Common Health Issues

Diabetes Inactive Insulin

• By Rich Health Editorial Team
• November 01, 2021

The insulin you buy is a protein that comes as a solution in buffered water. Under normal conditions it can last a month stored at room temperature, and even longer in the refrigerator. Insulin is fairly stable stored this way, but extremes of temperature or excessive agitation can cause the protein to denature or unfold and become inactivated. Often, protein denaturation causes a change in the visible appearance of a protein solution or suspension. 

 

However, different preparation of insulin look a little different to begin with. Some are clear, some are a little cloudy. It is important to know what your particular insulin should look like. If there is a change in the appearance of your insulin preparation, it could mean the insulin is no longer active. Using inactive insulin could cause you to lose control of your blood glucose level and even lead to emergency situations. Any time your blood glucose level rises unexpectedly and you have not forgotten an insulin injection or altered your diet or exercise pattern, check for changes in your insulin.

 

DIABETES INACTIVE INSULIN SYMPTOMS

If you are controlling your blood glucose level with insulin, any unexplained episode of hyperglycemia could mean that your insulin has gone bad. A sure sign of hyperglycemia is a high blood glucose reading (anything above 250mg/d). Other signs of hyperglycemia include: intense thirst, a dry mouth and the need to urinate frequently. If your blood glucose rises too high for too long, life-threatening situations such as diabetic ketoacidosis or hyperglycemia hyperosmolar state can occur. Symptoms of diabetic ketoacidosis include nausea and vomiting, weakness, abdominal pain, warm dry skin, loss of consciousness, or a fruity odor on the breath

 

DIABETES INACTIVE INSULIN RISK

Using any insulin that has changed in appearance or has expired could lead to hyperglycemia, diabetic ketoacidosis or hyperglycemic hyperosmolar state. Repeated episodes of hyperglycemia over time can increase your risk of many of the complications of diabetes.

 

What You Should Do

If you are experiencing any of the symptoms of your hyperglycemia, you need to treat this right away. First, measure your blood glucose level. If is higher than 250mg/dl, also check for ketones. If you have ketones in your urine and show any of the signs of diabetic ketoacidosis, call your doctor right away. If your blood glucose level is higher than 300mg/dl, seek emergency treatment at once.

 

If your doctor tells you to take an additional dose of insulin, do not use insulin from the same container if there is a visible change in the insulin. Open a fresh bottle that has not expired.

 

DIABETES INACTIVE INSULIN PREVENTION

To prevent using a spoiled container of insulin, it is important to store it properly and check its visual appearance before each use. Also check the expiration dated. Do not use any vial of insulin that has expired. Unopened and unused bottles of insulin can be stored in the refrigerator until needed, as long as they have not expired. When you open a bottle of insulin, write the date that you opened it clearly on the label. Opened bottles of insulin that are stored in the refrigerator should be discarded after 3 months. Opened bottles of insulin are best kept at room temperature, but should be discarded after 1 month. 

Also check for changes in the appearance of your bottle of insulin. Never use insulin if it looks abnormal. Regular and lispro insulins are clear. Always check for any floating or settled particles, cloudiness or change in color. Other types of insulin, such as NPH or lente, come as suspensions. With suspensions, the insulin is never completed dissolved, even when new, and may have a cloudy appearance due to tiny particles floating in the liquid. 

 

However, in these preparations, the cloudiness should be uniform. You should not see any large clumps of material. If you see any sort of clumpiness, discard the bottle and open a new one. If you dilute your insulin, use only the diluent recommended by the manufacturer. Diluted insulin can be safely stored for 4 to 6 weeks in the refrigerator. 

 

If you find something wrong with newly purchased insulin, return it to where you bought right away. If anything develops later on, try to figure out what have caused it. Did you shake it too much or store it in a hot glove compartment? Did you leave it out in the cold, causing it to freeze or thaw? Any excessive agitation or extremes of temperature can cause insulin to denature and lose its strength.

 

ADJUSTING TO HUMAN INSULIN

If you have insulin allergies or problems with animal insulin, you will probably appreciate the widespread availability of human insulins. In addition, synthetic modified insulin can provide you with even greater flexibility in developing a treatment plan that works for you. Maybe you need the fast action of lispro to accommodate changes in food intake or exercise, for example. Human insulin, in general, tend to peak faster than animal counterpart, so you need to adjust your insulin dose and schedule when you switch to human insulin.

 

Symptoms of Adjusting to Human Insulin

Some people experience more bouts with hypoglycemia when switching to human insulin from animal insulin. Any of the symptoms of hypoglycemia or hyperglycemia could mean that you are having a problem adjusting to human insulin. Symptoms of hypoglycemia include hunger, shakiness, nervousness, sweating, irritability, impatience, chills and clamminess, rapid heartbeat, anxiety, light-headedness or dizziness, blurred vision, nausea, sleepiness, tingling or numbness in the lips or tongue and confusion. Symptoms of hyperglycemia include dry parched mouth, extreme thirst, sleepiness, confusion and warm dry skin with no sweating

 

What You Should Do

If you have recently switched to human insulin from an animal insulin and are experiencing any of the symptoms of hypoglycemia or hyperglycemia, test your blood glucose level right away. If your blood glucose level is low, your insulin may have kicked in too early, according to how you have timed your meal and your injection. If this is the case, you may need to eat something right away. If your meal is not ready, eat a fast-acting carbohydrate. It is less likely that you will experience hyperglycemia when adjusting to human insulin. Should this occur, it will probably be mild (a blood glucose level between 200 and 300mg/dl). If this is the case, consider going for a brisk walk or other moderate activity. If your blood glucose level climbs over 300mg/dl, something else may be contributing and you may need to treat it urgently.

 

Prevention

When switching to human insulin or any other kind of insulin, it is best to plan ahead to prevent swings in blood glucose from occurring in the first place. Talk to your doctor or diabetes educator about how to best make adjustments in your schedule. Bear in mind that all human insulin enter the bloodstream more quickly, start acting earlier, peak earlier and last for a shorter period of time than their animal counterparts. 

The synthetic human insulin lispro, for example, is active within 15 minutes of injection and peaks in about an hour. This form may be handy if you don’t know exactly how much you will eat at a meal, because you can inject it when you eat or even after you have eaten

 

In general, you will inject human insulin closer to the start of your meal. You may need to experiment to figure out which timing works best for you and the insulin you are taking. If your insulin is kicking in too soon and triggering hypoglycemia, eat your meal closer to the time of injection or consider lowering your insulin dose. If you are finding that your long-acting insulin is not lasting through the night, you may want to take your insulin a little later. 

 

Also take into account where in your body you are injecting the insulin and how this affects the absorption time. If you need your insulin to last longer, consider injecting into your arms, or better yet, your thighs or buttocks, where it will be absorbed more slowly.

 

While you are adjusting to human insulin, monitor your blood glucose level frequently. This will tell you whether your insulin is kicking in too soon and whether you need to change the timing, dose or site of injection. Your health care team can help you interpret your blood glucose readings and figure out how to change your insulin injection schedule, if necessary.

 

Sources and References

• The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette

 

• Insulin storage without refrigeration by Munvaradzi Makoni

 

• Human versus animal insulin in people with diabetes mellitus: A systematic review by Bern Richter, Gudrun Neises and Karla Bergerhoff