something comes out, sometimes it takes three or more tries. THEY SUCK!!!! I hate those things, never had this problem with any other pen.

Read the manual. They do not suck They are working properly. You are not following the directions. You are supposed to shoot 2 units at a time into the air until insulin flows out. It's called an air shot.

[owlyn]

Heat will break down the preservatives. So length of time spent in extreme temperatures is very topical. I'd be interested in the source for your final conclusion.

Even if kept at the proper temperature, you should dispose them after 28 days because of bacteria growth. They don't break down due to not being refrigerated for 28 days if kept at a reasonable (e.g., room) temperature. Others here will testify that they have used their insulin long after the 28 days with no insulin potency problem. If you let them get too hot (or too cold), or have the temperature fluctuate greatly too frequently, you will have problems.

[desertwindsaz]

I hope hot weather does not affect insulin. The last few days its been 109 to 113. This is quite typical for us ths time of year. When going out, I always keep my insulin between ice packs in the lunch bag to keep the insulin cool. This keeps until the end of the day. So from about 7 or 8 am to about 5 or 6 pm.
Jonathan Hi just joined this web site today and you are my first contact. I am a Type 1 diabetic myself. However, I'm old enough to be you grandfather. I live in Mesquite, Nevada on the border with Arizona. I live with my my wife with my son and his wife and my grandson. I am a retired fireman and got my diabetis from chemical exposure (Agent Orange in Vietnam. And unfortunately the heat will cause problems and not just from Insulin but also all your other body systems. On real hot days I really get tired and run down. This week has been rough the air conditioner broke down aand it took some time to get it fixed.

[BUFORDHWY]

[QUOTE=Subby;478346]This is not correct. The recommended temp for insulin to be at when using it, is room temperature, not "cold". To quote the pharmaceutical notes for my Novorapid:



I said storage conditions - please reread your package insert, what are the recommended storage conditions for the insulin. Thanks.

[BUFORDHWY]

[QUOTE=Subby;478346]This is not correct. The recommended temp for insulin to be at when using it, is room temperature, not "cold". To quote the pharmaceutical notes for my Novorapid:

Where the heck are you getting your info - just do a basic google search insulin name storage conditions. Do you store all your insulin that way - don't post across the board generalizations. My gosh, what's up with your post?


Humalog in a vial may be diluted with STERILE DILUENT for Humalog®, Humulin® N, Humulin® 50/50, Humulin® 70/30, and NPH Iletin® to a concentration of 1:10 (equivalent to U-10) or 1:2 (equivalent to U-50). Diluted Humalog may remain in patient use for 28 days when stored at 5°C (41°F) and for 14 days when stored at 30°C (86°F). Do not dilute Humalog contained in a cartridge or Humalog used in an external insulin pump.

NovoRapid should be stored between 2°C and 8°C. Do not freeze. Cartridges in use or carried as a spare should be kept at ambient temperature (below 30°C) for up to 4 weeks but should not be exposed to excessive heat or sunlight. 10 ml vials may be kept at room temperature (below 30°C) for up to 6 weeks.

Unused LEVEMIR should be stored between 2°and 8°C (36°to 46°F). Do not freeze. Do not use LEVEMIR if it has been frozen.

[owlyn]

[QUOTE=Subby;478346]This is not correct. The recommended temp for insulin to be at when using it, is room temperature, not "cold". To quote the pharmaceutical notes for my Novorapid:

Where the heck are you getting your info - just do a basic google search insulin name storage conditions. Do you store all your insulin that way - don't post across the board generalizations. My gosh, what's up with your post?


Humalog in a vial may be diluted with STERILE DILUENT for Humalog®, Humulin® N, Humulin® 50/50, Humulin® 70/30, and NPH Iletin® to a concentration of 1:10 (equivalent to U-10) or 1:2 (equivalent to U-50). Diluted Humalog may remain in patient use for 28 days when stored at 5°C (41°F) and for 14 days when stored at 30°C (86°F). Do not dilute Humalog contained in a cartridge or Humalog used in an external insulin pump.

NovoRapid should be stored between 2°C and 8°C. Do not freeze. Cartridges in use or carried as a spare should be kept at ambient temperature (below 30°C) for up to 4 weeks but should not be exposed to excessive heat or sunlight. 10 ml vials may be kept at room temperature (below 30°C) for up to 6 weeks.

Unused LEVEMIR should be stored between 2°and 8°C (36°to 46°F). Do not freeze. Do not use LEVEMIR if it has been frozen.

I'm not sure if you are confused about this or not, but just for clarity, it works like this: Unopened insulin should be stored in the refrigerator. Once it is opened, you should keep it at less than 86f but above freezing (usually winds up being around room temperature). It does not have to be stored in the fridge. It should be disposed 28 days after opening.

[Subby]

]This is not correct. The recommended temp for insulin to be at when using it, is room temperature, not "cold". To quote the pharmaceutical notes for my Novorapid:

Where the heck are you getting your info - just do a basic google search insulin name storage conditions. Do you store all your insulin that way - don't post across the board generalizations. My gosh, what's up with your post?


Humalog in a vial may be diluted with STERILE DILUENT for Humalog®, Humulin® N, Humulin® 50/50, Humulin® 70/30, and NPH Iletin® to a concentration of 1:10 (equivalent to U-10) or 1:2 (equivalent to U-50). Diluted Humalog may remain in patient use for 28 days when stored at 5°C (41°F) and for 14 days when stored at 30°C (86°F). Do not dilute Humalog contained in a cartridge or Humalog used in an external insulin pump.

NovoRapid should be stored between 2°C and 8°C. Do not freeze. Cartridges in use or carried as a spare should be kept at ambient temperature (below 30°C) for up to 4 weeks but should not be exposed to excessive heat or sunlight. 10 ml vials may be kept at room temperature (below 30°C) for up to 6 weeks.

Unused LEVEMIR should be stored between 2°and 8°C (36°to 46°F). Do not freeze. Do not use LEVEMIR if it has been frozen.

You've got some weird bee in your bonnet. The topic is "does hot weather affect insulin". IE, when opening and carrying it around, using it. Not, how do we STORE our insulin. There was no question or change of advice of STORING unused insulin in the fridge.

I don't know why you're so aggressive and offended here, you certainly don't have a reason to be so. I'll leave that circus trick to you. It sure diesn't help win arguments, if that's the way you see it.

[retired60]

Hi Ultima...

just to follow up on the idea it might be you not the insulin... I have to increase my basal insulin by up to 30% on hot days, due to insulin resistance in my body. This is consistent and has occurred for me for many years.

Just like stress can affect us and how effective our insulin is, so, it seems, temperature can affect us too. So, just understand that this does happen to other people.

How to tell if it's your insulin or you? I guess, be sure your insulin is relatively fresh and see if it still occurs. By relatively fresh, I mean that it would definitely have to be really really hot (or be left in sunlight) for the insulin to be affected within a few days of being taken out of the fridge. My bs almost always elevates when it gets hot and it does get hot here in Ole Miss. I didn't increase the insulin tho I just reduced the carbs some....... it will get back to normal when it cools off. I don't know what hot weather has to do with it but it has an effect on me.

[Subby]

My bs almost always elevates when it gets hot and it does get hot here in Ole Miss. I didn't increase the insulin tho I just reduced the carbs some....... it will get back to normal when it cools off. I don't know what hot weather has to do with it but it has an effect on me.

It can be frustrating, can't it?

It would make sense that a type 2 or someone with some pancreas still contributing, might in be able to reduce carbs for some effect. As I got zero basal insulin provided by my body, it's up to me to change my basal - this is before I even go near food, I could eat nothing all day and still be very high from the strange heat effect, given my normal basal doses.

[sable_032592]

i'm on lantus and humalog and the paper that comes with the insulin in the humalog says it's only good for 2 weeks outside the fridge, while lantus is good for 28 days... so i would think that any fairly rapid insulin must be only good for a few weeks...

but keep in mind that any insulin shouldn't be exposed to high temperatures, so perhaps the insulin you're using isn't as effective anymore, try opening a new one...

[jtausch]

I keep my Lantus vial in the butter section of the fridge door. I draw and inject 8 units 2x daily (9am & 9 pm). One vial lasts me just over 2 months.

As far as my bolus, I use Humalog and when on the pens, I keep unused in the fridge until the first use, then at room temp. until used up (usually about 1 month).

Here in Tx., it's been unusually hot with not much rain (still humid, in the Houston area) and although I have not changed my basal, I find I need bolus fewer units for meals.

Uhm 2 months for you lantus? I read on the web md website about lantus and they say only 28 days after it is used(OPENED) then to throw it away. You might want to read your inserts that come with the lantus and see if that has changed. I use levemir and it has a open shelf life of 42 days after opening, where my novolog has only 28 days. It seems a waste since i throw a allmost full bottle away