Two Letters Re: Diabetics in Disasters

Mr. Rawles,
I’d ike to describe a way to flash-freeze insulin for (theoretical) long-term storage.

I have had Type 1 Diabetes for 15 years.  I was raised in a house that always had food storage, extra fuel for heating, and tried to prepare as best we could.  After I was diagnosed, I realized that I would not be able to survive long if anything happened to the insulin supply chain.  Meir L. mentioned getting pens instead of vials to get more insulin per month.  I started out by asking my diabetes care provider to write my monthly prescription for a little more insulin than I used each month (which some physicians may or may not do, depending on what they’re comfortable with), and slowly built up a rotating stock of insulin.  In doing this I found I could only keep about a year’s supply on hand because I kept running into the expiration dates on the insulin vials.  I used to give away my almost expired insulin vials, however I don’t do this anymore. After 15 years of maintaining this practice, I now have a large supply of insulin.

I am now a Diabetic Nurse Practitioner (DNP) and I care for many patients with diabetes.  I know that conventional wisdom says that you can’t freeze insulin because it will change the shape of the protein molecules that make up insulin, thus rendering the insulin ineffective.  Two years ago I read the letter on your blog from November 30, 2011 entitled “7 Letters Re: Type 1 Diabetes – There Has to Be a Way to Prepare”.  With great interest I read the account of the man who found the old 1970 patent about flash freezing regular Insulin.  I read the patent from start to finish, and thought that it made sense.  If you freeze the insulin fast enough then the proteins don’t have time to change shape. 

I was excited to try this, because I wanted to see if it would work the same with new, modern insulins.  The insulin used in the 1970 patent was regular insulin, which is not used much any more.  Modern insulins are either rapid acting, long acting, or a mixture of both, and their chemical structures are slightly different from regular insulin.  I decided an experiment was in order.  Since I work in a Family Medicine clinic, I have access to liquid nitrogen that we use to freeze warts and other skin lesions.  I used the nitrogen (with my employers permission) to freeze the main brands of modern insulin.  I first froze a vial of Humalog (rapid acting) and a vial of Lantus (long acting), kept them frozen for about a month, then thawed them out and tried them on myself.  To my amazement and joy they worked just like they should.  My blood glucose reacted to these frozen-thawed insulins just like it does to new insulin.  I used up both vials completely and found that they stayed at full potency through the entire vial.  I then repeated the experiment with Novolog (rapid acting), Apidra (rapid acting) and Levemir (long acting), and each of them worked perfectly after being thawed. 

This news has expanded my ability to store insulin for the long term.  Instead of having just a 1-year supply on hand, I can now store up as much as I can save.  I should point out that I have not done a complete experiment.  My big assumption is that keeping insulin frozen will extend the expiration date.  One important note on my experiment:  I have not kept insulin frozen for 15 years, then thawed it out and tried it to see if it maintained potency.  What I have done is proven that you can flash freeze insulin and have it still function normally after being thawed.  The longest I have had a vial frozen and then used it successfully is one year.  That being said, I now freeze about half of the insulin I get, and use the other half in my rotating stock.  I no longer have to give any away.
One other option for stocking up on insulin is to buy regular insulin with cash.  It is a little known fact that regular insulin is not a prescription medication.  One can walk into any pharmacy and buy regular insulin like any OTC medication, you just have to pay cash for it.  At Wal-Mart one vial of 1000 units costs around $25.  

I hope this information is helpful for any other people with Type 1 Diabetes out there.  It has given me greater hope in preparing for an uncertain future. – Diabetic Nurse Practitioner

 

JWR,
Diabetes is a serious health problem and can be difficult to stock up on and prepare for a SHTF situation. I have have had diabetes for 18 years and luckily have not had any major problems. I wanted to make a few comments on the article Diabetics in Disasters, by Meir L. I personally have one of the Frio packs and they work very well, these would be great for a BOB as long as you can access a water source every two days. Also for a long term power outage/bug in situation a small portable propane/AC/12VDC powered cooler such as a  Porta Gaz portable gas refrigerator Porta Gaz 61211 Silver 3-Way Portable Gas Refrigerator by Porta Gaz, would be great compared to a regular propane powered refrigerator is more expensive, plus a small one you could take with you in your bug out vehicle if need be. 

(I am not a doctor and am not offering medical advice)

I personally have used open insulin that was three years past expiration and it still work properly. (They were refrigerated the entire time). I also would like to mention one other thing. I am on a tight budget and the common insulin such as Lantus (which I used to use) and others without insurance cost $100 plus. I recently found out that Wal-Mart sells insulin over the counter for $25 for a 10ml vial which is 1000 units. They offer as fast acting insulin, Novolin R, an intermediate insulin, Novolin N, and a pre-mix, Novolin 70/30. I will say that you should ask your doctor before you start using a different kind of insulin, but in my personal opinion, this would be something to add to your medical preps for a low cost; because when the SHTF, and insulin will be better than no insulin for people with diabetes. Brad O.