Hello all! I am traveling out of the country for the first time since being diagnosed with type 1 diabetes 3 months ago. I am going to Jordan for 1 week - leaving in approximately 3 weeks. I want to bring extra insulin pens with me but know that it needs to stay refrigerated or cool until opened. Does anyone know of any type of cool pack that I could purchase? Also, any other tips and advice for traveling to a third world country with diabetes would be very much appreciated.. I'm very nervous!
Take a look at Frio packs.
What sort of travel are you doing? Camping/hiking? Staying in locations with no AC for days at a time?
What pens are you using?
Humalog and Levemir pens
I will be doing some camping and hiking and occasionally staying in locations with no AC, but not for days at a time
I wouldn't get too worked up for such a short trip. Insulin stays fresh for at least 1 month at room temperature from what I recall. Just don't leave the insulin in the car in the blazing sun every day while you're out hiking for instance. If it is only one week I usually don't bother with any special treatment for the insulin, I just keep the backup doses in the luggage and the one I currently use in my backpack. If I stay in a place with a fridge I place the backup doses in there if possible and usually only if I stay a longer period of time, otherwise I am afraid I might leave those behind when I move to the next location :)
If you are worried about leaving the luggage in the car in the blazing sun for extended periods of time while sightseeing you could possibly consider getting a cold pack but I'll let others chime in since I never used any of those.
One thing to remember is to lower the doses of insulin if you're becoming more active than while @home, otherwise you'll get more frequent hypos :) A CGMS can help monitor your BS but you have to remember to lower the doses yourself...
I second the Frio vote; I love mine, because all you have to do is "recharge" it with water. I also second the comment that a one week trip shouldn't be too much trouble. If it is somewhere you will be returning to, you might want to check their pharmacies while you're there; many third world countries sell modern insulin over the counter (one pen, rather than a box). I lived in Guatemala for 2 years and that's how I got my insulin (cost of about $13-15 for a pen).
Could you tell me a little more about living in Guatemala? I was considering teaching at a school in Haiti for a year, but the director of the program I was applying with was concerned about a T1 living in a third world country for a year. I'd like to keep that option open for my future though. :)
Guatemala, actually, is where I was living when I figured out that I had been misdiagnosed and was, in fact, Type 1. It really didn't offer any insurmountable obstacles to me. As I said I could buy insulin otc. I did find an endo in Guatemala City who confirmed my Type 1 diagnosis, but only saw her the once. There is both a small population of ex-pats and a small population of wealthy Guatemalans, so in the city there was good medical care. Everything there was divided into public and private hospitals and the private were up to standards. I don't know that the same would be true in Haiti. But I did have to travel out of the country every 6 months for my visa so could get my needs met in the U.S. on a trip if necessary. Insulin, test strips, etc all available though I did have to switch meter brands.
Downsides: My insurance didn't cover "out of system pharmacies" at the same rate so though meds were much cheaper, my reimbursements were much lower. I never saw any glucose tablets (though I didn't hunt in the city which was an hour away). The pharmacies were always running out of things so I needed to plan enough ahead of time to account for waiting a couple days for a shipment. You didn't have as many choices. For example, Apidra was the only rapid insulin and Lantus the only long acting.
Living in another country, especially a third world country comes with it's own brand of bueracracy which is often more flexible than in the U.S., but less logical, if that makes sense. It can be frustrating, but for the experience, it's worth it. I think everyone should live in another country for awhile. It's an amazing experience!
If you are considering it and this is feasable I would consider a visit first. Then you can check out the pharmacies, doctors, hospitals, etc. Also check in the Thorntree website (a part of Lonely Planet). You can connect to other Americans and Europeans who may be living there and get the "inside scoop". Finally, check with your insurance re reimbursements, etc. One somewhat sneaky option is to get a year's prescriptions before you leave the U.S. Then see if there is a mail/courier service that sends to an address in the U.S. and then courier's it down. I did that for awhile. The courier service isn't cheap but allows you to get mail away scripts covered by your insurance.
I went to Ecuador for 10 days last January and I didn't do anything special for my insulin, I have vials to fill my pump, and I just packed them in my carry-on and left them in my bag, wrapped in cloth the entire week. Insulin can last for awhile outside refrigeration, but I did hear that if you have it outside of refrigeration for a bit, you shouldn't put it back into the cold afterwards.
It doesn't hurt the insulin at all to put it back into refrigeration, and can only help it.
There is no problem with putting it back in the fridge after its been out for a while (even days or weeks), in fact the longer you keep it cool the more effective it will stay (heat and time both increase degradation of insulin independent of each other).
I was told by a CDE when I was diagnosed that changing the temps too much can cause a quicker breakdown of the compounds. She said you should try to maintain a regular temperature for vials.
Just be sure to bring your "back up bag" extra pen(s), strips, monitor, battery etc. In case something happens to the one you are currently using. Also if you are traveling with companions you may want to stash an extra in one of their pieces of luggage. I do not worry about refrigeration for my pens when on a 1 week trip.