Problems with fridge...need advice on Lantus storage ASAP

[Becky & Morlei]

I need everyone's advice on this...
Last night we got home from the Hunger Games midnight showing around 2:45am, I opened the fridge and was like why doesn't it seem cold? I look at the thermometer and it's reading 46 F...wth???? We've been having some issues with the fridge, it's a little older but our landlord kept it in good condition. It has ranged from 38-42, but mostely staying at 40. I figured maybe it was just fluctuating, turned it down a tad and went to bed. This morning it was still 46 F. I'm going to have to throw out the meat, cheese, and eggs but I'm more concerned about my Lantus because we're only on the first pen...we still have four unused ones in there. I put the insulin box in a plastic bag and set it on top of a tupperware container filled with ice with a dishcloth inbetween. The thermometer placed right on the dishcloth is now reading 38 F. Is that sharp of a degree change (from 46-38 in about an hour) bad for the insulin? Is my insulin still ok to use? I know the range is 36-46 F but it's been at the top of that range since last night. I'm almost having a panic attack over this because Morlei has been having flat yellows so I wouldn't be able to tell if the insulin is bad from her numbers. Please help!!

 

[arozeboom]

Re: Problems with fridge...need advice on Lantus storage ASA

Based on this I think you should be ok but let the experts chime in!

PROPER HANDLING OF LANTUS and LEVEMIR

Lantus and Levemir should be inspected visually prior to administration and should be used only if it appears clear and colorless.

Never shake or roll your vial, cartridge, or pen.

In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
Be careful your refrigerator is not so cold that the insulin freezes. Do NOT use Lantus or Levemir if it has been frozen.

Never reuse syringes. You'll run the risk of contaminating the whole vial/cartridge/pen.

Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.

If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon (this is probably what makes "floaties", it forms a white precipitate). Better to waste a drop than ruin whole vial, cartridge, or pen.

Pre-filling Syringes with Lantus (see page 3) is NOT recommended.

Lantus and Levemir should not be diluted or mixed with any other insulins or liquids.

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

The first thing I did was come on here to re-read the sticky so I hope it's ok...I've got the landlord coming over around 4 and he's going to look at the coils, he said he would buy a new fridge if necessary. I'm just worried that the insulin may become compromised sitting right at 46 F. If the unopened ones are exposed to a temp higher than 46 F when do I need to discard them? A few minutes, a few hours?

 

[Sienne and Gabby (GA)]

Re: Problems with fridge...need advice on Lantus storage ASA

As long as the insulin is clear -- no floaties or crystals -- it's likely fine to use. People have left their Lantus sitting out for more than a few minutes and the temp will rise. You may need to be observant to see if the insulin dose develop floaties or if you start getting weird numbers but, overall, I think you'll be fine.

 

[arozeboom]

Re: Problems with fridge...need advice on Lantus storage ASA

Do you have a cooler you could put it in until the fridge situation gets settled? You might not need to have it sitting in the bowl of ice that way.

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

Do you have a cooler you could put it in until the fridge situation gets settled? You might not need to have it sitting in the bowl of ice that way.

I think we have a cooler somewhere in the garage, I'm leaving work either before or at 2 so I'll rush home and look for it. I'll have more room in the fridge since I'll be throwing half of the stuff out so should I just throw some ice in the cooler with the insulin and stick it back in the fridge with a thermometer? Sorry to be so panicky about this but I am OCD about proper temperatures, especially with food and now the insulin. And the fact that we haven't even finished the first pen makes it even worse...all I can think about is shoot, I'm taking two days off for my capstone exam next week so money is going to be tight...I can't afford another box right now.

As long as the insulin is clear -- no floaties or crystals -- it's likely fine to use. People have left their Lantus sitting out for more than a few minutes and the temp will rise. You may need to be observant to see if the insulin dose develop floaties or if you start getting weird numbers but, overall, I think you'll be fine.

I always check the insulin to make sure there isn't any floaties before I draw up a dose but now I will be extra observant. How do the crystals form? Would that be from the insulin getting too cold?

 

[arozeboom]

Re: Problems with fridge...need advice on Lantus storage ASA

Every time Ruby throws a wonky number at me I'm ready to blame it on bad insulin. (even though I didn't start using the vial until February 24th and its hasn't been out of the fridge for more than 10 minutes :roll: )

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

I know! We had a good day on Saturday, Morlei dropped to 177 at +6 and we were like woohoo, it's finally starting to work! Then she goes back to her flat cycles...and the first thing I think about is the fridge temp. But if humans are supposed to leave the pens out once they're in-use and it's good for 28 days or so, then a temp of 46F should be ok. I just started freaking out and the only thing that calmed me down any was getting a post on here so everyone could give their advice.

I saw that you're doing an increase tonight, up to 1u? Good luck! We'll be crossing our fingers/paws! :smile:

 

[arozeboom]

Re: Problems with fridge...need advice on Lantus storage ASA

Morlei is way more consistent than Ruby. She'll have one or two good cycles, then back to the pink.
And yes, we're increasing in about 2 hours! I think I would worry less if the was just more level across the board. These big swings she gets can't feel good.

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

Yeah, I can't imagine her feeling the greatest with those swings, poor thing. But we're getting there! And you're taking such good care of her, her cycles will settle down once you hit the right dose.
I've said it before, when Morlei gets a green I'll be peeing my pants, my post will read PEE ALERT PEE ALERT! Haha! :lol:

 

[Melanie and Smokey]

Re: Problems with fridge...need advice on Lantus storage ASA

My pharmacy left ours laying on the shelf for almost 24 hours from when it was called in to when I picked it up, and handed it to me without batting an eyelash.

It may shorten the life of the vial, but it isn't going to make it instantly bad. Just keep an eye on the vial and numbers in the future for signs that it is pooping out.

 

[arozeboom]

Re: Problems with fridge...need advice on Lantus storage ASA

I'll keep an eye out for that!

I think the longest Ruby has stayed under 300 is about 4 cycles.

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

My pharmacy left ours laying on the shelf for almost 24 hours from when it was called in to when I picked it up, and handed it to me without batting an eyelash.

It may shorten the life of the vial, but it isn't going to make it instantly bad. Just keep an eye on the vial and numbers in the future for signs that it is pooping out.

Oh geez...how hard is it to keep it in the fridge? I decided to fill her insulin at Smith's because they were the cheapest but I was very pleasantly surprised by their service, the pharmacist took it out of the fridge that has a big sign saying "DO NOT UNPLUG OR MOVE - MEDS INSIDE" and very carefully put it in a bag and handed it to me. She then explained all the instructions for humans use but I didn't stop her and just nodded my head because I was happy she took the time to explain how to use it.

So say Morlei is still in flat yellows and I start to see her rise up slowly to high flat yellows or possibly pink and there's no other explanation for it, would I consider the pen pooped out and throw it away?

 

[julie & punkin (ga)]

Re: Problems with fridge...need advice on Lantus storage ASA

glad you've got the pen issue worked out. i think for now, i'd stop worrying about it. whenever you change pens, make sure you note it on the spreadsheet so if there's a question at morlei's numbers, we'd see whatever info about the pen as well.

i did want to ask you, becky, what brand of meter are you using? i looked at Morlei's ss the other day when you posted and mentioned that morlei was up to 3.25u at the time (i think that was the dose.) that is a lot of flat yellow - i had a lot of that when i was using the freestyle lite with punkin and i was curious about your meter.

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

glad you've got the pen issue worked out. i think for now, i'd stop worrying about it. whenever you change pens, make sure you note it on the spreadsheet so if there's a question at morlei's numbers, we'd see whatever info about the pen as well.

i did want to ask you, becky, what brand of meter are you using? i looked at Morlei's ss the other day when you posted and mentioned that morlei was up to 3.25u at the time (i think that was the dose.) that is a lot of flat yellow - i had a lot of that when i was using the freestyle lite with punkin and i was curious about your meter.

We've been using the relion micro since day one, I got the control solution and use it on every new bottle of strips...I have tested myself and my other cats and got normal numbers. I hope our meter isn't bad!

 

[julie & punkin (ga)]

Re: Problems with fridge...need advice on Lantus storage ASA

i'm not saying your meter is bad. i'm saying you got one flat yellow kitter there! just wondering why we're not seeing some lower numbers and more of a curve. i'm glad you're following the protocol guidelines and increasing the dose regularly.

has she had her teeth cleaned?

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

I bought a kitty toothbrush and have been trying to get her used to that...not working so well. But no, I haven't taken her in. I want to but after what happened to that one little kitty that went blind I'm really scared to.

 

[julie & punkin (ga)]

Re: Problems with fridge...need advice on Lantus storage ASA

sienne posted a condo yesterday with a lot of good information on getting a dental. we've seen often that if a cat has gum problems or decay, they are near-impossible to get regulated. punkin had a dental last march and i'm going to set him up to do another one.

things can always happen, but i think if you read the info from sienne's post and find an appropriate dentist/vet, you're doing everything possible to ensure that nothing does happen.

i'll find the post and bump it up for you.

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

sienne posted a condo yesterday with a lot of good information on getting a dental. we've seen often that if a cat has gum problems or decay, they are near-impossible to get regulated. punkin had a dental last march and i'm going to set him up to do another one.

things can always happen, but i think if you read the info from sienne's post and find an appropriate dentist/vet, you're doing everything possible to ensure that nothing does happen.

i'll find the post and bump it up for you.

Ok, I bookmarked it and will talk to my fiance about it, I really think we need to get it done. She has the best teeth out of our four cats, so pretty and straight lol, but obviously that doesn't mean much, like you said she could have gum problems or decay. Maybe we can get her in once we get our tax returns. Thanks Julie!

 

[Noreen&DC&Frisky]

Re: Problems with fridge...need advice on Lantus storage ASA

I just phoned my pharmacist and he said that Lantus can sit out of the fridge at room temperature and it would not hurt it.
It will last for about 30 days at room temperature.
If keeping it refrigerated at all times the cartridge should last 60 days.
He also told me that even if the box is at room temperature for 24 hours and then put back in the fridge it would be fine.
People sometimes pick up their insulin and have to drive a couple of hours before they get home and refrigerate it.
I would just keep an eye on it and also on the numbers.

 

[Ella & Rusty & Stu(GA)]

Re: Problems with fridge...need advice on Lantus storage ASA

Hi Becky and Morlei,
This is the first time I have visited your condo and I just wanted to say "welcome". You might be interested in the Frio wallets for emergency situations. They require only cold water to keep the insulin at safe temperatures. Human diabetics have used them successfully on wilderness treks where refrigeration was non-existent. Here's a link.:
http://coolerconcept.com/

I am aware that these wallets do not keep stored insulin as cold as 36-46 degrees F., but they do keep it at a safe temperature and you don't need any refrigeration, not even to activate the crystals. I have one for emergencies like power outages (which can last for days where I live).

Good luck with getting your landlord to fix your 'frige!

Ella & Rusty

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

I just phoned my pharmacist and he said that Lantus can sit out of the fridge at room temperature and it would not hurt it.
It will last for about 30 days at room temperature.
If keeping it refrigerated at all times the cartridge should last 60 days.
He also told me that even if the box is at room temperature for 24 hours and then put back in the fridge it would be fine.
People sometimes pick up their insulin and have to drive a couple of hours before they get home and refrigerate it.
I would just keep an eye on it and also on the numbers.

Thank you! That makes me feel a lot better.

Hi Becky and Morlei,
This is the first time I have visited your condo and I just wanted to say "welcome". You might be interested in the Frio wallets for emergency situations. They require only cold water to keep the insulin at safe temperatures. Human diabetics have used them successfully on wilderness treks where refrigeration was non-existent. Here's a link.:
http://coolerconcept.com/

I am aware that these wallets do not keep stored insulin as cold as 36-46 degrees F., but they do keep it at a safe temperature and you don't need any refrigeration, not even to activate the crystals. I have one for emergencies like power outages (which can last for days where I live).

Good luck with getting your landlord to fix your 'frige!

Ella & Rusty

I'll look into those, that'd be good to have because we sometimes have rolling blackouts that last a little longer than expected. Our landlord cleaned the coils and said to call him tomorrow if it doesn't cool down and he'll go look at fridges fos us.

 

[Becky & Morlei]

Re: Problems with fridge...need advice on Lantus storage ASA

Fridge is sitting at 44 F, safe for the insulin but still too high for food. Landlord said he'll go to Home Depot today and have them deliver the fridge to the house...hopefully it won't take too long. The insulin is still in the cooler just in case the fridge freaks out again...guess we'll be eating out of the freezer for the next few days because for some reason that part is perfectly fine.

 

[Hillary & Maui (GA)]

Re: Problems with fridge...need advice on Lantus storage ASA

another option until you have a reliable fridge is to ask a neighbor if you can store the insulin their fridge or even the landlord's fridge (if he is on site).

Or can you take it to work and store it there until you have a fridge.