Refrigerator on a roof

House and refrigerator in New Orleans after Hurricane Katrina.

by James Hubbard, MD, MPH

So many of my readers with diabetes worry how they can ever survive a long-term disaster, especially if they require insulin to live. As they know, there’s no substitute for it, and insulin doesn’t store forever.

With a good expiration date, though, insulin can keep a good year or two. The key is proper storage. To last more than a month, it must be refrigerated.

Fortunately, this is possible even without electricity.

5 Options for Insulin Storage During Disasters

  1. Get a generator. Just have lots of gas and oil to keep it running.
  2. Get a refrigerator that runs on propane. Just have plenty of propane.
  3. Get a solar-powered refrigerator, such as one of SunDanzer’s. But get ready for sticker shock. A tiny one costs $699. (For the only one that’s battery-free, you’ll still need to have your own solar panel.)
  4. This one’s so cool :) but you have to live in an area where the humidity doesn’t get to seventy-five percent or it doesn’t work. It’s called a zeer pot, or a pot-in-pot. All you need are a couple of different-sized clay pots, sand, a cloth to cover it, and water. The water doesn’t even have to be drinkable. At the bottom of this post is a video I found on how to make it. I haven’t used or made one, so you may want to try it out in advance with a thermometer inside, to see how well it works. The problem I see with this is you never know what the exact temperature in it will be, and it might fluctuate, but in a desperate situation, it could be worth a try.
  5. Store your insulin in a hole in the ground. Just be sure it’s four feet or more deep, and the insulin is in a watertight container. That’ll keep the bottles at around fifty degrees Fahrenheit.

The package insert usually says to keep the insulin below 40 degrees Fahrenheit and to never freeze it, so the first three options are the best. But, if we’re talking about life-or-death survival here, and no other cold-storage options, I think the last two are certainly worth a try. In fact, there’s a study from India, where it’s hot and electricity-limited, that shows keeping the bottles below 77 degrees Fahrenheit. may work as well as keeping them colder. (Sorry, the link is a PDF file.)

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How to Get Enough Extra Insulin to Store

Your health-care provider may balk at prescribing two years of insulin in one fell swoop, but not a few extra bottles for backup. Next time, request a few more. Ask your pharmacist for the ones with the longest expiration—one, two years.

Keep alternating your stockpile, using up the ones with the earliest expiration date and replacing them with your newest bottles.

The stress, exercise changes, and diet changes in a disaster will play havoc on a diabetic’s blood sugar, so be sure to store extra glucose monitors, batteries, and test strips with long expiration dates. After opened, the strips should last three months in cool, dry storage. And don’t forget some glucagon. Show someone how to use it in case your sugar drops too low.

Islets of Hope, a website for people with diabetes, has insulin-storage specifics, though the article was written in 2006. Double-check the information with the current manufacturer’s instructions for your medicine.

Next post is for non-insulin-dependent diabetics.

Does anyone have insulin-storage tips, comments? Has anyone ever built a zeer pot?


Photo (of flood-devastated Lower 9th Ward in New Orleans after Hurricane Katrina) by Infrogmation on Wikimedia Commons.

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