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Medical Forum / Diseases and Disorders / Diabetes / August 2008

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Insulin shelf life

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Fastmoggy - 22 Jul 2008 21:05 GMT
HI all
Bit worried about my mother in law who's on insulin.
Just heard that her 'carer' who is being paid to look after her has bogged
of on holiday for 2 weeks.

Now my mother n law needs 2 jabs a day so she 'prepared' all 30 shots before
she left.

What i want to know is...is this a safe thing to do?
Also will insulin be ok left in the syringe for that long if left in fridge?

My wife and i are a bit worried as this person who is paid the full carers
allowance has just bogged off without telling anyone else!
It's complicated !
Cheers
Chris+1
Fastmoggy - 23 Jul 2008 21:08 GMT
Hi anyone...
if anyone read the mail then i/we do need to know your thoughts/answer!
As we live over 40 miles away it makes things difficult so just want to know
if what i mentioned is ok? would make my wife a bit happier.
Im still D+E plus tabs so i don't know much about the jabbing thing...yet!
Thanks in advance for any replies on this as we are 'concerned  but an hour
away!
Chris+1
John Williamson - 23 Jul 2008 21:53 GMT
> Hi anyone...
> if anyone read the mail then i/we do need to know your thoughts/answer!
[quoted text clipped - 4 lines]
> away!
> Chris+1

I'm also on oral meds, and not on insulin, so I would suggest you check
with the insulin makers.

Apart from anything else, though, I would be concerned about a damage or
contamination risk from leaving loaded syringes lying round loose,
especially if the replacement carer is not trained to prepare the dose,
which would make me wonder if they've been trained to handle stuff in a
sterile & safe manner.

On a side note, would it be possible for her to go onto preloaded
injector pens? Just dial up the dose, change the needle & inject. I know
they last quite a while in the fridge, are easy to use, & are quite
resistant to contamination.

Sorry not to be more positive.

Signature

Tciao for Now!

John.

Fastmoggy - 23 Jul 2008 22:19 GMT
>> Hi anyone...
>> if anyone read the mail then i/we do need to know your thoughts/answer!
[quoted text clipped - 21 lines]
>
> Sorry not to be more positive.

Hi john,

Just to add
Mother in law 73 and not the best when it comes to diabetic care!
I did search around the insulin makers sites and it looks like a grey area?
All the shots are pre set so margin for error and i suspect the call to
Tunisia might be a little stressful at 11pm!
Your mail did say...>>especially if the replacement carer is not trained to
prepare the dose,
No replacement carer just a box full of needles in fridge!
Bearing in mind this person is being paid by the government via the benefit
system to look after her has suddenly jetted off to sunny climes and is
still being paid is a farce!
As i said in original mail..it's complicated (families) but we just want to
know she will be ok?? otherwise it's a 80 miles a day journey after i finish
a 12 hour shift to make sure all is well and things are as they should be
whilst the person who is claiming all the benefits of 'carer' is lying on a
beach £134 better off!
Sorry for going on but we just need to know if what's been done is a safe
thing to do.
Thanks
Chris in a Muggy 26.9*c Nottingham
Andy Hall - 23 Jul 2008 22:58 GMT
> Just to add
> Mother in law 73 and not the best when it comes to diabetic care!
[quoted text clipped - 16 lines]
> Thanks
> Chris in a Muggy 26.9*c Nottingham

Starting point is to find out exactly which insulin product it is and
look up the manufacturer's literature on it.

That will tell you what the story is for keeping the stuff.
Fastmoggy - 23 Jul 2008 23:10 GMT
>> Just to add
>> Mother in law 73 and not the best when it comes to diabetic care!
[quoted text clipped - 27 lines]
>
> That will tell you what the story is for keeping the stuff.

Just looked at her prescription
The 'stuff' is kept at her daughters so never seen it!
Only 5 days to go before she returns and M i Law still kicking! but with a
couple of 'diabetic' problems in last 10 days!
Basically all we would like to know is, is the insulin still effective after
say 7 days after it has been loaded into a needle? And would anyone here do
such a thing?
It's something and possibly nothing but my wife worries anyway!
John Williamson - 23 Jul 2008 23:55 GMT
>> Starting point is to find out exactly which insulin product it is and look
>> up the manufacturer's literature on it.
[quoted text clipped - 9 lines]
> such a thing?
> It's something and possibly nothing but my wife worries anyway!

As Andy said, find out what she's using (It'll be on the prescription)&
call the maufacturer's helpline number on the packaging. If anyone
knows, they will. It's possible, if you know the name of the insulin
being used, that your local pharmacist will either know the answer or be
able to tell you who to speak to at the manufacturers. I know mine's
pretty knowledgeable & helpful.

The internet's useful, but there's often no replacement for a good old
fashioned discreet phone call or face to face chat.

If all else fails, try calling the DSN or her doctor at the surgery &
explain, they may help or they may quote patient confidentiality at you,
it depends on what the care arrangements are & how the relationships
with the surgery are going.

Finally - A "couple of problems" isn't *necessarily* major. As long as
your M-i-L is hypo aware, then she can take the appropriate actions.
Going hyper won't cause immediate problems unless it's pretty bad.

Signature

Tciao for Now!

John.

DaveT - 24 Jul 2008 15:43 GMT
>>> Just to add
>>> Mother in law 73 and not the best when it comes to diabetic care! I
[quoted text clipped - 33 lines]
> loaded into a needle? And would anyone here do such a thing?
> It's something and possibly nothing but my wife worries anyway!

Sorry I am Late but-
As the others are saying you need to know what insulin she is on for an
accurate answer. Most synthetic insulin's have a 28day run but when
refrigerated last longer. Animal insulin's last a lot longer (years? when
in the fridge).
Pre-filling syringes and storing them in a fridge is a sensible move and
safe as long as the fridge stays above freezing (all insulin comes to
grief if frozen so the temperature needs to be watched in winter time.)
as it is summer? stop worrying all should be ok.

Signature

DaveT

Fastmoggy - 24 Jul 2008 21:26 GMT
> Sorry I am Late but-
> As the others are saying you need to know what insulin she is on for an
[quoted text clipped - 5 lines]
> grief if frozen so the temperature needs to be watched in winter time.)
> as it is summer? stop worrying all should be ok.

Thanks Dave,

Put my wife's mind at rest at least. Not being in the 'Stuff myself yet im
not sure who it keeps!

Oh well as long as she safe then i need not worry too much!!!!!!!!!!!!!
Nuff said!
Cheers
Chris in a Very warm Nottingham 26.6C here or 22.3 outside...
Tiger_Lily - 26 Jul 2008 00:04 GMT
>>> Just to add
>>> Mother in law 73 and not the best when it comes to diabetic care!
[quoted text clipped - 35 lines]
> such a thing?
> It's something and possibly nothing but my wife worries anyway!

when you draw up 2 different types of insulin into 1 syringe, as time
goes on the activity profile of the insulin changes......... the rapid
acting insulin binds to the insultard (i'm assuming she's using this),
causing 2 things....... the rapid insulin is no longer rapid, and the
duration of the longer acting insulin is decreased by the
'contamination' of the rapid insulin

this isn't a problem when you draw up the insulin and use it right away

i'm trying to find something about insulin breaking down the plastic
barrel of the syringe as well, as i recall something in the dark
recesses of my memory :)

i would be VERY upset about what this 'carer' has done..........
alternate arrangements should have been made for someone to come in and
draw up her insulin every day !

Signature

kate
type 1 since 1987
www.diabetic-chat.org
www.diabetic-talk.org
http://www.diabetes-support.org.uk/newly%20diagnosed.html

John Williamson - 23 Jul 2008 23:27 GMT
> Hi john,
>
> Just to add
> Mother in law 73 and not the best when it comes to diabetic care!
> I did search around the insulin makers sites and it looks like a grey area?

Probably not something they test for product licencing. A few days
should be OK, but I'd not like to offer any sort of guarantee.

> All the shots are pre set so margin for error and i suspect the call to
> Tunisia might be a little stressful at 11pm!
> Your mail did say...>>especially if the replacement carer is not trained to
> prepare the dose,
> No replacement carer just a box full of needles in fridge!

Not good. Contacting the local office could unfortunately be a problem
if it's a family member claiming the carer's allowance. Maybe a word
with her doctor's surgery about getting a health visitor to drop in as
an emergency thing? This will probably need to come from your Mother in
Law, though.

Depending on her eyesight, can she reliably distinguish between a loaded
& empty syringe?

> Bearing in mind this person is being paid by the government via the benefit
> system to look after her has suddenly jetted off to sunny climes and is
> still being paid is a farce!

Can you urgently get in touch with the local benefits office & politely
but firmly explain the problem? They may be able to arrange temporary
emergency cover without causing a crisis.

> As i said in original mail..it's complicated (families) but we just want to
> know she will be ok?? otherwise it's a 80 miles a day journey after i finish
[quoted text clipped - 3 lines]
> Sorry for going on but we just need to know if what's been done is a safe
> thing to do.

Possibly, but it's hardly best practice. Ideally, doses should be
checked against existing BG level & expected food consumption, &
adjusted accordingly, as discussed here on a number of occasions.

On the positive side, as long as she doesn't go too far out of control,
it shouldn't cause any long term harm if it's only for a week or two.
Maybe you could nip over as soon as practicable & discuss what she's
eating & check the dose. Then tell her to call you if there's a problem.
Can she do & would she be willing to tell you the results of a fasting
test & a post prandial test each day? Aim for a slightly higher reading
than normally desirable to avoid hypos, but not so high that she risks
ketosis.

Maybe someone who injects could please come in on this one?

You could also try misc.health.diabetes

Signature

Tciao for Now!

John.

VivienB - 28 Jul 2008 12:51 GMT
>claiming all the benefits of 'carer' is lying on a
>beach £134 better off!

I don't know how you arrived at that figure, Carers Allowance is only
£50.55 a week. Perhaps you are including something else. A minority of
carers are getting CA - for example, if they get another benefit there
is an 'overlapping rule' that means they get only an 'underlying
eligibility'. Also, you have to be occupied by caring duties a minimum
of 35 hours per week to be eligible. In addition, you are supposed to
inform the DWP if you leave GB - but I am damned if I would (if I
could get away), since CA is so stingy.

The lack of back up to allow carers to take a break is disgraceful,
all over the country. But many elderly people are difficult (read:
impossible) to persuade that they should have an assessment by social
services, or pay for care agency staff to come in to provide support.
The Attendance Allowance or DLA care component that your MiL must be
receiving for the CA to apply, is intended to be used for this sort of
purpose. Believe me, if you have not been a carer for any length of
time, you cannot begin to understand the desperate need for a break
from time to time.

Of course, none of this applies, if you meant a paid PA and not a
carer.

Regards, VivienB

Caring for disabled elderly father, on 30u Insulatard and
2x2 80mg Gliclazide per day (plus other medication)
Please respond to group; mail to newsgroups address is deleted.
Fastmoggy - 28 Jul 2008 22:21 GMT
>>claiming all the benefits of 'carer' is lying on a
>>beach £134 better off!
[quoted text clipped - 26 lines]
> 2x2 80mg Gliclazide per day (plus other medication)
> Please respond to group; mail to newsgroups address is deleted.

Hi Vivien,
Try this link,
http://www.direct.gov.uk/en/DisabledPeople/FinancialSupport/AttendanceAllowance/
DG_10012425


I think that the 'higher payment' is for 'other' disabilities apart from
being diabetic. Also the £134 is for 2 weeks or £67 a week.

Oh and the 'benefit can be paid into any account!

I fear a sudden rush to the DWP tomorrow! LOL

>>>>>Believe me, if you have not been a carer for any length of
time, you cannot begin to understand the desperate need for a break
from time to time.>>>

This i agree with and we go every Sunday on my day off  so not much chance
of a nice weekend away..(Not sour grapes!) We only found out not long ago
that this 'carer' only visits a couple of days aweek for around 30 minutes.
Other times we were told she spent the day at the carers house looking after
her daughter whilst she went out with friends! SO the DWP seem to be paying
her to get her mother to babysit! ( yes we are angry!)
She also seems to do little if any 'care duties', my wife seems to spend
allot of time cleaning up the flat when we are there.
As for a break..that's fine if cover is sorted and the fact that her carer
goes on 4 'major' holidays abroad a year plus others in uk in-between.

Ok hope that answers your query on CA payment.

We were just so infuriated when we got the phone call from my wife's mother
who was in a panic with a badly infected foot which the chiropodist had cut
whilst trimming her  toes too close and was rushed to hospital It was only
then we knew where her 'carer' had gone to!
End of day she was ok but this shouldn't have happened.

Thanks for answering the thread

Cheers
Chris+1 !!
In a hot hot hot hot hot muggy Nottingham Temp in house 27*c  pheww
Peter C - 02 Aug 2008 00:10 GMT
> Regards, VivienB
>
> Caring for disabled elderly father, on 30u Insulatard and
> 2x2 80mg Gliclazide per day (plus other medication)
> Please respond to group; mail to newsgroups address is deleted.

Hi there VB,
who is on insulatard and gliclazide ?
You or your dad?
That's a quite baffling combination - once a T2 starts on insulin
there is little point taking a sulfylonurea although metformin is
deemed to be advisable for T2s ion insulin.
VivienB - 07 Aug 2008 17:02 GMT
>> Regards, VivienB
>>
[quoted text clipped - 8 lines]
>there is little point taking a sulfylonurea although metformin is
>deemed to be advisable for T2s ion insulin.

My father. There is no way Dad could take anything which could cause
digestive disturbances - he gets enough of that sort of problem
without!

Regards, VivienB

Caring for disabled elderly father, on 30u Insulatard and
2x2 80mg Gliclazide per day (plus other medication)
Please respond to group; mail to newsgroups address is deleted.
 
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