August 19, 2017

Preparedness for Diabetics

According to the American Diabetes Association there are 25.8 million people with diabetes and 79 million people with pre-diabetes; I am one of the 25.8 million. For a few different reasons, diabetes is also one the hardest diseases to prepare for in terms of a survival situation.

I have done plenty of research and I was able to find some good information, in bits and pieces, scattered across the web. I’ll try to put it all together, in hopes that I can help those with or those caring for someone with diabetes learn how to prepare for living with diabetes in a survival situation.

Disclaimer: I am not a doctor; all information provided is based off my own research and personal experience. I would advise you to use the information I give here as part of your research. Instead of covering what diabetes is, what insulin is or the different kinds of it, I am just going to cover the difficulties in term of preparedness.

Insulin is the chief reason this disease is difficult to prepare for. Many of the modern delivery systems (pens) make it very handy, but also cause a very short shelf life. Because of this, building a supply of insulin can be difficult. Insulin also has to be kept in temperatures less then 86F and above freezing at 32F.
Shelf Life

Here is a Chart for Insulin Storage and Expiration. The top chart is for the insulin pens, some of which have a shelf life of as little as 7-10 days, with the longest going as far as 28-30 days. The bottom chart is for bottled insulin; the left column is the one that is most interesting to me. It points out that insulin that is refrigerated properly (not frozen) will last until the expiration date on the package, which is often 1-2 years after purchase.
Keeping It Cool

As I write this, the Midwest is going through a nasty heat wave, with temps in the low 100’s and a heat index of around 115 F. Right now we’re sitting in an air-conditioned room (praise God). If there were an extended loss of power, it could take as little as a few hours or as long as a few days for the insulin to reach temperatures that make is unsafe for use.

Here are a few ideas that I have come across through my online travels and a fantastic product that could very well be a game changer in terms of preparing for diabetes in a survival situation.

One option is to buy a small fridge that runs on propane and a few cylinders of propane. Another option I saw was to store it in the toilet tank, as that water is often cooler then the air around it (that’s why toilets sweat). If you have no other good option, as a last ditch plan you could dig a hole a few feet deep as the temperature should be within limits.

The option that I like the most is one I discovered recently, FRIO Insulin Cooling Wallet

“The principle is simple. To activate the wallet, immerse it in cold water for 5-15 minutes. Crystals contained in the panels of the wallet then expand into a gel, which remains cool for several days — relying on the process of evaporation for cooling. Just towel dry the outside and it’s ready to go! To use it again, put the FRIO® back in water — it can be reactivated over and over again”….” FRIO® wallets keep insulin safe for a minimum of 45 hours”

I don’t own one of these, mostly because I’m not insulin dependent, but I might be buying one as a gift.

New insulin requires no refrigeration
Everything I know about this I have learned from this article. If their claims hold true, this discovery is huge. Here are just the first two paragraphs.

“A young Monash University chemist and her colleagues have successfully strengthened insulin’s chemical structure without affecting its activity. Their new insulin won’t require refrigeration.

They have just filed a series of patents with the support of their long term commercial partner ASX-listed Circadian Technologies who are now negotiating with pharma companies to start the long process of getting the invention out of the laboratory and into the homes of people with diabetes.”
What Kind of Insulin?

When it comes to building up a supply of insulin, while convenient, the pens’ short shelf life throws them out. This leaves the vial. As stated above, vials of insulin that are not punctured can last one to two years. If preparing for insulin dependent diabetes is a big concern, you may want to talk to your doctor about switching to this type of insulin.
Purchasing Insulin

I came across a chart that shows state-by-state requirements on whether you need a prescription for insulin or syringes. I want to preface what I am about to say with this: I am not making a brand recommendation; I am just passing along something I read while researching this article. That being said, on one of the forums I saw, there was a user that mentioned they have found that Walmart sells a generic brand of Novalin called Relion. They claimed that Novalin is normally $45+ a bottle while Relion is only $24. I checked a few on-line sources and found this to be true.

This insulin should be rotated just like anything else. Start out slow and increase your store of it as your budget and fridge space allow. I think it would be a good idea to have at least a 90 day supply on hand, but seeing as the shelf life is a year or two, you could get a year supply and just keep rotating it.
Can Syringes Be Reused?

I think we all know that sharing a syringe is a dangerous thing to do, but can you reuse it yourself and, if so, for how long? Here is a six page article called “A Look at the Reuse of Insulin Needles”. Here is a study done on “Multiple Use of Disposable Insulin Syringe-Needle Units”. Here are some of the details:

“Fourteen insulin-dependent diabetics were asked to use their insulin syringe-needle units three times in succession to determine the efficacy and safety of this practice. The mean duration of time each patient participated in the study was 20.4 weeks, and a total of 2,000 injections were taken. No signs of infections at the injection site were observed. Multiple use of disposable insulin syringe-needle units appears to be safe and cost-beneficial.”

While researching, I also found instructions on how to sharpen used syringes. However, I can’t find the site now and doing a search directly brings up way too many drug related sites.
Non-Insulin Dependent Diabetics

Doctors have told me that if your parent has diabetes you have a 50% chance of getting it and if their parent has it, you have a 75% chance. That being the case, I have also heard two doctors say most type two diabetics do not need to be diabetics. There is a real chance that with life style changes the diabetes can be controlled with diet and exercise or even completely reversed. I kick myself for not making the lifestyle changes that I have had to make because of the diabetes sooner. I fall into the 25% that is genetically predisposed but I am really trying to reverse it with diet and exercise.

I have heard doctors say that the medications for type 2 diabetics only help a little, that the real help comes from, you guessed it, diet and exercise. The plus here is that storing up a large supply of type II diabetes meds isn’t nearly as important as storing insulin for our type 1 brothers and sisters. I recommend that you have a store of type II diabetes medication on hand. I have also read that Cinnamon as well as Apple Cider Vinegar can aid in keeping blood sugar levels low.
Another Useful Site

Bay Medical has an article on their site that has some good information. It is called “Caring for Diabetes During A Disaster”. Some of their food storage items they selected could be improved, but over all it’s good info. They also mention a glucose tablet or hard candy, I think this is a must for any diabetic. I carry the tablets as part of my EDC (Every Day Carry).

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