Monday, June 11, 2012
I opened a new vial of Novolin R nine days ago. I noticed almost immediately that my blood sugar wasn't doing what I was expecting... but it doesn't always. About three days later I had a strange high in the night. I was right around 300 and stable (had been right around 300 for three hours) when I woke up at 4:30 AM. I took five units of insulin. This was based on the theory that each unit of insulin lowers me by 50 mg/dl but only over the course of four hours, and that it does so at a roughly steady rate. So I expect each unit to drop my blood sugar by about 12 mg/dl/hr for four hours. And I figured I'd be getting up in another two hours, at which point I'd have dropped about 120 mg/dl, to 180 mg/dl and everything would be cool. Instead I woke up three hours later to find that by my CGM, I'd dropped 200 points in the first two hours after injecting and had been really stable for the previous hour. I was very surprised but diabetes is full of surprises so I let it go. Then a few days ago I had another night time high. This time it was 2:30 AM, but my blood sugar was once again looking stable around 300. This time I took 4 units, and went back to sleep. I woke up at 6 AM, expecting to see blood sugar still dropping. Instead, again, I saw a flat blood sugar that had dropped rapidly and dramatically after my injection, but which had dropped only about 10 mg/dl in the previous hour. Well, one time is just diabetes weirdness, but twice in a week after opening a new vial of insulin makes me think. I'd been noticing that it didn't seem like my insulin was being active as long as I was expecting and that it was having more punch in the hour or two after injection than I'd been expecting, but I hadn't been sure because those times when there was food complicating things. Now I'm feeling pretty sure. Which leads me to the question... is this really regular I'm injecting? As I see it, either I'm imagining patterns that don't exist, or my body has changed the way in processes insulin (and coincidentally did this after I opened a vial from a different lot), or this batch of Regular is different, or this isn't Regular. It's the last theory I'm thinking about. This insulin isn't acting like the Novolin R I've been using for a year. It's acting a lot more like Novolog. Novolog is sold for twice as much but doesn't actually cost more to manufacture, as far as I know (there's no reason why it would). Is it possible that, on purpose or by accident, one was labeled as the other? I don't see why not. I've been puzzling it over and puzzling it over and I'm not sure if I should contact the FDA. It's not like I have an adverse event to report, and besides, how likely are they to trust my impression of the duration of action of insulin? Most people probably don't really know their DIAs. Contacting Novo Nordisk has some of the same issues, but I think I'll contact Novo Nordisk all the same. Just in case other people are having the same issues with insulin from this lot.
Posted by Jonah at 11:28 PM