How to keep insulin cool during a power outage seems like a hypothetical case study, but it's not. Power outages in the USA happen every day. A few minutes without electricity shouldn't affect the insulin stored in your fridge. But what if the power is not back for several hours or even several days? How can you protect your stocks of insulin and keep them refrigerated if there's no more electricity? Let's get to that disaster preparedness scenario for people living with diabetes!
Table of Content:
- Why does insulin have to be refrigerated?
- How to keep insulin cool during a power outage?
- Keeping in-use insulin safe below 80°F
- Keeping stocks of insulin refrigerated with a portable insulin cooler
- Keeping stocks of insulin refrigerated in your unplugged fridge
- What to do if you could not refrigerate your insulin?
Why does insulin have to be refrigerated?
Insulin is a temperature-sensitive medication used for the treatment of both type 1 and type 2 diabetes. This synthetic human-like hormone allows diabetics to lower their blood glucose levels. It is very sensitive to extreme temperatures and temperature changes. Insulin that has frozen or gotten too warm is good for trash. Here's a little reminder of adequately storing your insulin and keep its potency to the maximum.
Insulin Storage Chart
As a general rule, unopened insulin vials, pens, or cartridges need to be stored at fridge temperature - between 36°F (2°C) and 46°F (8°C). Once opened and/or out of the fridge, they're stable for about a month at room temperature - between 56°F (13°C) and 80°F (26°C).
I say "about" because expiration dates and temperature recommendations slightly differ from one insulin to another. Always check the specific storage recommendations for the insulin you're using. They should appear on your medication notice or instruction sheet. Most insulins are safe for only 28 days once out of the fridge. But a few ones, such as Tresiba, Toujeo, Novolin, Levimir, and Humulin have more extended stability (up to 56 days for Tresiba).
No insulin resists high temperatures. Whatever insulin brand you are using, it should never be exposed to temperatures above 80°F (26°C) for long periods.
Here's an indicative storage temperature chart for the most commonly used insulins:
These numbers are indicative. Storage recommendations can vary whether insulin is stored in vials or pens. Always double-check on your insulin notice paper.
What happens if you don’t refrigerate your insulin
Insulin that's not stored refrigerated or protected from the heat when in use loses efficiency. Insulin is a protein dissolved in water. Like every protein, it spoils over time. It gets contaminated by bacteria and starts to break down. Just like putting your meat in the fridge helps keep it fresh longer, cold storage allows your insulin to stay effective longer.
There's no direct danger to inject insulin that has not been kept cold. It's not going to poison you nor to make you sick. It just won't work as well. Ultimately, if your injecting insulin that has gone bad, your blood sugar levels will rise and be very hard to manage.
The main risk is severe and prolonged hyperglycemia (high blood sugars). If unable to lower blood glucose, people with type 1 diabetes mainly risk diabetic ketoacidosis, leading to diabetic coma in the worst cases. In type 2 diabetes patients, the main complication is hyperosmolar hyperglycaemic state (HHS), a severe dehydration.
Keeping insulin cool and protected from the heat, whether you're at home, traveling, going to the beach, working in the sun, or victim of a power outage is essential. Your diabetes management depends on it.
How to Keep Insulin Cool During a Power Outage?
Blackout! Whether caused by an external event (storm, ice, hurricane, etc.) or a system failure, there's no more electricity at home. You have no idea when it will be back. This power outage leaves your fridge temporarily out of service. What will happen to your stocks of insulin that you've been keeping safe in the fridge? Are you going to lose thousands of dollars' worth of medication? Of course not! Here's what you can do to keep your insulin cool even during a power outage:
Keeping in-use Insulin Safe Below 80°F during Power Outage
Any insulin vials or pens that you'll be using within the next 28 days (or more depending on what insulin you're using) do not need to be refrigerated anymore.
All you have to do is make sure your in-use or soon-to-be in-use insulin is kept at room temperature - between 56°F (13°C) and 80°F (26°C) - and protected from high heat. Do not leave it in the sun nor near the stove. If the ambient temperature is over 80°F, you will need to use a medication cooler.
On its USB-lid function, 4AllFamily insulin cooler keeps your insulin safe below the threshold level of 80°F (26°C) when the outside temperature is 90°F (32°C). You can plug it into a portable power bank, a solar panel, or your car cigarette lighter.
When plugged into a solar panel, the insulin cooling bottle keeps your insulin safe at room temperature for as long as needed when the outside temperature is at 90°F (32°C).
Keeping Stocks of Insulin Refrigerated with a Portable Insulin Cooler:
It's a bit trickier. Your stocks of insulin need to be refrigerated between 36°F (2°C) and 46°F (8°C). The cold chain should not be interrupted for too long. During a power outage, your fridge is not working anymore, and it will stop refrigerating after a few hours only.
A performant insulin cooler is the most reliable solution to keep your insulin refrigerated without electricity. At 4AllFamily, we've dedicated the last two years to engineering our portable medication cooler.
When the outside temperature is as high as 104°F (40°C), the Biogel+USB function keeps insulin at fridge temperature for 48 hours and below 80°F (26°C) for 68 hours. It's the highest cooling performance on the market today.
Suppose you do not have a solar panel nor a portable power bank to use the USB-lid function. In that case, the Biogel-only cooling method still keeps your insulin at fridge temperature for up to 28 hours and at room temperature for up to 46 hours. Check out detailed performances and features. It can really save your insulin during an extended power outage!
Keeping Stocks of Insulin Refrigerated in Your Out-of-Power Fridge
If you don't have any portable insulin cooler, you can still keep your insulin refrigerated in your fridge even when out of power. It's just going to be more of a hassle.
If it's not too old, your refrigerator can keep the inside temperature for about 4 hours after losing power. You'll then need to put your insulin in the freezer compartment and keep the door closed. Your insulin should stay cold enough for another 48 hours. Make sure your it does not freeze, though. Insulin that has been frozen isn't safe for use anymore. Do not put your vials or pens in direct contact with the ice. Wrap them in a cloth or place them inside a small box. Unplug your freezer to prevent it from freezing your insulin when the power comes back.
According to the FDA, "50 pounds of dry ice should keep an 18 cubic foot fully stocked freezer cold for two days". Refilling your freezer with ice every 48 hours until power comes back is a great solution. If you don't have a freezer, you can follow the same steps with an ice chest or a lunch cooler bag instead.
What to do If you Could not Refrigerate your Insulin?
When the cold chain has been brutally interrupted, and you haven't been able to refrigerate your insulin for an extended time, you might have to throw away your stocks of insulin. But before such a waste, here's what you can save.
Use your insulin within 28-days
Remember that when unrefrigerated, your insulin is safe to be used within 28 days (more for some insulins). This recommendation comes directly from the drug manufacturers. It has to be taken seriously, but you can probably push for a few more days, and your insulin will be working just fine. There's obviously a safety margin here.
In any case, if you're experimenting unexplained high blood sugars and/or have the feeling your insulin is not working as usual, throw it away and get a new pen or vial.
How to tell if your insulin has gone bad?
If your insulin looks cloudy, has changed color, has clumps or "strings" in it, chances are it's gone bad. Throw it away. Do not use insulin that you suspect has gone bad.
Share your bits of advice and experiences too! Have you ever had to keep your insulin refrigerated during a power outage?