Keeping insulin properly

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vince13

vince13

Well-Known Member
Relationship to Diabetes
Type 1.5 LADA
If I am put onto insulin in early February, as now seems likely, can someone advise please about keeping it safely ? As yet I don't know what kind of insulin I'll be put on and don't know if different types need different care.

My main concern is that we have already booked a 23 day cruise to somewhere really hot (cruising all the way, not flying) and haven't, at this stage, booked a cabin with a minibar/fridge.

I know the Diabetes magazine says not to use insulin if it has been out of the fridge for 28 days but would it be worthwhile upgrading to a cabin with a fridge (at about ?1600 more each) to put my mind at ease or can I keep insulin out for up to 28 days - even in a hot climate ?

Any advice would be appreciated as I will need to rebook to get the upgrade before I am due to see my surgery nurse or consultant again.
 
cruising with insulin

No need to upgrade for insulin only! As you're crusing all the way, you won't be very hot for the whole 23 days - it's very unlikely to be 30oC in your UK port and first and last days of cruise, for example.

Cruise ships have other fridges on board, not just in cabins. You could ask the medical staff about keeping a supply in their fridge. There are other ways of keeping insulin cool (keep cartridges inside capsules, take box along for information, but don't keep cartridge capsules in box) - eg Frio cool packs, which work when soaked in water, stainless steel vaccuum flasks (from hiking shops, hardware shops etc) filled with cool water eg from bottled water from fridge etc (actually, doesn't have to be drinking water quality, as it's never going to touch insulin rubber); plastic tub containing insulin, wrapped in a wet cloth, replenish water when water evaporates. Make sure that insulin doesn't get frozen eg do not allow it to go in the icebox or freezer section or any fridge.

It is essential that you take your insulin in hand luggage (you will be separated from your main luggage during the embarcation process), and take spares - approx double what you expect to use. If travelling with someone else, you might consider splitting the suppplies into 2 lots of hand luggage. Not sure how you are travelling from home to UK port, but keep insulin out of direct sunlight, out of bus holds (heat from engines) etc.

When you know what type of insulin you will be using, it's worth checking with the manufacturer - I've found them surprisingly helpful and less cautious than you might expect. There's not much point speculating without knowing which type(s) you'll be using, but basically, insulins are tougher than you might expect.

Also remember that blood glucose meters and strips don't like to get too hot, but don't need to be refridgerated.
 
Thank you - that's reassured me and also given me quite a lot of ideas. I'm very grateful for your reply with such positive information.
 
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glad to help - bon voyage

Glad the info was useful. One other area occurs to me - travel insurance. Depending on whether you already have an insurance policy (annual or single trip for the cruise) or are yet to arrange, make sure that you inform the company if / when you start insulin. Getting insurance with diabetes but no complications or other medical problems is not as difficult as some claim - if a company wants to charge you more, try another one.

Obviously also ensure that you have a EHIC (European Health Insurance Card, which replaced E111 form some years ago) - it's valid for 5 years in European Economic Area and Switzerland, plus some overseas French territories, particularly certain islands in the Caribbean / Atlantic Ocean, which may be relevant for your cruise. Some insurance policies do not cover the cost of replacing lost medicines, but EHIC ensures that you don't pay any more for medicines than local residents, although very few countries charge nothing for insulin - we're very lucky with the NHS.

Bon voyage - and send a virtual postcard / write when you get home!
 
We're not off until later in the year - but thank you anyway. The insurance angle is one I'll have to tackle. We do have annual travel insurance but at last renewal I was only diagnosed as Type 2 and on diet control only - now (or after early Feb when I next see the Consultant when he said I'd be transferred onto insulin) I'll have to tell my insurers about the change but I'll bear in mind what you say about getting quotes from different insurance people - is the one specifically recommended through Diabetes UK website more competitive do you know ?🙂
 
travel insurance

Personally, I've always needed to look for a specialist activity insurer as I want to cover eg trekking above 2000m altitude, nordic ski touring, volunteer marshalling at adventure races etc. I guess that more companies can quote for a cruise. However, don't assume that Diabetes UK will be the cheapest / most appropriate insurer without checking. Of course, using DUK insurance is a way of supporting the charity financially - and it may be the best policy for you. It's not impossible to get annual insurance with a chronic medical condition, but you do need to declare it when taking out a policy AND declare any changes in your circumstances during the year.
 
I used my frio wallet for my holiday to Tunisia for this year and it was very effective, I would reccommend getting one, you can buy them online. I have used both the diabetes UK travel insurer and the one reccommended by diabetes.co.uk,

always take extra supplies than you think you will need just in case, have a letter saying that you are diabetic and need to carry certain items. best to get this from DSN as GP's will often charge.
 
Many thanks Nikki. I'll get one of the Frio wallets. I'd seen them mentioned on another post on this site but it's good to have a personal recommendation. At the very beginning of diagnosis (I'm sure you will remember !) there is SO much to think about - I hope it gets easier as time goes by when I know what I'm doing (and accepting the situation more too as it seems the first thing I think of when I wake up and the last thing at night - "I'm diabetic now"). Good news though - my reading was 7 first thing this morning so something must be working for me - lowest since April this year !!

This site is great for feedback - happy New Year to you and thanks again for the response.
 
keeping insulin cool and protected

Sorry I couldn't personally recommend Frio, but I've never used one, not even handled one. When I started using insulin, used what I already owned, not least because I had only just returned to UK with no job, too much savings and insufficient NI record to get any income support, and with all the experience I had gained in a year overseas virtually useless, even less chance of getting a job. I have nothing against Frio pouches, not that anyone has suggested that!

However, stainless steel vaccuum flasks do have a couple of advantages over Frio - cheaper and offer physical protection from knocks, not just from temperature. They are also heavier and bulkier, to a degree depending on size - anything from 0.3 litre to 0.5 to 0.6 to 1.0 litre - but prices not too dependent on size.

By the way, there's a relevent article about Cruise Ships by a mother & daughter, both nurses, 1 working in a travel clinic, the other a lecturer on baord cruise ships, in Practice Nursing, 2005, Vol 16, No 8, pages 388 to 393. The article mentions discussing special requirements, including cabin facilities, diet etc when making a booking, mentions maintaining normal monitoring regimes, care or regular medication & medical equipment and concludes by stating the advantages of cruise holidays for thsoe who cannot or prefer not to fly and having food and medical assistance available at all times on board. The article was obviously aimed at helping practice nurses to give better travel health advice.
 
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insulin on cruise

Many thanks for your continued input. I'll see if I can find that article - as a newly diagnosed Diabetic any extra information from people with experience is invaluable to me at present (as opposed to people I'm meeting who "know all about Diabetes" but don't live with it - you know the sort ?).

Thanks again - and a very happy and healthy 2009.
 
Travelling with diabetes

Although written a while ago, this article was written by someone with diabetes, aimed at travellers, not nurses / medics - in fact, the Wanderlust (adventure travel magazine) medical advisor asked the author to write it from a personal viewpoint. Readers of Wanderlust don't tend to go on cruises, although may travel on ferries on multi day voyages down the coast of Chile, for example. I don't say this as a criticism, just to explain the audience. Some things have changed since 2000 eg EHIC replaced E111.

Travelling with diabetes, by Jean Sinclair, Wanderlust, Feb / March 2000, pages 42 & 43.
 
vince13 said:
If I am put onto insulin in early February, as now seems likely, can someone advise please about keeping it safely ? As yet I don't know what kind of insulin I'll be put on and don't know if different types need different care.
Click to expand...

Copepod gave excellent advice. I've been insulin dependent for 30 years and until recently I used to have 5 or 6 foreign trips a year. I found the Frio bag useful on a trip to Australia, but bear in mind that it works by evaporation - the water that gets absorbed evaporates and cools the contents. So don't keep your Frio bag in the same bag compartment as the novel you're reading!

Do take extra insulin, but I would recommend that you keep a cartridge or two in a separate place to the rest. A few years ago in a hotel in the US I was changing my basal insulin cartridge in my room bathroom and dropped the cartridge. Of course it smashed on the tile floor. This was a day before I was due to return and it was my last cartridge. Luckily (I don't recommend this) I was in the habit of putting spent cartridges in my washbag to dispose at home, but I hadn't cleared out the bag for a few weeks. Since I have a large basal dose I had 10 units or so in each cartridge and so I could make up my dose with those "left overs". Now I make sure that I carry enough spare, and I have a spare in my jacket so that if I drop my washbag and break all the cartridges I still have an emergency spare.

One thing that might be useful is to get from your GP the names of alternatives to your insulin. The cruise ship medical bay may have some insulin (or be able to get it for you) but not necessarily the exact type. So the names of alternatives (or even the insulins that you should not take) would be useful.

Richard
 
Thanks for the advice, Richard. Once again it proves that those actually living with diabetes are able to pass on their experiences rather than just giving advice out of a textbook. I'm adding all these ideas to my list !

Kind regards,
 
sofaraway said:
I used my frio wallet for my holiday to Tunisia for this year and it was very effective, I would reccommend getting one, you can buy them online.
.
Click to expand...

Is there some trick to getting those Frio things to work? I bought one as I went abroad over Xmas. The bag expanded as it should and it felt moderately cold, but after I took it out of my bag a few hours later (I would note that this is when I have either been in the car or air conditioned buildings for some hours), the inside of it felt distinctly warm.

As this was my 'spare' insulin supplies, I was quite concerned that it wasn't being kept at the correct temperature.

In contrast, I bought one of the cool cases (non Frio), it contained a gel pack you put in the freezer overnight. The case stayed perfectly cold for many hours and I felt it was a FAR better solution.

The Frio stuff I have will be returned as IMO, it's not fit for purpose and wasn't cheap! I definitely wouldn't recommend it.

G-man
 
g-man said:
In contrast, I bought one of the cool cases (non Frio), it contained a gel pack you put in the freezer overnight. The case stayed perfectly cold for many hours and I felt it was a FAR better solution.

G-man
Click to expand...


OK that would work at home but what if I'm not near a freezer regularly? I can ask the Drs on the cruise to keep insulin for me in their fridge but can hardly ask the chef to let me store a gel pouch in with the meat or fish !
 
amazing what you can store in ship freezers!

Admittedly this was not on a civilian cruise ship, but I once had to bring back biological samples (beetles in vegetation) in a ship's freezer. I asked the crew, and after a moment's reluctance, the support of important science won over - so the samples, all in zip locked plastic bags went into a freezer that was now vacated by food, as it was over 1 month since port. The person in charge rationised that if anyone had died, their body would have been kept in the freezer, so a few dead beetles were OK! However, my request to leave some spare insulin in the medical fridge caused the doctor some upset, despite being much nearer to use usual use of the facilities!
 
the frio isn't designed to keep insulin cold like in a fridge but at a normal room temperature. For me mine did that job well. Was your insulin actually warm or was the pouch just warm in comaparison to the cooled room that you were in?
 
sofaraway said:
the frio isn't designed to keep insulin cold like in a fridge but at a normal room temperature. For me mine did that job well. Was your insulin actually warm or was the pouch just warm in comaparison to the cooled room that you were in?
Click to expand...

The insulin and the case itself was warm. The whole frio pack was warm but about an hour afterwards it cooled down a bit. The inside of the backpack wasn't warm at all.

For me, it wasn't a great solution.
 
vince13 said:
OK that would work at home but what if I'm not near a freezer regularly? I can ask the Drs on the cruise to keep insulin for me in their fridge but can hardly ask the chef to let me store a gel pouch in with the meat or fish !
Click to expand...

Why not! It's designed to be in a freezer used for food so clearly it's non-toxic!

G-man
 
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