This might sound like a stupid question but I'm just curious. I have been told that one cannot use the vial of Lantus after 28 days?

I gather it become inert or something like that?

Why?

The reason I ask is that it would be much easier for me (even though I label the vials and they are in my fridge), well, it would be easier if I could start a new vial on the first of the month. Much easier.

Is there really a reason why I can't do this?

I mean we are talking 31 days or 30 days in a month, so would those two days really have me using an inert product? I find it very hard to believe that if I am taking my 8 units for 28 days and the 29th day comes and BAM, it's not working any more? Hard to believe.

Thanks much if anyone knows the answer or has even done this themselves.

Melody

I believe that the Lantus is delicate in some way.

Using past the 28 days MAY work, and it may not.

Here is a link that illustrates that:
http://care.diabetesjournals.org/content/26/9/2665.full

This may be due to how the Lantus is synthesized. And it may be more prone to bacterial degradation, from repeated needle withdrawals.

Drug companies do extensive testing on products with short expiration dates. So I would think in this case they found that Lantus just does not keep. Some of that is overkill, perhaps, and the only way to know for sure is by checking your blood sugars at the beginning of a new vial, and at the end of a vial to see if they change like that article I found for you.

For a mild diabetic like you are Mel, it may not be as critical as in a brittle diabetic using higher doses. You'll just have to test it out yourself. I see some people online using it up to 45 days with extreme care as to not contaminate the vial.

One thing I would try is keeping the vial in a ziploc in the frig. And even some light blocking type of container. A large amber drug vial may be sufficient.
Or some other container, so airborne food nano particles cannot get to the top of the vial and also protect from light. Bacteria, fungus spores can then settle on the lids of insulin, so keeping the open vial as clean as possible would prolong the shelf life once opened. And notice the light sensitivity! Protect from light. For example, I would not warm up the whole vial prior to injecting. I'd pull up your dose, put the vial back in the frig away from light and let the syringe warm up a bit.

So the bottom line is ???? you may or may not be able to squeeze more days out of your expensive Lantus.

Mrs. D.

Sounds like a plan to me. My usual routine before I take a shot it, open fridge, open the little compartment (where I keep all the vials), take out the box (all my vials are in their boxes, even when I am using the vial. I just mark the with the date I started.

So the new one, I marked November 4th. That's the one I take out before I go to bed. I take it out, I put the Lantus in the syringe, I immediately put the vial back in box and place in little compartment in fridge, then close fridge. No light gets through at all.

I then inject myself, and dispose of syringe.

What I will do however is wipe the top of the lid with an alcohol prep before I use it and after I use it. That might keep it from getting anything.

Nothing to get because the vial is always inside the box and the box is always in the little compartment, but I want to make sure.

Because I keep a log, at the end of the month, I will go November 30 (two days past the expected expiration date). I will then compare the dates and see if at the end of the month my sugar is the same in the morning when I get up. Hey, I'm doing another experiment, aren't I??? lol

So I started the 8 units of Lantus on November 4th before I went to bed.

The 7 and a half weeks on NO Lantus yielded me a morning reading of 187 to 200 and afternoon of 170 and sometimes higher.

This morning it was 135.

Big difference. Baby steps.!!!

I would never have thought that this small amount of Lantus would make a difference. My friend is a diabetic (as a matter of fact, many of my friends are type 2s).

She is morbidly obese and is 67. She was diagnosed 10 years ago.

She was on Lantus 80 units, and all sorts of pills but nothing worked.

They put her on Lantus, a shot of novalog before each meal, then Glyburide and something else at night.

Then they switched her to Levamir. Lots of that too!!

Didn't change. She gets up sometimes and it's 200.

Sometimes it's low and she gets the shakes and has to run to drink soda.

She can't drink it fast enough the hypo thing she gets is so dramatic.

She could have accompanied me to the Accord program, we could have done it together and she just might have gotten a handle on her diabetes but she said "No, I can't eat like you do, it's too hard".

Of course I don't say anything because it's her body and her business.

But when I hear that she is on 80 units of basal insulin, 3 shots a day of short acting insuling, various oral meds and sometimes she gets up and it's 200 and she will say "well, I had some crackers before going to bed", well, I say TO MYSELF "crackers will give you a 200 reading in the morning when you take all of that medicine???"

I'm STILL trying to understand how diabetes works in the body.

I know people who are type 1, take 4 shots a day, go to Dukin Donuts and drink something called a Coolata (and this person had a mom who died at 53 of undisclosed diabetes), so when this person told me "I just had a Coolata and I said "but you're a type 1, you take 4 shots a day, why did you drink a Coolata?" She laughed and said "Cause it's fun"

IT'S FUN??????

Please explain this to me. This person's father is type 1, has had 4 eye operations and takes 4 shots a day

AND THEY BOTH RARELY TEST THEIR SUGAR.

I was talking with the father one day and said "You don't test your blood sugar every day??" He said "nah, I like to eat and I like my cannolis (Italian pastry), and I know how I feel and how much insulin to give myself before I eat and I'm not giving up my pastries". He's skinny as a rail.

Honestly, I really thought EVERY diabetic tests themselves like 3 times a day and they never eat any sugar.

Boy was I wrong.

I don't understand how a person who lost their mother at the age of 53 can then go into a Dunkin Donuts and drink a Coolata and not test their sugar.

Each to his own I guess.

Melody
P.S. Thanks for explaining the Lantus to me, I'll let you know what happens when I get to November 30th.

You'll notice from that link... that doctors and even pharmacists are not really informed well about stability issues! I find that appalling.

Even with all that detail, you'll notice "real answers" are not really explicit on that link from the companies.

Here is a little trivia factoid:

When Humulin came out... remember that? There was much hoohaa about it being stable at room temp!
Well some reps from Lilly were telling pharmacies they didn't have to refrigerate it anymore. One major hospital I used to temp at kept it on the shelf... and I was horrified!
I even mentioned it to them.

Eventually they started putting it in the frig...but for all those months it wasn't stored in the frig at all.

Now at the nursing home place, they only refrigerated in "transit" (which takes up to one 24 hr day), HumaLOG and Lantus and Levemir etc. All the other insulins went without a cooler. Some transit time is allowed for the regular ones.

But on that link I gave you I was shocked to see the comment that NPH had only a 7 day active rate. I have NEVER seen that anywhere before! True few people use the NPH anymore, but STILL 7 days! I wonder if that is "new" or a misprint?

Want to hear something really scary?

When I was in the Accord program, every time I went in for my new supply of Lantus, the person getting me the Lantus would leave the room, come back and hand me some boxes containing the vials and THEY WERE NEVER COLD. They were all room temperature. I then was told "You only have to refrigerate Lantus after you open it". So what did I know?

When the Accord program was over, and I began to get it from my insurance company's mail order pharmacy, the first time I received it, the doorbell rang, the UPS, or Fed Ex (can't remember which), handed me a big box. I said "what on earth is this?

I opened it and inside was a refrigerated cold pack with Lantus. Overnight Delivery by the way.

I then phoned them because I had never gotten my Lantus that way before and said "you deliver this in a refrigerated box?" and the person said "oh yes, that is how insulin is supposed to be delivered, now you put it in the fridge".

Holy Cow!!!

Mel

Well, I wonder how accurate that Accord program's data is now?

This quote is from the link above in this thread!

Well, I just might ask them when I go into the Accordian part of the Accord trial. It's schedule to start sometime in 2011.

I didn't have a problem. I was lucky. When I first started the Accord program, I was on 2000 metformin, was still obese and actually went into it because the meds were free and I would get ekgs, exams, etc. So to me, it was a no brainer.

I really didn't change my eating habits way back then. Not that I ate everything in front of me, but I didn't eat the way I do now.

They kept me on the 2000 metformin, but gave me Lantus. I started at 10 (which I gather they start everyone at), and every time I went (once a month), they would increase the Lantus. I actually got up to 47 of the Lantus and I was still on the 2000 of the Metformin.

But the Metformin was killing my stomach so I went off of that. And then I went to a nutritionist with Alan, learned how to eat correctly and began to lose weight. Not a lot because I had no metabolism to speak of. That's when I asked the doctors "I eat like a champ, how come I don't lose weight"?

And THAT's when I learned that people on insulin have a much tougher time losing weight than people NOT ON INSULIN. I asked why and I was told "Because it's a hormone and it stores in the fat cells"

I then said: 'Now why didn't anyone tell me this earlier" and the answer I got was

"If we told all women that there is a chance they might gain weight or not lose weight they would NEVER take their insulin"

And they were right, because women are vain creatures.

Why I was able to lose weight, well I have no idea, but little by little and we are talking 5 years of eating well and two years of eating WELL!!! Well, I managed to get down to the small amount of Lantus.

I really believe that the reason I was able to lose more weight towards the end is that I was only on a small amount of Lantus. For the past year I was on 20, then 15, then 10, then 8 , then one day at 5.


Not like being on 47. But I do remember YEARS ago, when they gave me Metformin, I couldn't lose anything. But now that I think back, I really didn't give myself the opportunity of good eating.

Big difference now. Really big difference.

I probably eat the Mediterranean diet (olive oil, no dairy, etc.) haven't eaten any red meat for years, but I now eat Buffalo maybe once a week.

So in my case all this paid off. I have many friends who would NEVER eat like I do. They say I eat like a rabbit with all my sprouts and fish, and such.

I mean we laugh about it. I say "Oh yeah, well, I'm doing this to save my life".

Hey, we have to try!!!!

lol