Levemer & Humalog Insulin

[AnnaS]

I thought we had this down with my mom but we are learning something all the time. One of my sister's and I have been dealing with my mom's diabetes since my sister passed last year in March (she lived at home and was a diabetic also).

Of course I can call the doctor and pharmacy -

I know the insulin gets refrigerated but did not realize that once opened/used - it can stay out up to 42 days - is the same for the short acting Humalog? (I am going to read the box anyway as soon as I go to my mom's house hopefully later).

Also - she normally does the Levemer - long acting once in the morning but I just read on-line that it is usually done at night?

I think her doctor, which she goes to every 6 months, must think we knew all this.

We also recently learned not to use alcohol before or after her shots (it gets inside which causes it to burn).

Any other suggestions would be appreciated. TIA>

 

[PatsMom]

I think Levemir might have a longer stable period after opening than Humalog but read the package insert or ask your pharmacist to make sure. I know that Lantus is only good for 30 days after opening unless the rules have changed since I last used it which was a few years ago.

I did my Lantus at night. I know some Levemir users who divide the dose between morning and night. Your mother's doctor might be doing mornings because she asked to have it done then and he was agreeable to it. If she is not doing her own shots the timing might have something to do with when a caregiver can be there.

Do not refrigerate the in use insulin vial or pen. When I was on insulin it really stung if the insulin was right out of the fridge. When it was time for a new pen I would get it out well in advance of my shot.

I don't use alcohol either because it stings. But the classes to teach you how to do the shots will all say the alcohol swab before the shot is important. All I can say is I have been injecting for over 5 years and the swabbing lasted about a week for me. I've never had an infection.

Is your mother testing her blood or are you doing that for her? Very important when on insulin to keep a close eye on the glucometer. You might want to talk to her doctor or diabetes educator about the best way to deal with highs and lows and especially sick days.

 

[AnnaS]

I think Levemir might have a longer stable period after opening than Humalog but read the package insert or ask your pharmacist to make sure. I know that Lantus is only good for 30 days after opening unless the rules have changed since I last used it which was a few years ago.

I did my Lantus at night. I know some Levemir users who divide the dose between morning and night. Your mother's doctor might be doing mornings because she asked to have it done then and he was agreeable to it. If she is not doing her own shots the timing might have something to do with when a caregiver can be there.

Do not refrigerate the in use insulin vial or pen. When I was on insulin it really stung if the insulin was right out of the fridge. When it was time for a new pen I would get it out well in advance of my shot.

I don't use alcohol either because it stings. But the classes to teach you how to do the shots will all say the alcohol swab before the shot is important. All I can say is I have been injecting for over 5 years and the swabbing lasted about a week for me. I've never had an infection.

Is your mother testing her blood or are you doing that for her? Very important when on insulin to keep a close eye on the glucometer. You might want to talk to her doctor or diabetes educator about the best way to deal with highs and lows and especially sick days.

She tests her sugar at least three times a day - she should do 4. Sometimes she is so tired of pricking (is that the word) her finger that she does it twice. She was also giving herself the short acting when it was really high. She is tired of all the needles. We tell her she cannot do that since her sugar is not under control. She is trying again to test it a few times a day and give the units according to her sugar number. We tell all the time too that she must do the short acting 5/10 minutes before eating.

She lives alone (we are always there) and does not speak English and barely writes. She has log to write the numbers down for us.

I think the no alcohol is going to help and I just came from there and took out the started pens out of the refrigerator - maybe it will help with the stinging (is that a word again?). Thank you again.

 

[bumbershoot]

I am going to read the box

Read the package insert. Go to the manufacturer's website. Get ALL the info, not just what's on the box.

If she's having these problems, sounds like she needs more than twice a year appointments. Does her doctor speak her language? If not, does someone go with her to translate? If not either, go with her or change doctors to one who speaks her language. (with a not-fluent-in-Korean (anymore)-OR-English Korean MIL who will say "yes" even if she doesn't understand the question (so fun when she's in the ICU), I know what I'm talking about)

Check what classes her insurance covers, and take them. See if the classes are given in her native language.



I wonder if a pump is something you guy should be looking into? Maybe it would make it easier on her? (it's only a question...I don't know if it would be easier)

DH takes injections of something else. The drug must be refrigerated, but he found that if he puts it in the syringe then warms it up a little bit (just holding it against his body for a few minutes), it barely stings at all, compared to when he was injecting cold liquid.

 

[mickeyplanner08]

OK, just take one pen out at a time and then keep it at room temperature until gone. I don't take Levemer, but my Lantus I do keep in the fridge. It is supposed to be tossed after 30 days, but I'm too cheap. I just use it until I start to see my numbers creep up-usually around day 45 or so into a vial. That may or may not be a reasonable thing to do for your mom.

Is her diet fairly consistent? If it is she may have better luck with less frequent blood sugar checks. I totally get the getting sick of it business. Finger pokes are worse to me than the insulin shots themselves. I usually have very little pain with them when I give in my abdomen, but others really find that site uncomfortable.

Good luck to all of you! Bless you for helping your mom with this, I know it is a lot of work!

 

[Disney Doll]

Bolded

I thought we had this down with my mom but we are learning something all the time. One of my sister's and I have been dealing with my mom's diabetes since my sister passed last year in March (she lived at home and was a diabetic also).

Of course I can call the doctor and pharmacy -

I know the insulin gets refrigerated but did not realize that once opened/used - it can stay out up to 42 days - is the same for the short acting Humalog? (I am going to read the box anyway as soon as I go to my mom's house hopefully later). All insulins have a "shelf life" once they are opened. The packageinsert should tell you about the specific insulin.[/B

]Also - she normally does the Levemer - long acting once in the morning but I just read on-line that it is usually done at night? It is usually done at night but there are some MDs who have it done during the day. There are alsosome MDs that split the dose. Ask your Mom's MD specifically what he/she prefers/recommends. I will tell you that in the hospital we give the Levemir at night, unless specifically directed to do otherwise.

I think her doctor, which she goes to every 6 months, must think we knew all this.

We also recently learned not to use alcohol before or after her shots (it gets inside which causes it to burn). The reason an injection site gets wiped with alcohol is to prevent an infection...there is some thought that microbes on the skin can get into the site when the needle passes through the skin. If you wipe the area with alcohol and let it dry, there shouldn't be a problem with stinging. However, there shouldn't be a problem with not using alcohol either. Insulin needles are very fine and not very likely to pick up too many microbes on the way through. If you would feel better, just wipe the injeciton area with a little soap and water.Any other suggestions would be appreciated. TIA>

I assume that when you refer to your mothe'rs doctor, that you are speaking of an endocrinologist (an MD who specializes in diabetes and other related issues). If your Mom does not see an endocrinologist, I recommend you have her start. As a specialist, they are up on the latest avialble treatments etc. There are glucose monitors that use smaller lancets so they don't hurt as much, there are many strides being made in the care of diabetics which a specialist might be privy to and a regular primary care physician might not be.

 

[zurgswife]

It is actually the cold insulin that cause a burning feeling. Humalog has an out of frig life of about 28 days... If you use pens just take one out at a time.

We don't use alcohol swabs either for shots or BS finger sticks. Drys out the skin terrible if you use on a regular basis. You will find they will in a Dr's office but you don't need to do the same at home.

 

[Lynne M]

She (or you) really, really needs to talk to her doctor and let them know that you need some direction on how and when to use the medications. Diabetes management is complicated, and NO doctor should assume you'll just be able to figure out what to do. Go with her to the doctor, have him run down his exact instructions for how and when to take the insulin, and take notes for her.

Call your local hospital and ask if they offer any diabetes classes. I think most do, and I'm sure they'd be a great help to you and your mom.

 

[kbeverina]

My husband takes his Lantus in the mornings and my son did as well before he went on the pump, so I would just follow the doctor's advice on that. There are some lancet devices that enable testing on the forearm, so maybe that would help her. I think it will get better over time, though. She'll get calluses on the sides of her fingertips and it won't hurt when she tests anymore.

Is she making her own decisions with dosages and adjustments and all that or do you do that for her? Do you think her insurance company would cover a Continuous Glucose Monitor? She would have to insert the sensor and test occasionally with the meter, but it gives a continuous reading of her blood glucose and you'd be able to see how she's doing overall--is she going up and down a lot, is she going low at certain times, is she taking enough Humalog when she eats, etc. If she's refusing to test, that might be your best option.