Type 1 - Connect

Hi fellow type 1

I have recently moved to using a TSlim control iq pump. I will be travelling overseas in May for 6 weeks UK and Singapore. I am seeking advice about the Frio cool bags for insulin. I have previously used these for insulin pens when travelling. My question is can they be used for 10 ml insulin vials also ? Or what do any of you use for international long haul flights? Appreciate any feedback.

I have used the Frio for 20 years and when I got the first ones, they advertised it with both pens and vials. 

I have travelled all over the world including numerous intercontinental long haul flights using Frio cooling and have never had a problem with insulin.. 

Hi fellow type 1

I have recently moved to using a TSlim control iq pump. I will be travelling overseas in May for 6 weeks UK and Singapore. I am seeking advice about the Frio cool bags for insulin. I have previously used these for insulin pens when travelling. My question is can they be used for 10 ml insulin vials also ? Or what do any of you use for international long haul flights? Appreciate any feedback.

A study recently in "medicalnewstoday.com "where they did an extensive study, they found insulin does not need to be refrigerated. Has that been confirmed?

I have used the Frio for 20 years and when I got the first ones, they advertised it with both pens and vials. 

I have travelled all over the world including numerous intercontinental long haul flights using Frio cooling and have never had a problem with insulin.. 

Hi fellow type 1

I have recently moved to using a TSlim control iq pump. I will be travelling overseas in May for 6 weeks UK and Singapore. I am seeking advice about the Frio cool bags for insulin. I have previously used these for insulin pens when travelling. My question is can they be used for 10 ml insulin vials also ? Or what do any of you use for international long haul flights? Appreciate any feedback.

Not sure if access is restricted outside research organisations, but I just found a Cochrane review of something like 22 papers and additional data from manufacturers showing no clinically significant loss of viability for insulin stored at high temperatures for several months. Even when activity does begin to decline, it's in the range of a couple of % decline, not massive loss of function.

"The review found that it is possible to store unopened vials and cartridges of specific types of human insulin at temperatures of up to 25°C for a maximum of six months, and up to 37°C for a maximum of two months, without any clinically relevant loss of insulin activity. Data from one study showed no loss of insulin activity for specific insulin types when stored in oscillating ambient temperatures of between 25°C and 37°C for up to three months. This fluctuation resembles the day-night temperature cycles experienced in tropical countries." From: https://www.cochrane.org/news/human-insulin-less-temperature-sensitive-previously-thought

A more detailed summary of the same review says "In the clinical study, authors investigated insulin stored for six weeks in an unglazed clay pot or in a refrigerator. Outside temperatures were between 34 °C and 43 °C, and clay pot temperatures were between 25 °C and 27 °C. The study authors only reported on the glucose level in the blood of eight healthy volunteers after injecting clay‐pot‐stored insulin or refrigerator‐stored insulin. Insulin in the clay pot had similar glucose‐lowering activity to insulin in a refrigerator.

Laboratory studies on prefilled syringes stored at 4 °C to 23 °C for up to 28 days showed no clinically relevant loss of insulin activity.

Nine laboratory studies examined unopened vials and cartridges. In studies with no clinically relevant loss of insulin activity, temperatures ranged between 28.9 °C and 37 °C for up to four months. Two studies reported a more pronounced loss of insulin activity after one week to 28 days at 37 °C. Four studies examined opened vials and cartridges at up to 37 °C for up to 12 weeks, and showed no clinically relevant reduction in insulin activity.

Two laboratory studies analysed storage conditions for shifting temperatures between 25 °C and 37 °C up to 12 weeks, resembling daytime and night‐time fluctuations in tropical countries. There was no loss of insulin activity for short‐acting, intermediate‐acting and mixed insulin (a combination of short‐acting and intermediate‐acting human insulin).

Four laboratory studies, two on vials, one of them on opened vials, and two on prefilled syringes, investigated sterility and reported no bacterial contamination.

Four manufacturers provided previously unpublished temperature and storage conditions data. If unopened human insulin vials or cartridges were stored at up to 25 °C for a maximum of six months or at up to 37 °C for a maximum of two months, only small amounts of insulin activity were lost. " From: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015385.pub2/full

So basically, TL;DR version, even if you're travelling for a couple of months in tropical regions with no refrigerator access, you should be fine. Ideally, if possible, store your insulin in the fridge, but don't stress if you can't. Even when loss of activity was noted in the studies, for most cases the loss was in the zone of less than 5% loss - for most applications, this probably wouldn't even add up to 1 extra unit needing to be injected!

A study recently in "medicalnewstoday.com "where they did an extensive study, they found insulin does not need to be refrigerated. Has that been confirmed?

I have used the Frio for 20 years and when I got the first ones, they advertised it with both pens and vials. 

I have travelled all over the world including numerous intercontinental long haul flights using Frio cooling and have never had a problem with insulin.. 

Hi fellow type 1

I have recently moved to using a TSlim control iq pump. I will be travelling overseas in May for 6 weeks UK and Singapore. I am seeking advice about the Frio cool bags for insulin. I have previously used these for insulin pens when travelling. My question is can they be used for 10 ml insulin vials also ? Or what do any of you use for international long haul flights? Appreciate any feedback.

Not sure if access is restricted outside research organisations, but I just found a Cochrane review of something like 22 papers and additional data from manufacturers showing no clinically significant loss of viability for insulin stored at high temperatures for several months. Even when activity does begin to decline, it's in the range of a couple of % decline, not massive loss of function.

"The review found that it is possible to store unopened vials and cartridges of specific types of human insulin at temperatures of up to 25°C for a maximum of six months, and up to 37°C for a maximum of two months, without any clinically relevant loss of insulin activity. Data from one study showed no loss of insulin activity for specific insulin types when stored in oscillating ambient temperatures of between 25°C and 37°C for up to three months. This fluctuation resembles the day-night temperature cycles experienced in tropical countries." From: https://www.cochrane.org/news/human-insulin-less-temperature-sensitive-previously-thought

A more detailed summary of the same review says "In the clinical study, authors investigated insulin stored for six weeks in an unglazed clay pot or in a refrigerator. Outside temperatures were between 34 °C and 43 °C, and clay pot temperatures were between 25 °C and 27 °C. The study authors only reported on the glucose level in the blood of eight healthy volunteers after injecting clay‐pot‐stored insulin or refrigerator‐stored insulin. Insulin in the clay pot had similar glucose‐lowering activity to insulin in a refrigerator.

Laboratory studies on prefilled syringes stored at 4 °C to 23 °C for up to 28 days showed no clinically relevant loss of insulin activity.

Nine laboratory studies examined unopened vials and cartridges. In studies with no clinically relevant loss of insulin activity, temperatures ranged between 28.9 °C and 37 °C for up to four months. Two studies reported a more pronounced loss of insulin activity after one week to 28 days at 37 °C. Four studies examined opened vials and cartridges at up to 37 °C for up to 12 weeks, and showed no clinically relevant reduction in insulin activity.

Two laboratory studies analysed storage conditions for shifting temperatures between 25 °C and 37 °C up to 12 weeks, resembling daytime and night‐time fluctuations in tropical countries. There was no loss of insulin activity for short‐acting, intermediate‐acting and mixed insulin (a combination of short‐acting and intermediate‐acting human insulin).

Four laboratory studies, two on vials, one of them on opened vials, and two on prefilled syringes, investigated sterility and reported no bacterial contamination.

Four manufacturers provided previously unpublished temperature and storage conditions data. If unopened human insulin vials or cartridges were stored at up to 25 °C for a maximum of six months or at up to 37 °C for a maximum of two months, only small amounts of insulin activity were lost. " From: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015385.pub2/full

So basically, TL;DR version, even if you're travelling for a couple of months in tropical regions with no refrigerator access, you should be fine. Ideally, if possible, store your insulin in the fridge, but don't stress if you can't. Even when loss of activity was noted in the studies, for most cases the loss was in the zone of less than 5% loss - for most applications, this probably wouldn't even add up to 1 extra unit needing to be injected!

A study recently in "medicalnewstoday.com "where they did an extensive study, they found insulin does not need to be refrigerated. Has that been confirmed?

I have used the Frio for 20 years and when I got the first ones, they advertised it with both pens and vials. 

I have travelled all over the world including numerous intercontinental long haul flights using Frio cooling and have never had a problem with insulin.. 

Hi fellow type 1

I have recently moved to using a TSlim control iq pump. I will be travelling overseas in May for 6 weeks UK and Singapore. I am seeking advice about the Frio cool bags for insulin. I have previously used these for insulin pens when travelling. My question is can they be used for 10 ml insulin vials also ? Or what do any of you use for international long haul flights? Appreciate any feedback.

Not sure if access is restricted outside research organisations, but I just found a Cochrane review of something like 22 papers and additional data from manufacturers showing no clinically significant loss of viability for insulin stored at high temperatures for several months. Even when activity does begin to decline, it's in the range of a couple of % decline, not massive loss of function.

"The review found that it is possible to store unopened vials and cartridges of specific types of human insulin at temperatures of up to 25°C for a maximum of six months, and up to 37°C for a maximum of two months, without any clinically relevant loss of insulin activity. Data from one study showed no loss of insulin activity for specific insulin types when stored in oscillating ambient temperatures of between 25°C and 37°C for up to three months. This fluctuation resembles the day-night temperature cycles experienced in tropical countries." From: https://www.cochrane.org/news/human-insulin-less-temperature-sensitive-previously-thought

A more detailed summary of the same review says "In the clinical study, authors investigated insulin stored for six weeks in an unglazed clay pot or in a refrigerator. Outside temperatures were between 34 °C and 43 °C, and clay pot temperatures were between 25 °C and 27 °C. The study authors only reported on the glucose level in the blood of eight healthy volunteers after injecting clay‐pot‐stored insulin or refrigerator‐stored insulin. Insulin in the clay pot had similar glucose‐lowering activity to insulin in a refrigerator.

Laboratory studies on prefilled syringes stored at 4 °C to 23 °C for up to 28 days showed no clinically relevant loss of insulin activity.

Nine laboratory studies examined unopened vials and cartridges. In studies with no clinically relevant loss of insulin activity, temperatures ranged between 28.9 °C and 37 °C for up to four months. Two studies reported a more pronounced loss of insulin activity after one week to 28 days at 37 °C. Four studies examined opened vials and cartridges at up to 37 °C for up to 12 weeks, and showed no clinically relevant reduction in insulin activity.

Two laboratory studies analysed storage conditions for shifting temperatures between 25 °C and 37 °C up to 12 weeks, resembling daytime and night‐time fluctuations in tropical countries. There was no loss of insulin activity for short‐acting, intermediate‐acting and mixed insulin (a combination of short‐acting and intermediate‐acting human insulin).

Four laboratory studies, two on vials, one of them on opened vials, and two on prefilled syringes, investigated sterility and reported no bacterial contamination.

Four manufacturers provided previously unpublished temperature and storage conditions data. If unopened human insulin vials or cartridges were stored at up to 25 °C for a maximum of six months or at up to 37 °C for a maximum of two months, only small amounts of insulin activity were lost. " From: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015385.pub2/full

So basically, TL;DR version, even if you're travelling for a couple of months in tropical regions with no refrigerator access, you should be fine. Ideally, if possible, store your insulin in the fridge, but don't stress if you can't. Even when loss of activity was noted in the studies, for most cases the loss was in the zone of less than 5% loss - for most applications, this probably wouldn't even add up to 1 extra unit needing to be injected!

A study recently in "medicalnewstoday.com "where they did an extensive study, they found insulin does not need to be refrigerated. Has that been confirmed?

I have used the Frio for 20 years and when I got the first ones, they advertised it with both pens and vials. 

I have travelled all over the world including numerous intercontinental long haul flights using Frio cooling and have never had a problem with insulin.. 

Hi fellow type 1

I have recently moved to using a TSlim control iq pump. I will be travelling overseas in May for 6 weeks UK and Singapore. I am seeking advice about the Frio cool bags for insulin. I have previously used these for insulin pens when travelling. My question is can they be used for 10 ml insulin vials also ? Or what do any of you use for international long haul flights? Appreciate any feedback.

Hi fellow type 1

I have recently moved to using a TSlim control iq pump. I will be travelling overseas in May for 6 weeks UK and Singapore. I am seeking advice about the Frio cool bags for insulin. I have previously used these for insulin pens when travelling. My question is can they be used for 10 ml insulin vials also ? Or what do any of you use for international long haul flights? Appreciate any feedback.

Hi fellow type 1

I have recently moved to using a TSlim control iq pump. I will be travelling overseas in May for 6 weeks UK and Singapore. I am seeking advice about the Frio cool bags for insulin. I have previously used these for insulin pens when travelling. My question is can they be used for 10 ml insulin vials also ? Or what do any of you use for international long haul flights? Appreciate any feedback.