You keep Insulin in the fridge so normal cold should not be a problem. Once open you can keep at room temperature indoors so only problem is if you have to carry it with you I carry it in a soft Glasses case with my glasses and If it is really cold it is on the inside of My jacket or trouser Pocket so in extreme cold it is warmed by my Body heat under my overcoat etc.
Not a problem here in Thailand or I suspect in the Caribbean. If Frozen goes cloudy I believe don't use.