Home Diabetes Care Your Insulin Got Too Hot? Here’s Why It Might Be Wonderful

Your Insulin Got Too Hot? Here’s Why It Might Be Wonderful

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Your Insulin Got Too Hot? Here’s Why It Might Be Wonderful

Summer is coming on fast within the Northern Hemisphere and with it, the annual worry of individuals with insulin-treated diabetes: How do I keep my insulin cool once I’m out of the home?

Prior to now, we’ve reviewed a few of the many products designed to maintain vials and pens of insulin cool. And our Diabetes Each day forums are filled with opinions on the very best solution to keep insulin pumps cool when out in hot weather.

But plans are laid to waste, mistakes are made, and sometimes even the very best of us realize that we’ve let our insulin languish in the recent summer sun. After which we’re stuck wondering: Is my insulin still good? Should I throw it away? For those of us that struggle to pay for our insulin, these questions might be very stressful.

It’s my opinion that insulin is more resilient to heat than most individuals within the diabetes community realize. And I fear that an incredible deal of perfectly potent insulin gets thrown within the trash unnecessarily.

Let me be clear: I’m not a physician; I’m not a chemist. I’m only a guy. I’m not giving advice. This text has been reviewed by an authority, to be sure that I haven’t made any egregious amateur errors in interpreting the skilled literature, nevertheless it doesn’t count as expert advice.

In this text, I’ll share my considering. You’ll be able to draw your individual conclusions — or, even higher, discuss your thoughts along with your doctor.

The Official Word on Insulin Storage

Specifications differ barely from one kind of insulin to a different. But generally speaking, listed below are the rules for insulin storage as outlined by manufacturers:

  • Insulin ought to be refrigerated before it’s used.
  • Once opened, insulin might be stored at “room temperature.”
  • Once opened or faraway from refrigeration, insulin ought to be used inside 4 weeks (as much as six weeks for some types).
  • Insulin might be exposed to a maximum temperature of 77 degrees F (as much as 86 degrees for some types).

What happens in case your insulin exceeds the utmost temperature? The instructions that include my basal insulin put it clearly:

“If a vial has been frozen or overheated, throw it away.”

In order that signifies that if I’m going on a walk on a 90 degree day and neglect to bring some device to maintain my insulin cool, I should throw it within the trash. Is that reasonable?

The Dagahaley Refugee Camp Study

I’m aware of 1 especially compelling study on insulin’s effectiveness in very popular climates. In 2021, the journal PLOS ONE published the outcomes of a study facilitated by the legendary nonprofit Doctors Without Borders. This study was performed with a humanitarian imperative. If they might show that insulin was more resilient than the manufacturer’s specs suggested, it could significantly alleviate the burden faced by the various individuals with diabetes living in hot climates without access to refrigeration.

The study was conducted in Kenya’s Dagahaley refugee camp, a part of what often is the world’s largest refugee complex. Dagahaley is nearly exactly on the equator. It’s hot. The study’s scientists measured a day by day maximum temperature of 98.6 degrees F and an overnight low temperature of 77 degrees F. In line with the official guidelines, no insulin can be secure outside climate-controlled storage.

Unfortunately, fridges are scarce within the Dagahaley camp, and few diabetes patients are in a position to keep their insulin at home. As a substitute, they should travel to a treatment clinic multiple times per day so as to receive their life-giving injections. (Just consider, for a moment, how difficult that will make your day and your blood sugar management.)

The scientists desired to understand how much potency insulin retained when exposed to high temperatures equivalent to these. And so, researchers stored one batch of insulin in ambient conditions in Kenya and one other in an incubator programmed to oscillate between 77 degrees F and 98.6 degrees F. A 3rd batch was kept cool as a control.

I’ll cut to the chase: After 4 weeks, all of those insulins were fully and equally potent. The insulin that warmed up to just about 100 degrees F — not only once, but each day for a month — was just nice!

Just wait, it gets even higher. Impressed by the above results, the researchers prolonged the experiment to a complete of 12 weeks. The result held: The entire insulins, even those exposed to sweltering temperatures day by day, were still potent. The insulin that had been warmed to just about 100 degrees F a complete of 84 times, and never once allowed to chill right down to room temperature, remained exactly as effective because it was the day that it was manufactured.

It does appear that regular overnight cooling was critical to preserving insulin’s potency. Further experimentation showed that insulins stored repeatedly at 87.8 degrees F or higher “degrade rapidly and now not conform with [pharmaceutical standards] after 4 weeks.” There actually are places on this planet where the overnight temperature is hot enough to degrade insulin, but even in these conditions it could be days or perhaps weeks before insulin loses potency.

What about even higher temperatures? The study was not designed to guage them, but there’s one tidbit that may prove interesting. The researchers wanted a “negative control” of heat-degraded insulin to make use of for his or her study, in order that they cooked a batch of insulin for half-hour at 176 degrees F. This insulin did lose potency — but shockingly little: “a decrease in insulin content of 9 to 14%.” If I’m reading the study properly, the scientists decided that a 30-minute exposure to 176 degrees F was actually not hot enough to sufficiently denature the insulin, and in order that they needed to cook some more insulin at a fair higher temperature, 239 degrees F.

The researchers hope that their work proves that individuals in tropical environments without access to refrigeration can keep their insulin at home. It wasn’t their intention, nevertheless it may additionally prove that the insulin you are taking on a summer camping trip shall be similarly secure.

More Data on Insulin Durability

This was not, by any means, the primary academic study on insulin’s potency after its exposure to higher temperatures.

  • A study from way back in 1972 found that insulin retained sufficient potency for “10 years at 15 degrees C [59 degrees F], 20 months at 25 degrees C [77° F], three months at 35 degrees C [95° F], or 10 days at 45 degrees C [113 degrees F].”
  • A 2009 study proposed that insulin stored at 25 degrees C (77 degrees F) had an estimated shelf lifetime of 199 days.
  • A 2012 study found that insulin in a pump can retain potency for 14 days when exposed to a continuous temperature of 37 degrees C (98.6 degrees F).

None of those studies is definitive, and none of them tells us exactly what we wish to learn about insulin left in a hot automotive for a number of hours. It’s also price noting that insulin formulations have modified over time and can change again. The older studies could also be of limited relevance today.

Nevertheless, the outcomes are striking. In controlled experiments, insulin consistently outperforms the manufacturer’s specifications for each shelf life and resiliency to heat. I didn’t cherry-pick the above studies; I used to be unable to search out any that proved otherwise.

Takeaways

To reiterate, I’m not giving anybody advice. I’m just explaining my amateur understanding of the subject. And it’s price noting that we don’t have much evidence regarding the potency of insulin exposed to prolonged extreme temperatures.

A automotive parked within the sun on a hot day can get very popular, much hotter than 100 degrees F. In the event you were to go away your insulin in a closed automotive within the Southwestern United States on a sunny summer’s day, for instance, it could easily be exposed to hours of temperatures exceeding 120 degrees F. Not one of the studies above make clear how long insulin might retain potency in such conditions.

But I feel an image is emerging here — that insulin is more durable than the manufacturers ever suggest it’s, and that it may well be expected to retain potency in most nonextreme situations. It’s unsurprising that pharmaceutical businesses need to err on the side of caution, but given global problems with insulin access and scarcity, things is likely to be higher if we had a more realistic understanding of insulin-handling parameters.

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