Smaller Vial Equals Improved Potency

ApidraThe unofficial theory I’ve heard is: that which makes Apidra® work quicker (remember apidra is Pig Latin for rapid) also makes it more susceptible to “going bad” quicker. I think of it this way: its composition is broken down allowing it to do it’s job faster, but that broken-down state means that it’s closer to losing its potency.

I read this somewhere some time on some forum. It made sense to me so I tend to believe it. I don’t know if it’s accurate.

After using Apidra® for a while and having great success, I started to notice that toward the end of a 1000 u vial of insulin, numbers seemed to creep up a bit. To isolate this variable to be sure the higher BGs coincided with the age of the insulin vial takes data tracking and analysis. The work I did in this area was not extensive, but in general, I think the older the vial, the lesser the potency.

I did not see this with Novolog®. Once I took a vial out of the fridge I didn’t put it back. I continued this practice with Apidra®. I had heard Apidra® was more vulnerable to spoilage from heat. So at first I tried to keep the vials in the fridge between changes. That became cumbersome.

My dear friend, Cari, told me that she uses pen vials for her son’s insulin source (a fellow OmniPodder). This serves two purposes:

Apidra Pen1) It allows for flexibility if you need to give an injection. Say you have a pump delivery issue (and yes, ours are almost nonexistent at this point, but not completely eradicated) rather than needing to change a Pod or draw up a dose with a regular needle because perhaps it’s not exactly convenient to do so in the middle of a restaurant or when you’re on the pitcher’s mound, you are prepared with the ease and convenience of an insulin pen.

2) The amount of insulin you have unrefrigerated at any time is significantly less. The vials are 300 u rather than 1000 u. Instead of using one vial per month, we’re using one a week.

Poof! The monthly bg creep issue was eliminated. I no longer worry about the age of the insulin and whether it’s gone bad.

With so many variables to manage with diabetes, being able to eliminate one is a win! With two day site changes and smaller vials, we’re up to two! Win, win!!

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19 thoughts on “Smaller Vial Equals Improved Potency

  1. This may be a silly question, but how do you draw the insulin from the pen to deliver into the pod??

    • Not silly! I wondered the first thing at first too! The tip of the pen is just like a regular insulin vial. You have to put needle tips on it to use it as an insulin pen each time you use it. Otherwise, it works exactly the same! (If you look in the picture, you can see the threads at the end where the pen needle would be screwed on. What you don’t see is the rubber stopper where you can draw the insulin from). Does that make sense? I’m not sure I explained it well. 🙂

  2. Pingback: Apidra® | Pumping 48 hours | This is Caleb…

  3. Yay! I’ve heard the same thing and contemplated using the pens as well. (And I have to admit.. I had to chuckle when you said “monthly BG creep issue”…. my low-brain saw a creepy man in black with “BG” stamped across his chest peeping around a corner.)

  4. Great problem-solving skills, Lorraine!! Now, just wait until Apidra is removed from your insurance company’s formulary of “preferred” medicines; as many people are now finding Novolog is being replaced by Humalog. Personally, I prefer Humalog myself, but I find the argument of “therapeutically equivalent” hard to swallow.

  5. Good idea. When I travel, I bring pen cartridges that I can use to either fill my pump or (God forbid it fails) use in my pen. I haven’t thought of only getting pen cartridges instead of vials, though. Is it any more expensive ?

  6. You are right on. My son has been using Apidra for two years and early on I noticed the same thing. I, like you made some changes and his A1C now stays about 7.2. Considering his other medications my son takes that increase his sugars the Apidra works great! I am glad that you have your website. It keeps us all in the loop striving for a common goal. Balance. Thanks J

  7. This is so interesting and something I’d like to take notice of. This is also a perfect example of why I love the DOC – finding out the things a dr will never tell you!

    • I know! I’m so glad Cari shared it with me! I would have never thought of it.

  8. Thank you for this idea! I used to get so frustrated when my daughter’s Apidra filled pod would stop working, for seemingly no reason, and then I’d pull it and find stinkin crystals in the cannula. This would happen on day 1, 2, or 3 and I could not find any rhyme or reason to the cause. I finally realized that it was almost always happening during the last two weeks of having the vial open. We’ve solved the problem by now opening a fresh vial every two weeks. With her only using around 120 u per vial, just think of all the insulin we’ve been wasting! Switching to the 300 u cartridges is the perfect solution. Thank you for sharing!

  9. I’ve learned so much from DOC, it’s great to know something I was doing helped someone else!!

  10. Makes sense. I just went on a pump for the first time yesterday, and I didn’t bother getting a big vial (of Humalog) because I have so many pens/pen vials already. I didn’t even draw the insulin out, I just screwed a needle on the pen and injected it right into the pump cartridge (but this was on a t:slim, not an Omnipod, so maybe the filling requirements are different). I don’t use a ton of insulin, so I think I’m going to keep going with this method. They also say pens protect insulin better from light/heat (I don’t even always refrigerate my Humalog pens) and they’re certainly a lot harder to break than full-sized vials.

    • Oooo…the point of protection is an interesting one. I hope pumping is treating you well, Christopher!

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