Travelling with insulin

[TCO98]

Hi all!

I was recently diagnosed with Type 1 back in April this year, bit of a shock but seem to have got a good understanding of most things now and my blood sugar levels are in a good place!

However, I'm going away for three months in September and wanted to ensure I am as prepared as I possible can be. A few Qs which I wondered if anybody could help me with:

- Going away for an extended period means I'll need to take a reasonable amount of unopened insulin. I've been advices this needs to be kept in the fridge, however, this won't be possible when I'm on the move a lot - are there any tips/recommendations for how to keep insulin cool when travelling? How important is this?

- Likewise, I have the glucogen injection pen kept in the fridge in case of hypos, would I need to take this with me? I imagine I can manage hypos without it, but if not, how would I keep this cool too?

- Do people have any other things I should consider when going away for a long period? Worried I might forget something!

Thanks very much!

 

[CEL95]

I'd be keen to know the answers too!

Thanks for asking 🙂

 

[helli]

Welcome to the forum @TCO98

In response to your questions

- Going away for an extended period means I'll need to take a reasonable amount of unopened insulin. I've been advices this needs to be kept in the fridge, however, this won't be possible when I'm on the move a lot - are there any tips/recommendations for how to keep insulin cool when travelling? How important is this?

Insulin is fine at room temperature for a total of around 30 days.
This is usually interpreted (and I have never had any issues doing so) as number of days out of the fridge when you take it out and put it back again and then take it out. So, if you have access to a reliable fridge (fridges in backpacker hostels may not be reliable, for example), you can put it in the fridge upon arrival.
When travelling somewhere very hot, I use a Frio wallet to keep the insulin cool. It will not be as cool as a fridge but they have always done me well.
When it is not so hot, I just make sure my clothes in my hand luggage insulate it. Yes, make sure you keep ALL your diabetes supplies in your hand luggage so you don't reach your destination days before your insulin.

- Likewise, I have the glucogen injection pen kept in the fridge in case of hypos, would I need to take this with me? I imagine I can manage hypos without it, but if not, how would I keep this cool too?

For me, this depends where I am going, If I am going to be in the middle of nowhere, I would take the glucagon pen (and not worry about it being out of the fridge) but, if I was staying/travelling in a city/town with easy access to healthcare, I wouldn't worry. To be honest, as I have not needed it in more than 20 years, I don't even have one in date.

 

[Bruce Stephens]

Insulin is fine at room temperature for a total of around 30 days.

That's probably a conservative recommendation, and modern insulins are probably a bit more robust than that.

See https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015385.pub2/full

 

[Inka]

Welcome @TCO98 🙂 I second the Frio recommendation from @helli Where will you be staying (eg hotel, house, tent, etc) as sometimes I’ve been able to borrow a fridge or cool box temporarily when travelling.

Are you travelling alone? I don’t know anyone who has glucagon now as they don’t seem to prescribe it anymore, but if you’re alone you’re better off making sure your medical ID and info is clear and obvious. Presuming you have a CGM, set your Low alarm higher to get warning of impending lows.

 

[rebrascora]

Hi and welcome.

How long are you going for? Will you be travelling with someone who knows how to use Glucagon? If not then I wouldn't take it and to be honest I am quite surprised you have been prescribed it unless you have some history of
needing assistance with severe hypos. I have never been prescribed one and now we have CGM we are much less likely to have a severe hypo requiring assistance. Glucagon is designed to be used by a third party when you have lost consciousness or are unable to swallow although even that latter situation, you can hold your hypo treatment in your mouth and it will absorb through the cells inside your mouth often quicker than it would if you swallowed it, if you are able to chew it well. Plus the mouth is closer to the brain than the stomach, so keeping your hypo treatment in your mouth and swilling it around even with a normal hypo is more effective than a couple of chews and swallowing it down which can be a temptation when you are panicking over a hypo.

If you are likely to be using an unreliable fridge then some people recommend keeping their spare insulin in a small vacuum flask to protect it from freezing is a good idea. It is unlikely that a fridge would be able to malfunction and cook it so less of a worry but freezing is not good and of course check the fridge regularly and perhaps keep a bottle of water with the flask so that you can easily see if it is freezing. If the fridge available is not secure ie. a communal fridge, I would be reluctant to leave my insulin there and just use Frio but obviously it depends how long you are going to be away as a regularly refreshed Frio pouch might not be able to keep it cool enough to last you 60 days or longer.

 

[TCO98]

Hi all,

Thanks for the advice! Sounds like I should be all good with a Frio as I'm unlikely to have regular access to a fridge.

Good to know re. the glucogon too, sounds like it's v rare I'll need it at all.

Thanks very much!

 

[everydayupsanddowns]

I’ve also used Frio eg when camping / at festivals, and they are surprisingly effective. Though I’ve not needed to use one for more than about a week at a time.

I think there may be some sort of modern USB powered mini-fridges / coolers especially designed for travellers, but I’ve never needed to look into them.

One of the tricky things with insulin is that it can’t get too cold. And you have to be quite careful with unknown fridges even in the UK in holiday accommodation. On a recent holiday someone had set the holiday accommodation fridge to 2° and I only realised the following day when getting milk out of the fridge was really cold. I put it back to 8° which was plenty cold enough, and fortunately my insulin was in the door so a long wat away from the coldest part.

But if insulin freezes, it can ruin it (which is another reason why you are told to never put it in hold luggage on an aircraft, in cases your luggage gets below zero at altitude).

Hope you have an amazing trip - sounds like quite an adventure!

 

[SimonP]

Coolbag + ice (in a plastic freezer bag with a spare clip, sourced from a bar or in the US from ice dispensers in the hotels, etc.)

The first time I flew to Australia, many many years ago, my parents asked the cabin crew to stick my insulin (which was in a metal box) in the fridge. When it came back it was full of water having been placed in a container of ice which had melted during the trip. Thankfully the insulin still worked. I therefore wonder what the actual freezing point of insulin is. Not a recommended approach mind you!

Anyway, I still use a coolbag + actual ice (which is generally easy to source) to keep my insulin as cold as possible in between fridges if I'm going to be away for an extended period of time, and even in the summer I rode my bike with a coolbag + icepacks to keep my extra insulin cool - I wasn't trying very hard though (I've got a cheap and cheerful Bluetooth logger from Amazon, which was interesting to use in the Airbnb fridge too to check what it was doing - not particularly cold basically, ~8C, as well as to see what happened during the ride) - it started at around 15C at 7am once I'd packed it in my bag and left and ended up at 24C when I made it back home just over 12 hours later. In this case I was using a pair of small ice packs, if I did it again and if I were actually concerned, I'd use actual ice and top it up on the way (e.g. on the ferry might have made sense.)

Have fun 🙂

 

[SimonP]

FWIW, as perhaps it's of vague interest, two screengrabs and a photo. Screengrabs are the ride out (note the ice packs had been in the freezer before going into the coolbag and into my handlebar bag) then ride back (no freezer in the French Airbnb.)

Re the coolbag and one of the ice packs - I don't particularly recommend this coolbag, though I'm also not looking to replace it as it's a reasonable size to fit thing in but not too large. The slight annoyance is that it has two sides, both of which are insulated on both the inside and outside (so like a terraced coolbag 😉), I placed the ice packs in once side and the insulin in the other, had I had more time to experiment I'd have put an ice pack in with the insulin too I think (but I was in a rush and the ice packs only turned up the day before I left.)

For travel with more space I have a larger sandwich/lunch coolbag with a fold down top and much more internal volume, so I can arrange insulin and ice with a barrier inbetween, but importantly IMO, they are both in the same chamber. I've not tested this with the sensor, I will do so when I dig it out in the name of science! 🙂