Insulin in the summer

[TypeZero.]

Hi everyone, I’m about 3 months into my T1D diagnosis so this is my first summer with diabetes.

I know insulin can be used up to a month outside the fridge however I’m so worried about the insulin losing its efficacy. The weather is getting hot and it’s only going to get hotter.

Do you guys use a Frio cooling wallet when going out in summer? When I’m at home should I just refrigerate my insulin? I know cold insulin shouldn’t be injected and it may hurt more but it’s better than having your insulin go off and personally it doesn’t hurt me at all.

My neighbour is telling me her sister carries her insulin in a thermos flask all the time which sounds very excessive and bulky.

I live in the UK so our summers can get up to 33 degrees Celsius and sometimes random heatwaves causes the temperature to be like 39 degrees Celsius. I usually go on a holiday along the Mediterranean and it’s usually 25-40 degrees constantly so I’m just a bit unsure on this.

 

[Jaylee]

Hi,

Yes invest in a Frio.. I've been all over with it in a back pack or "day pack."
I would recomend something to carry it in like a secure "webbing" pocket in the pack to allow moisture to evaporate from the Frio.

 

[Antje77]

In summer I keep my in use pen in a Frio (thanks for the reminder, I'll switch tomorrow), in winter I keep it in the pouch provided by NovoNordisk. I just keep the pen in the Frio when at home, why switch when going out?
I bought a Frio big enough to throw in a handful of pen needles as well, as I like to keep enough of them with my pen, just like I do with the winter pouch.

The Frio doesn't cool as much as a fridge, so no stinging cold insulin.

 

[MarkMunday]

You can get a Frio if you like, but you really don't need it. I don't use anything to keep insulin cool and I have never had a problem. Just don't leave it in direct sunlight and it will be fine. You also have much longer than one month after taking it out of the fridge. Test it and see what happens. You will soon know if insulin is losing potency. Your blood glucose numbers after meals will get higher.

 

[MODY3]

In your home it should be no problem if you have it in your bathroom and out of sun. When you go out , it is better to have it in the special boxes provided by the companies in which some ice plastic bag exists to keep it cool. The night before you put into the freezer the ice plastic bag and that's it.
The only thing you should afraid of is not the insulin but your body during heatwaves. You should be careful as during heatwaves in some people not all, insulin is absorbed faster. Your doctor should guide you. And do not forget , always with you fast energy glucose for the hypos and your blood measure meter .

 

[SiGreenwood72]

I worked in Oman for a bit where it got up to 50°C. I hand to stop using my pump because the heat killed the insulin (Apidra) within a day, and that was only from walking in and out of buildings, to the car etc.. everywhere else had air con.
I just swapped back to a Basal Bolus regime as the Basal kept my BG levels constant and I just ate back at the hotel.

 

[Benito1234]

I’ve been T1D for over a decade and never had any problems with insulin losing its potency, a lot of what the consultants, diabetic nurses and dieticians say is absolute nonsense. When I was diagnosed I wasn’t even taught how to carb count, they told me to treat it as if I was T2. Marks right insulin will last longer than a month out the fridge and I agree with the advice he gave to just avoid leaving it in direct sunlight for a prolonged period. If you go to a country where it reaches temperatures of up to 40 degrees C I would personally invest in a cooling pack cause I’ve never been somewhere that hot. Best of luck with your new diagnosis though, anything your not sure about your better off posting on here to find out from experienced diabetics. Advice from our healthcare is useless nine times out of ten

 

[Benito1234]

Also be very careful with carb counting in the summer, I find I need a lot less insulin when the weathers hot. I did know why but I’ve completely forgotten the reason!

 

[Xtrius]

Hi everyone, I’m about 3 months into my T1D diagnosis so this is my first summer with diabetes.

I know insulin can be used up to a month outside the fridge however I’m so worried about the insulin losing its efficacy. The weather is getting hot and it’s only going to get hotter.

Do you guys use a Frio cooling wallet when going out in summer? When I’m at home should I just refrigerate my insulin? I know cold insulin shouldn’t be injected and it may hurt more but it’s better than having your insulin go off and personally it doesn’t hurt me at all.

My neighbour is telling me her sister carries her insulin in a thermos flask all the time which sounds very excessive and bulky.

I live in the UK so our summers can get up to 33 degrees Celsius and sometimes random heatwaves causes the temperature to be like 39 degrees Celsius. I usually go on a holiday along the Mediterranean and it’s usually 25-40 degrees constantly so I’m just a bit unsure on this.

Dear Newcomer, you are at the beginning of your handling of the diabetes.
Taking your medication, just as you put it..., it's quite enough to do the necessary things. You can have a weekend trip or a two weeks holiday, insulin stands for what is meant. No worries! But don't push it further... I am talking as 35 years experienced diabetic.

 

[bgst]

I agree with Mark and Benito 100%. Having been diabetic for 29 years if I followed every “rule” that the doctors told me I would have lost my mind!

I was diagnosed in South Africa where summers are much hotter. For the first 6 months of my diabetes I used something to keep the insulin cool - refrigerator / cool bag etc. But that quickly became too much hassle for a young teenager. Stopped that and just carried it in my pocket or school bag. only had issues when I left my insulin in a hot car or the top of a bag in the middle of a sunny field. Like all proteins, if you heat it up too much it denatures and cooks, just like chicken! Other than that, I have always used up my insulin before there has been any diminishing effectiveness.

Stop reading here if you want - rest is a bit off track:
Benito also mentions medical care. Remember that few medical professionals are also diabetic (I’ve met none) so you should make sure you are empowered to learn about your condition and how it affects you. It will be different to how it affects others, and different to what the text book says. Even Dafne has some shortcomings (which I believe they continue to update). Best thing that I can suggest is to keep a really accurate diary to understand your sugar levels and why you went high / low (temperature / food / exercise / amount of insulin / work / stress / relationships / excitement / other emotions) and how your body responds when you correct it.

There are some things that will make a big difference in the control of your diabetes and others that make fairly minor differences. Focus on the things that make the big differences in the beginning and you are sure to take control of this well.

Good luck!

 

[TypeZero.]

Also be very careful with carb counting in the summer, I find I need a lot less insulin when the weathers hot. I did know why but I’ve completely forgotten the reason!

Yes I agree so much. I had three hypos yesterday but they were all very mild (above 3.2 mmol/L). I’m using the same insulin to carbohydrate ratio but the insulin is working faster than my food so I barely get a peak and then go down really quickly after food.

The heat is subsiding now and it appears to return back to its old rainy self. If for some reason the heat comes back then I’ll try bolusing after a meal to allow my blood glucose to rise a bit or I’ll change my ratio to 1:12.5

 

[Benito1234]

Yes I agree so much. I had three hypos yesterday but they were all very mild (above 3.2 mmol/L). I’m using the same insulin to carbohydrate ratio but the insulin is working faster than my food so I barely get a peak and then go down really quickly after food.

The heat is subsiding now and it appears to return back to its old rainy self. If for some reason the heat comes back then I’ll try bolusing after a meal to allow my blood glucose to rise a bit or I’ll change my ratio to 1:12.5

It’s quite shocking how much difference it makes! bgst hit the nail on the head with keeping records of how everything effects you, have they put you straight onto the Libre Sensor? The app for it is brilliant for this and it saves carrying so many things around with you all the time, it’s weird getting used to it at first if you’ve been using a bloods meter but definitely worth it! Until I started using one I never realised how much my levels peaked after meals before returning to normal and had to change the type of insulin I use to correct it.

 

[TypeZero.]

It’s quite shocking how much difference it makes! bgst hit the nail on the head with keeping records of how everything effects you, have they put you straight onto the Libre Sensor? The app for it is brilliant for this and it saves carrying so many things around with you all the time, it’s weird getting used to it at first if you’ve been using a bloods meter but definitely worth it! Until I started using one I never realised how much my levels peaked after meals before returning to normal and had to change the type of insulin I use to correct it.

I self-funded a Libre based on the recommendation of a family member. I am yet to have a Libre assessment by my endo but will probably be unsuccessful anyways because I manage my blood sugars too well.

I used to get so many hypos but after reducing my Lantus they have become a rare thing and only happened recently due to the combination of bolusing for high carb meals and the hot weather (I’m too lazy to split my dose).

I don’t know if it is because of Covid 19 or if it’s their usual procedure but I am yet to physically see my endo or my dietitian, I had like 2 phone calls, a few emails but nothing from my endo yet and I’m three months into my diagnosis. I have been given a phone number to call if I need any help but I only call them to ask if my C-peptide is back and she usually sounds really angry so I avoid.

 

[Silkroad77]

Hey folks,

I just wanted to ask if I am doing wrong, my insulin is always kept in the fridge when unopened, I have a frio wallet to take with me, when I go to work.

I always keep my insulin in the fridge after it's been used, and put it in a frio wallet for work.

I've noticed that when I keep it at room temperature and don't use the frio when I go to work (I always have it in the fridge during hot summer days, I live in the UK) after a few hours it always seems to lose its potency.
I need to give myself an extra 2-3 units, else my BG goes to 11 and above-and it stays like this 3-4 hours after a meal.

Because of the above I put it back in the fridge, is this where I am going wrong?

I do ensure that it's not kept in direct sunlight or near heat sources, or near cold sources.

 

[kev-w]

Hey folks,

I just wanted to ask if I am doing wrong, my insulin is always kept in the fridge when unopened, I have a frio wallet to take with me, when I go to work.

I always keep my insulin in the fridge after it's been used, and put it in a frio wallet for work.

I've noticed that when I keep it at room temperature and don't use the frio when I go to work (I always have it in the fridge during hot summer days, I live in the UK) after a few hours it always seems to lose its potency.
I need to give myself an extra 2-3 units, else my BG goes to 11 and above-and it stays like this 3-4 hours after a meal.

Because of the above I put it back in the fridge, is this where I am going wrong?

I do ensure that it's not kept in direct sunlight or near heat sources, or near cold sources.

I use a frio pouch for my 'in use' pen but don't put the pen back in the fridge once it's out, I leave the frio in the shade, I've had insulin spoil in the heat so never leave a pen 'out' even in our winter, my basal lives in the fridge tho even when in use.

 

[ert]

I find I need less background insulin in the heat. Not that I find the UK hot. I mostly mean when I last went back to Australia.

 

[Silkroad77]

I use a frio pouch for my 'in use' pen but don't put the pen back in the fridge once it's out, I leave the frio in the shade, I've had insulin spoil in the heat so never leave a pen 'out' even in our winter, my basal lives in the fridge tho even when in use.

I've no idea what is going on with my insulin.
I always leave my insulin in the shade when it's in the frio wallet, or when it's in use and not in the fridge.
It's just weird!