Travelling South East Asia with Type 1 Diabetes - pump user

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Ellaraps01

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Hello everyone,

I am travelling to SE Asia for 3 months backpacking in Jan 2025. I use a Medtrum pump with Novo Nordisk Novorapid Insulin, but this insulin is not available in 10ml vials for pump use out there.

The Thai regulations state that I can only take 30 days worth of insulin with me into the country which is far less than I need for my trip.

I am looking for information about accessing insulin for pump use in SE Asia or anyone's experience of taking insulin into Thailand/SE Asia.

Any help would be appreciated as I'm struggling to work out what best to do!

Thanks,
Ella 🙂
 
Have you checked whether NovoLog insulin is available in Thailand?
Outside the UK, NovoRapid is sometimes called “NovoLog”.

Another option would be to get someone to join you from the UK for a week or two and bring some insulin with them.
 
You will be able to buy insulin OTC in Thailand, although in my experience, the pharmacist wanted a decent conversation of who would use the meds, for what and my understanding of their impacts and potential side effects. I'm not an insulin user, but left home earlier this year without BP meds. Silly girl!

Most things are available PTC in both Thailand and Vietnam, but be prepared not to have access to the same brands or product names. When I was buying, I looked my tablets up in MIMS and shared my phone with the pharmacist who got tapping into the PC to find best fit.

Bigger pharmacies tend to have pharmacists who speak English to a greater or lesser extent. Smaller pharmacies in villages it's be interesting.

I don't know where you are intending to be, but the University Hospital Bangkok is reportedly excellent and their pharmacy is likely to be as well stocked as anywhere.



My steer would be, in addition to the above, to join country local expat forums, like AseaNow.com, then drill down to where you intend to be. I'd join now, because there are insulin dependent folks there who could give you valuable info. https://aseannow.com/

All things being equal, we will be there for a few months after NewYear.
 
In vials though @AndBreathe ? When a friend visited on a round the world trip, he said there were only pens. Fortunately he just swapped back to pens temporarily but it would be good to be prepared as then the OP would have a chance to work out their pen doses in advance, if needed.
 
Inka said:
In vials though @AndBreathe ? When a friend visited on a round the world trip, he said there were only pens. Fortunately he just swapped back to pens temporarily but it would be good to be prepared as then the OP would have a chance to work out their pen doses in advance, if needed.
Click to expand...
Could they not just use a syringe to extract the insulin from the pens for their pump if only pens were available. More fiddly I imagine but probably still doable.
 
Inka said:
You can, I guess, but I was told not to do that @rebrascora (apart from the fiddliness).
Click to expand...

I think it’s much trickier with prefilled pens, but it’s pretty straightforward if you can get penfil cartridges. I don’t know if those are available in SE Asia.

When I switched to a pump I went through my small leftover stock of penfils and filled the reservoirs from them until I needed more and could order vials. It was very easy, and my DSN was happy for me to do that.

Hope you are able to find a solution @Ellaraps01

Have an amazing trip!
 
I think someone posted about this maybe a year ago and was using prefilled pens for their pump by dialing up the max dose and injecting it into the syringe several times in order to transfer the insulin but I might have that wrong.

Didn't we have someone recently in Indonesia who found it cheaper getting a flight to Australia for supplies.
 
I can’t even remember the reason I was given @everydayupsanddowns It might have been pressure?? I just remember being told not to draw insulin from a pen cartridge. I might have asked about it when I first got my pump, or maybe it was even when I got my first insulin pen. That was years ago now, of course, so maybe the advice has been updated, or maybe it just varies according to the DSN.
 
I just googled and found this from 2016:

www.england.nhs.uk

NHS England » Risk of severe harm and death due to withdrawing insulin from pen devices

A patient safety alert has been issued to warn NHS providers of the risk of severe harm and death if an insulin needle and syringe is used to administer insulin withdrawn directly from a pen device or replacement cartridge. Risk of severe harm and death due to withdrawing insulin from pen...
www.england.nhs.uk www.england.nhs.uk

So maybe it’s possible but not recommended?
 
rebrascora said:
Didn't we have someone recently in Indonesia who found it cheaper getting a flight to Australia for supplies.
Click to expand...
Thailand (which the OP mentioned) is not in Indonesia and further from Australia.
I appreciate the subject is “Travelling South East Asia” but that is a large area and flights to Australia are neither short nor cheap.
 
Yes I guess so?

I just injected the air like you would normally, so the bung didn’t have to move, and there wasn’t a huge amount of pressure involved.

Maybe your DSN had some experience of the bung coming out? Or the penfil cracking??
 
Inka said:
So maybe it’s possible but not recommended?
Click to expand...

I think that’s about u200 and u400 pens then being drawn up with a u100 syringe.

And in my DSN’s defence, I was doing it in 2011, before this notification had happened :D
 
Inka said:
I just googled and found this from 2016:

www.england.nhs.uk

NHS England » Risk of severe harm and death due to withdrawing insulin from pen devices

A patient safety alert has been issued to warn NHS providers of the risk of severe harm and death if an insulin needle and syringe is used to administer insulin withdrawn directly from a pen device or replacement cartridge. Risk of severe harm and death due to withdrawing insulin from pen...
www.england.nhs.uk www.england.nhs.uk

So maybe it’s possible but not recommended?
Click to expand...
That looks to be due to the risk of overdosing as units on a syringe may well not be the same as insulin units dispensed by the pen and there is obviously concern over the strength of the insulin as well, but if you buy the same strength insulin in a pen as you want to use in the pump and transfer it from the pen into a pump, there should be no concern as the pump will be dispensing the same units as the pen.

Interestingly in that thread where this was being discussed, I said I wondered if there was a concern about the glass cartridges shattering with the increased pressure with there not being any air in the pen cartridge and I was assured that the pen cartridges are plastic. I did a bit of experimentation last time I had an empty cartridge to dispose of and I took a mini hacksaw to my cartridge and it turns out they have a plastic shrink wrapped coating but are actually glass underneath.
 
Inka said:
In vials though @AndBreathe ? When a friend visited on a round the world trip, he said there were only pens. Fortunately he just swapped back to pens temporarily but it would be good to be prepared as then the OP would have a chance to work out their pen doses in advance, if needed.
Click to expand...
As you'll appreciate Inka, my experiences of insulin are non existent. The OP's best bet is to join the forum I suggested for his Thai leg and ask in there.

There is a medical section to the forum, and a small number of medically qualified folks who post. They don't give medical advice but are excellent for signposting and giving insights to costs.

(Of course, every forum has odd folks, but generally it's an OK place.)
 
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