The great unrefrigerated (& expired) insulin demo

Medicines Insulin
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The long-time Unlimiteds have already seen this kind of stuff. But for newer members, I wanted to share it with a new demo.

I am calling this a “demo” instead of an “experiment”, because really by now, there is no more experimenting. I know what is going to happen, I am just trying to show it.

Perhaps you recall this one from last year:
car-baked-insulin-an-experiment-for-irish

That was a fun thread! And it was a little bit different, it was in a hot car in the summer for 4 days.

But since people may still be worried about leaving insulin out of the fridge, I did it again, but in a different way.

Take a look at these pics, and notice two things.

I made a note of the date I took it out of the refrigerator. It has been unrefrigerated for over a year!

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And check out the expiration date. Almost 4 years past expiration!
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Other than normal basal, my last insulin bolus dose was 10pm LAST NIGHT. Over 15 hours of nothing but basal insulin.

Then I did a normal dosing amount for lunch, using my unrefrigerated and extremely expired insulin!

Here is the obligatory Dexcom trace. Where is the horrible insulin degradation? I can’t find it. At the time of writing this it has been 3 hours since my lunch, and I am still looking for the insulin failure.

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What I am NOT saying is that this is how you should treat your insulin. Don’t purposefully leave it in a hot car, don’t purposefully leave it unrefrigerated for over a year, don’t purposefully let it expire and use it 4 years later.

But what I am saying is - relax about it a bit. Insulin is much tougher than people think.
:guinea_pig:

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As you say, I am not surprised, but it is always nice to have more confirming evidence that the 30 day thing is just pretty much ridiculous.

On our front, my son now rides with a pen cartridge of insulin on him always for IM shots on stubborn highs. It sits in the sun, in the dugout, in the car, everywhere my son goes and we don’t worry about expiration and have never had a problem.

Most of our relaxed attitude about this can be traced to you, so thank you!

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Makes sense. I don’t replace my Humalog pen until it runs out, and since I started Afrezza, that doesn’t happen often. This treatment is partly due to your past posts about your experiments with Humalog.

I suspect my Tresiba insulin may be more sensitive to temperature though. I baby it a lot, and I wish I could be certain that it could weather high or low temperatures fairly well. Since you need a few days’ doses before it’s at full effect, experiments like this would be a huge hassle with Tresiba.

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Do you take Tresiba once per day, or twice per day?

On the plus side, with a basal insulin, there is less need to have it with you all the time. Unless you are leaving your house for an extended period of time, basal can generally sit in the fridge, you don’t need it with you all of the time.

For that very reason, I have admittedly done much less of these types of experiments with basals.

I agree, it would be much more of a hassle to test something like that with Tresiba!

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Love it. So now I can ditch my emergency small fridge I carry in my emergency pack in case of mildly beautiful weather on my trip to the corner food store.

Whew! It was heavy. :grin:

You know I’m only partly kidding… I’ve packed my insulin out in some serious cold pack stuff for an overnight trip out of town on many an occasion. I feel comfortable ditching that now. You’re freeing me, Eric, one ridiculous rule at a time. :grin:

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I can add my experience to your story. When we came to PNG, part of our cultural learning was to live in a village for 5 weeks. No refrigeration. No electricity. Tropical heat near the ocean. We were a bit concerned about my insulin, so we were allowed to stay in a village about a mile from a home with electricity and a refrigerator. We kept my backup insulin there. However, we were pleased to find that my insulin never failed! We used a frio bag and hung it where it could catch a breeze, so there was some coolness, but still not the same as refrigeration.
Thanks for sharing your story. Wish I had seen it before my first visit to the village! :slight_smile:

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Love to see this kind of stuff.

Reminds me of brewing with way old hops, frozen for 10 years. Homebrew wisdom says the hops were way too old, and should’ve been discarded… I had a feeling they were still good, and sent them to a guy to conduct a proper experiment, in the interest of science:. Brulosophy

In the end, folks were unable to tell the difference between new and old hops in the experiment. Minds blown in the homebrew community.

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I have to wonder if humalog lasts better than novolog. I had novolog expire before the 30 day point at an anime convention …where there was poor a/c. I got home and went to go take my dinner dose and found it was full of white specks and explained my high sugar at pre-dinner as well :confused: . I’ve heard people suggest that novo insulins and I think Apidra are more temperature sensitive ,too , though. I’ve had no like no humalog pens or admelog pens expire on me however? Lantus hasn’t either.

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Sounds like…another experiment!

I haven’t done the same silly stuff with Novo, but I am willing to try. :grinning:

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I remember when I was on Lantus feeling like it was sensitive to being out of the fridge in ways my short-acting insulin never was… mostly not a problem for me, but based on those experiments, I wouldn’t expect it to survive this same kind of demo (though would be super curious to see). Given that long acting insulins use various chemical means to create their prolonged durations, it makes sense to me that some of those may be less stable than the insulin molecules themselves.

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This is another great experiment, @Eric. Before we started this forum, I don’t think anyone one of us (except you!) expected to see so many proofs that insulin is much more heat-resistant than advertized. I know you really opened my eyes. @Chris’s experiments with cold were eye-opening in the same way.

I also believe you are totally right to remind everyone that this is not a reason to mistreat or mis-store insulin. We actually had spoiled insulin once this summer (my son forgot to put it in an insulated container, and he carried it in his glucose bag, in the sun without shade, 2 days on a row in 110 degrees of heat).

Thanks to these experiments on FUD, I am not worried about using our US insulin stock here, much of each already about a year old. Yet everytime we do a test against recently purchased insulin, it is as good as new.

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I want to add that taking unnecessary risks is not wise. Nobody should do that.

But living with unnecessary fears and restrictions and burdens can also detract from the quality of life.

I just want everyone to find the right middle-ground. I want diabetes to become small for everyone.

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I carried my Levemir in my purse for over a year after I got my pump and it still covered me overnight (it lasts about 12 hrs in me at my dose) when I used it when I didn’t want to bother with a site change. Thanks for this thread.

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Thank you for being the tester and sharing. :blue_heart:

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According to the Dexcom : Is your BG 50 +/- 25 between 1-4 pm? Wow!

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Here’s the scenario that I’m faced with—- all tips are welcome.

I’ll potentially be “working” (minus the “getting paid” part) for about 4 months strait every summer in Alaska… bouncing, flying, rappelling out of helicopters, jumping off of boats, etc all summer long, every summer for the next several years. I’ll need to be in suit and tie every day and packed extremely lightly… no more than a “carry-on” bag… with little to no opportunity to repack during this time. I’m struggling to comprehend how to manage that with my insulin/ cgm/ other diabetes supplies in a sustainable fashion for this long…

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Why?

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I can do two weeks with supplies in a carry on. That is no problem; most of the weight is cameras and computers which I also load into the carry on. When I say “carry on” I mean a messenger bag; something I can stuff under the seat.

I don’t think you will have a problem; I’ve seen people with “carry on” baggage that I couldn’t lift.

However: if you have to go 4 months between subscriptions I would suggest spending a month somewhere way outside the US first; somewhere where you can actually buy four months of subscriptions up front.

I recommend polyester. You can spray them with water and hang them outside to dry, oops, Alaska, freeze.

I’m not sure I would do that in Alaska, I would probably favor somewhere with less money and more heat; after all, as is the point of this thread, all the worries my mother had when we headed to Kenya for a couple of weeks in the '70s are gash.

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Yes I have my eye on a couple polyester mostly ones that are even machine washable… which would be huge. The only one I own currently since I learned how to properly size a suit is 100% linen… which looks like a million bucks if freshly pressed and doesn’t get sweaty… but wrinkles like crazy

The rx thing… I keep on hand well more than 4 mos of insulins and test strips… I’m more concerned with their proper handling to ensure efficacy and also concerned about the cgm which normally I don’t like to depend on— but think I’d be more dependent on I this situation…

I’m not sure I’d do this in Alaska either… but there’s always the carrot dangling at the end of the stick… and in this case it’s a very large one

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Pretty easy without a pump.

  • assorted refillable pens (for both rapid and basal)
  • pen needles
  • insulin vials (vials carry a lot more insulin than the 3ml pen cartridges)
  • Afrezza
  • test strips
  • small BG meter (Contour Next One!!)
  • lancets
  • a few syringes for emergency
  • Transcend glucose packs for emergency (try to use food whenever possible to save the Transcend’s)

That :arrow_up: is all you need. Everything else - like CGM - is a luxury item

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