Inge has an amalgam of health issues, the most serious of which is her high glucose levels. She has to take daily insulin shots, which must be chilled on ice.
That might have been good advice 30 years ago, but it certainly isn't now. Modern insulin preparations should be kept at room temperature while in use for up to 30 days -- keeping it refrigerated while in use is contraindicated due to the potential for thermal cycling to result in inaccurate dosing -- and keeping insulin "on ice" is never recommended due to the risk of the insulin being damaged by freezing.
> That might have been good advice 30 years ago, but it certainly isn't now. Modern insulin preparations should be kept at room temperature while in use for up to 30 days -- keeping it refrigerated while in use is contraindicated due to the potential for thermal cycling to result in inaccurate dosing -- and keeping insulin "on ice" is never recommended due to the risk of the insulin being damaged by freezing.
Do you have a citation for this? I'd be interested in researching more on this subject. My girlfriend tells me she needs to keep her insulin pens in the fridge. We've also noticed that her blood glucose will fluctuate for strange and mysterious reasons. Your comment wrt thermal cycling rings true, and I'm wondering if the temperature change from constantly going from fridge (~5C) to her purse (~20C) and back, several times a day, might be causing this
Every insulin pen "user guide" I've seen says "store unopened cartridges in a refrigerator; keep your pen at room temperature".
My girlfriend tells me she needs to keep her insulin pens in the fridge. We've also noticed that her blood glucose will fluctuate for strange and mysterious reasons. Your comment wrt thermal cycling rings true, and I'm wondering if the temperature change from constantly going from fridge (~5C) to her purse (~20C) and back, several times a day, might be causing this
The biggest problem with thermal cycling is that insulin pen cartridges, unlike insulin vials, aren't perfectly sealed -- the rubber stopper needs to be able to slide. As a result, when a cartridge is cooled and the liquid contracts, it will tend to draw a small amount of air into the cartridge. This will result in bubbles forming, and obviously injecting a bubble of air will be less effective than injecting insulin.
In young adults this is a nuisance more than anything else, since we're likely to notice bubbles, but in children (who don't understand the implications) or the elderly (who are less likely to notice this due to visual impairment) it can be a serious problem.
Assuming your girlfriend falls into the "young adult" age range, it's unlikely that her blood glucose fluctuations are caused by this; assuming you've ruled out monthly and diurnal patterns from endocrine causes, I'd look at diet -- protein in particular, since amino acid catabolism can dump glucose into your bloodstream at unexpected times.
That might have been good advice 30 years ago, but it certainly isn't now. Modern insulin preparations should be kept at room temperature while in use for up to 30 days -- keeping it refrigerated while in use is contraindicated due to the potential for thermal cycling to result in inaccurate dosing -- and keeping insulin "on ice" is never recommended due to the risk of the insulin being damaged by freezing.