Just by looking at the insulin bottle, we cannot determine whether it is spoiled or still usable, and there is no suitable way to verify the effectiveness of the insulin other than to check the correct storage.
These are the FDA instructions after reviewing the advice of the various insulin manufacturers :
1- Insulin can remain in effect until the expiration date if it is kept in the refrigerator during this period between 2-8 ° C.
2- Do not keep insulin in the freezer or in the first shelf near the freezer, otherwise if you notice that the insulin has frozen or ice crystals are inside, it must be disposed of immediately.
3- It is forbidden to expose insulin to sunlight or direct heat.
4- If insulin comes out of the refrigerator, it retains its effectiveness outside of it for up to 28 days at temperatures between 15-30 ° C.
5- Know that the temperatures that fluctuate most are extremely harmful to insulin, so it does not withstand much above 30 ° C, and it is not recommended to expose it to temperature imbalance (meaning from a hot atmosphere to a cold atmosphere, for example from the car dashboard to the refrigerator).
6- Cold insulin is more painful when injecting, so there is no objection to keeping the insulin at room temperature, whether in the form of a carbule, vial, or pen, provided that you keep the additional packages in the refrigerator until the open package is empty or remove the package from the refrigerator, before using half an hour because Cold insulin is painful.
7- To the pharmacist: It is always better to buy fresh insulin (which has been newly manufactured), as it is always better than the old one, even if it is still effective.
8- In cases of severe emergencies such as situations of wars and lack of drug supplies, may God bless you, so the insulin that we suspect is corrupt due to its poor storage is better than nothing and when supplies are returned and medicine is available, this insulin is disposed of and replaced with a valid stock.
9- When traveling, packages can be stored in a (thermos) in cold water or in a special bag to store insulin, which are available in pharmacies. Also, consideration must be given to wrapping the insulin in a cloth or a nylon bag in order to avoid insulin freezing.
1- https://www.diabetes.org/diabetes/medication-management/insulin-other-injectables/insulin-storage-and-syringe-safety
2- https://www.health.harvard.edu/blog/safe-and-effective-use-of-insulin-requires-proper-storage-2018120415486
3- https://www.iddt.org/about/living-with-diabetes/storing-insulin
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