Tips for storing insulin without refrigeration

THE EDITOR, Madam:

In the aftermath of Hurricane Melissa and the loss of electricity and therefore refrigeration, there is much confusion among patients, caregivers, and even members of the medical fraternity as to the storage of insulin used in the treatment of diabetes.

Patients are usually advised by their pharmacist to store the insulin in the refrigerator, and the prevailing impression among most is that the insulin is spoiled if refrigeration is not possible. The result of this is, they do not take the insulin, the blood sugar rises, and their diabetes goes out of control. This creates a very dangerous situation as the patient is at increased risk of all the complications. These include stroke, heart attack, worsening kidney and eye problems, poor wound and ulcer healing, gangrene, and amputations in the extreme.

Diabetes is classified as a chronic, non-communicable illness which can be very dangerous if not managed and monitored carefully. Strict lifestyle measures, including appropriate meals, exercise and adherence to prescribed treatment, along with careful monitoring of blood sugars, are important in the management of this condition.

In the past weeks since the storm, many patients have been reporting with higher levels of blood sugar, poor control of the condition, and reporting that they haven’t taken their insulin because there is no electricity to keep it cold.

According to guidelines from the American Diabetes Association and their Diabetes Disaster Response Coalition, insulin products contained in vials or cartridges supplied by all three US insulin manufacturers (opened or unopened) may be left unrefrigerated at a temperature between 59°F and 86°F (30°C) for up to 28 days, and continue to work.

For patients without refrigeration, here are some general tips:

1. Keep insulin away from direct sunlight and heat sources.

2. Use a cool, dry place to store insulin, like a shaded area or an insulated bag.

3. If available, use a thermos or insulated container with ice packs (not directly on the insulin) to keep it cool.

4. Immerse insulin in a cup of water (not directly in water, but in a sealed container or ziplock bag submerged in water). This method can help keep the insulin cooler than room temperature, especially if the water is changed regularly.

5. Monitor insulin for changes in appearance (e.g., clumping, discolouration) and discard if compromised.

Patients should contact their healthcare provider for guidance on insulin storage and dosing during this time. It is also essential to maintain regular blood sugar monitoring and adjust insulin doses as needed.

Patients, caregivers, pharmacists, etc, need to be updated and educated on these methods of safe insulin storage and the need to be adherent to the advice and instructions on dosing their insulin, to help maintain adequate blood sugar control.

DR PAUL A. KIDD

Santa Cruz

St Elizabeth