jfortier

If so, what do you do with your insulin during a tour?

I thought I heard that insulin in the pens does not need refrigeration, but my doctor said today that all insulin needs to be refrigerated.

Believe it or not, he suggested buying new insulin every two days, throwing the old away. Maybe I'll throw him away

Thanks for any info.


Jon

clayface

I've been using insulin pens for nearly a decade and never kept the ones I'm using in the fridge. I take them in my day trips now (and week long tours years before) and have never had a single problem.

cyccommute 

My wife is a type I diabetic and hasn't refrigerated her in use insulin in years. She even has a pump which keeps it next to her body for 3 days. Your doctor seems to be a little behind the times, jfortier. That said, keeping it in a pannier in the sun all day might cause some degradation. You could get a Camelbak and pack it with ice like I do, then store the insulin next to the bladder. Camelbaks will stay cold most of the day.

jcbryan

J,
I'm a type 1 with a pump, no problems with heat killing the insulin. I keep it in the pocket of my Camelback knockoff, like cyccommute said. I have been interested a "Frio" pocket thing to keep it cool during the summer forays
I've had more of a problem keeping my glucose meter cool enough to work. Nothing seems to work in the SW Oklahoma or Oregon summer heat.
Just keep records of your training rides and set your rates to reflect your bG. With my pump, I just set its basal delivery waaaay down and carefully monitor after eating.
I've toured the Lewis and Clark and across several Southern states with no big problems. The biggest problem I've found getting insulin one time without a prescription. My home state of Oklahoma requires no Rx for it, Idaho does (did?).
Don't let it keep you from touring, the rewards outweigh the risks. Drop me a PM if I can help.

Best, John

jfortier

Well, I guess that settles it, I'll just take it along and keep it as cool as possible.

Thanks for the info.

jfortier

I just looked at the Frio, it looks like the cats meow as far as hot weather.

Anyone know of anybody who has a frio product?

vosyer

Type 1 - 32 years, toured extensively never refrigated my insulin, my issue is food consumption and regulating the insulin. On a long tour my insulin need is down 75%. The pump is a hassel on a long tour - so I use what is kwown as a poor mans insulin pump mixing Lantus and humalog - I still need to eat like crazy and I use dluted sports drinks alot - all this takes getting some used to - but it is manageable.

clayface

When you say "mixing" is this liretally!?
I also use one dose of Lantus per day and several of Humalog (which are reduced, or at times even skipped, depending on the readings of the meter).

BRUCE NORTHCUTT

On tour, I carry an insulated water bottle on the mule bag on the bike rack. I fill it about 1/3 with ice. Use a plastic sandwich wrap bag to hold the insulin bottles and pens from dropping down on the ice. It keeps it well within the temperature ranges recommended for insulin. Then I replace the ice throughout the day. This bike runs on insulin power. Go for it. Ultreya.

2003 FRANCE Clovis - First Merovingian King of France
https://www.clovis.crazyguyonabike.com

2004 GERMANY Hermann - Germanic warrior in 9 AD
https://www.hermann.crazyguyonabike.com

2005 SPAIN Dulcinea - The kitchen wench in Don Quixote
https://www.dulcinea.crazyguyonabike.com

2006 SPAIN Peregrino - A pilgrim
https://www.peregrino.crazyguyonabike.com

jfortier

Bruce's remark about keeping the insulin "within the temperature ranges recommended for insulin" prompted me to actually read the paperwork that comes in every vial.

My Humalog states "If refrigeration is not possible, the bottle of Humalog that you are currently using can be kept unrefrigerated , up to 28 days, as long as it is kept at room temperature (below 86F) and away from direct heat and sunlight"

My Humulin N states the same, except for the 28 days, it does not give a time frame.

So for my tour in May, I should be all set. any in the summer months I will have to employ one of the methods, Frio, insulated water bottle, etc, to keep it below 86.

Michel Gagnon

I don't know where you plan to tour, but using a wet towel on a bottle would keep it a few degrees cooler because of evaporative cooling. Of course, this means you have to carry enough water to "loose" some that way.

Magictofu

Or an old sock... that's what I usually do to keep my beverage cold and as long as you are cycling it stays cool. Have a look at the picture featured here.

DocF

I'm insulin dependent and on a pump. I use a Frio pump pouch when I'm outside in hot weather as insulin will deteriorate rapidly at 90 degree temperatures. When I'm travelling, by any means, my extra insulin is kept in a larger Frio pouch. They work!

https://www.friouk.com/

Good luck,
Doc

edp773

I was insulin dependant for 32.5 years before my transplant. I found a small styrofoam container that holds two bottles of insulin and two syringes. This works well in a wide mouth water bottle. This product is made by Medicool.inc, who makes the frio.

For shorter trips, I purchased a glucose meter bag that has a seperate compartment to hold insulin and came with small ice bags. There are six 1.5 inch square mini blue ice bags.

The frio sounds interesting, but I would test it on short trips first.

georgewietor

Good point. Mixing Lantus physically in the syringe with other insulins is not recommended and may be harmful. We used to get one or two patients in the hospital who insisted that they always did it this way. Maybe they died. Or used separate injections and lived happily ever after. LONG subject. Anyway, we often store our insulins at room temp once opened, for convenience, for relatively short spans of time.
Pmail if you need any info. George in Grand Rapids

DocF

A couple of important things here. The Frio has been well tested. At least one U.S. Army officer had served two tours in Iraq carrying his insulin supply in Frios and his pump in a Frio. Second, Medicool is a marketer; they do not make anything and the Frios are less expensive ordering direct from the manufacturer in the U.K.
Third, I, along with George, cannot emphasize enough that one cannot mix Lantus with any other insulin. The chemistry of this insulin is such that it will not mix with others. Read the directions and follow them. I oculd continue to rant, but this is a bicycle discussion board.

Good luck,
Doc

vosyer

First of all you are all wrong about mixing lantus with Humalog ! Doc - I don't know if that's your internet tag line or you are a physcian - but you are obviously not a endocronologist. The mixing of insulin has been a common practice for atleast 15 years - and was never been limited to just Lantus or Humulog. The purity of insulin has come a long way - I am a third generation diabetic guy - after 35,000 injections later I have the personal experiece to state you are incorrect. I have never let being a diabetic limit my life in anyway - just got back from 2 days of snowshoeing, single shot a day instead of 3 normally - and even that was to much. Again I say it again under normal circumstances insulin does not need to be refrigarated during your tour, the qualifier on this it that I rarely when it's over 90 degrees.

Food intake, and the right type of calories on board and when you take your shots is the tricky part about touring. The secret to start off with is test test test, but before you go on the road do some playing on your own with some short 200 to 300 mile trips. You need to be able to distinguish bonking and being low with to much insulin. Don't push yourself and at times you have to let your food catch up to your insulin - drink drink drink - you may have difficulty distinguishing dehydration from being low.
Cardinal rule - don't ride when you are low - accidents happen that way.

I am planning North to South 2007 and Trans-America 2008 . mw

DocF

I should preface this by saying I am not a doctor.

When I was using multiple daily injections, I was mixing Humalog and NPH. I, along with my two Type 1 diabetic daughters always mixed insulins except when using Lantus. Lantus is acid based and cannot be mixed with the alkaline based other insulins. Read the directions. Read the ADA website.


American Diabetes Association

Lantus

Quoted from the Lantus website: "DO NOT DILUTE OR MIX LANTUS® WITH ANY OTHER INSULIN OR SOLUTION. It will not work as intended, and you may lose blood sugar control, which could be serious. Do not change your insulin without talking with your doctor. The syringe must not contain any other medication or residue. You should not use Lantus® if you are allergic to insulin. Lantus® is a long-acting insulin you inject just once a day, at the same time each day."

As little as two hours in hot Florida sun on the beach can ruin a cartridge or bottle of Humalog. I know this from experience.

I don't let my diabetes, nor do my daughters, limit my life. I do what I want, when I want and don't use it as an excuse. I also do take reasonable precautions and I do understand my condition, probably better than does my health care team.

Doc

vosyer

Doc,

You scared the **** out of me with your comments - below is the lasest ADA research from their conference in June 2005. By the way Glargine is another name for Lantus.
mw

(ADA RESEACH San Diego)

In Mixing Rapid-acting Insulin Analogs with Insulin Glargine in Youth with Type 1 Diabetes, a team of researchers from the Barbara Davis Center in Denver reported on a six-month study of 55 kids with type 1 diabetes who mixed Lantus with a rapid acting analog (NovoLog or Humalog) and compared their blood sugar control with 55 kids who did not mix. Their data showed no significant differences in HbA1c; percentage of blood sugar readings in, above, or below a target range; nonsevere and severe hypoglycemia; or episodes of DKA. In summary, the ream concludes that mixing Lantus with a rapid acting analog had no effect on blood sugar control and doing so results in fewer daily injections, possibly offering kids an easier diabetes regimen.

Everyone still needs to test and have a schedule - for what ever it's worth I read 50 articles before finding the lastest information. Most of the information on the Internet was out dated and very little research had actually been done in a controled setting. Good information is very hard to find - so ask your physcian then make up your own mind. mw

rguysailing

I've been a diabetic for 45 years and go to Barbra Davis Center in Denver. When Lantus first came out they did not want you to mix the two. Now I think they are saying it is OK.

I don't know why anyone would want to not use a pump!!!! Much easer control your diabetes, at least you have some control over the insulin but not with shots.

Its very common to have an A1C of less than 6.2 and with shots it never or all most never gets that low unless you are verrrrrry carful...

Just my two cents

Michigander

My grandma died in her 70's as a fat insulin dependant diabetic. My grandpa from the other side of my family used to be insulin dependant, and then he got some help from this guy:

www.garynull.com

I will not pretend to be an expert, or even somebody who knows much of anything about diabetes, but what I can say for certain is that with a proper healthy diet and exersise, nobody needs insulin, and can live a longer and healthier life without it. My grandma died using insulin. My grandpa managed to straigten himself out and get off insulin. He now joggs every day, which is not bad for a 85 year old who smoked from age 15-60, and who has had diabetes for about the past 20 years. I have said it before on BF, and I will no doubt say it again. Anybody who has or would like to avoid health problems should take a good look at Gary Null. He is the worlds leading nutritionist, and among other things, the main reason Magic Johnson has done so well with HIV.