Insulin Storage in a Disaster Scenario: How to Keep Things Cold?

If you have diabetes you might wonder how you can ever survive a long-term disaster, especially if you require insulin injections on a daily basis. Unfortunately, there’s no alternative for it, and insulin doesn’t store forever.

With a good expiration date, 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.

Options for Insulin Storage During Disasters

  1. Get a solar generator. And be sure to have enough oil and gas to keep it running.
  2. Get a refrigerator that runs on propane. And make sure you 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. 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.

What happens if you don’t refrigerate your insulin?

Cold storage keeps insulin fresh longer. Insulin is a water-dissolved protein and when it goes bad, it starts to break down which makes it more difficult to absorb into the body. In such a situation blood sugar levels rise, making it harder to control.

There’s no direct risk of poisoning if your insulin hasn’t been kept cold, especially if it’s only been a short period if time. It simply won’t function as effectively. If you inject insulin that has gone bad, the result would be that your blood sugar levels will rise.

People with type I diabetes must take insulin injections. If they do not properly manage their blood sugar levels, they may develop complications such as diabetic ketoacidosis.

Can insulin go bad?

Yes, insulin can go bad. If the insulin has changed color, has lumps in it that it is likely that it has gone bad and then should not be taken.

How long can insulin last in warm weather?

Insulin can last for 28 days if it has not been refrigerated. Now do not make this a hard rule as it will depend on the types of circumstances the insulin was kept. If the insulin has been kept in 120-degree heat and in direct sunlight you likely will find that your insulin may go off much sooner than if it was kept at room temperature.

How long does insulin last?

About one year after purchase, although most types of insulin begin to lose their effectiveness between 3-12 months from the time they were manufactured.

Some studies recommended throwing away insulin at 3 months while others we have seen for 1 year or more.

You may see this referred to as “expiration” but what we actually mean is that insulin has lost its ability to lower blood sugar effectively.

New Studies

A joint study published today in PLOS ONE by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) and the University of Geneva shows that:

"Shows that a range of insulins can be stored at warmer temperatures than previously recommended, making it easier for people with diabetes who live in places without reliable access to refrigeration—such as refugee camps and other low-resource settings—to adhere to effective treatment. These findings show that various insulins can be stored at temperatures ranging between 77°F and 98.6°F for four weeks without becoming less effective."

According to Doctors Without Borders, this new finding of no refrigeration requirement in a climate of up to nearly 99°F will be revolutionary for poor-income individuals living in tropical environments.

More on this can be found on their video here.

How to Get Enough Extra Insulin to Store?

Your healthcare 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.

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 opening, 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.

References

[1] Diabetes Disaster Preparedness. https://scriptdrop.co/2020/09/09/diabetes-disaster-preparedness-insulin-dos-and-donts

[2] Disaster Preparedness and Diabetes. https://www.diabetesselfmanagement.com/managing=diabetes/general-health-issues/disaster-preparedness-diabetes/

[3] Managing Insulin in an Emergency. https://www.cdc.gov/diabetes/library/spotlights/managing-insulin-emergency.html

[4] Insulin Storage: A Critical Reappraisal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783014/

Photo by Kelly L/Pexels

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