Hello Jim, I am with diabetes during 58 years and rested in Crimea, Georgia and never had problems without any Frio. But in Palermo I am really frightened how to survive. Everything depends also on the type of walls. I was at the conference in Milan in 2014, it was hot outside and a room temperature without sny conditioner inside. Here the temperature inside becomes very quickly as outside and I do not know what I may do to save at least strips and sensors.
Dear Pam, which temperature was in tve plsce where your insulin snd strips were kept? My collaborator lived in Texas, he said they have 40 degrees C, but “I have conditioner st home, I have confitioner in the csr, in the shop and at eork. So I do not feel the hear at all”. I have serious concerns in Palermo, I am afraid that it may be 40 here as last year was. I cannot change glat, I with unususl difficulty flund sny flat at all.
Hi @Elenasa1 from here in in the US )Washington, DC). We have some engineers(?) and technical professionals on the forum (@joe ?) who might be able to give you some specific advice, but I recall when I used to get my insulin via mail order it arrived in a styrofoam package with cooling packs inside and packaging around the insulin to keep it from touching them while staying chilled.
I’m wondering if you could make some sort of insulated container - a styrofoam box (not very portable, I know) or even use a small cooler, with chilled packs or even cold water inside. Put items that might get wet such as strips or sensors, in a baggie (maybe double) and use some type of holder for the insulin to keep it from coming in direct contact with the cold packs, just in case. I use these to protect my insulin from falls (they are not designed for cooling) - I got them from Etsy dot com, a crafts website in the US but you may be able to find something similar closer to where you are.
Wishing you all the best.
Hello Alex. You have the most valuable experience. But I am also agree with Paul that effects of heating are cumulative. Everything has become to spoil in Palermo. I cannot keep conditioner switched on all time because it will cost me thousands of euros, which I do not have. I sleep with a conditioner, it is very difficult without it. And switch on both conditioners during a day because my refrigerstors also suffer. So the main your advice is to keep insulin and strips as deap as possdible, among the clothes, is it? At home I kept strips in the secretary of the locker, it was the coolest place in the apartment.
Hello @Elenasa1 3 to 25C is absolutely fine for insulin. It will not spoil at these temperatures. Below 10 it might get “bubbles” you will see it when it warms up.
30 is a little warm but, for a 10mL vial, 30C is about the limit for a month of use. At 37c and the insulin will only last about 5 days but it is fine to take out small amounts you intend to use in 5 days.
If it is 37 during the day it is very hot, I recommend to use the refrigerator for your main supplies, and only remove what you will use in 5 days. Good luck 
my grandfather grew up in Palermo.
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@joe i remembered you have technical expertise (to say that tree least) but never in my wildest dreams would I have imagined you had family from where @Elenasa1 is staying. You never get know what treasures you’ll find on the forum!
Elena, regarding your sensor coming off due to sweat, have you tried patches? I use ones called Simpatch which I get on Amazon, and find them very effective. It can get up to the mid- and occasionally high 90s here (the 30s where you are) and rarely do mine come off.
I was diagnosed in 1963 and growing up we kept my insulin in the fridge until it was time to take my shot. People usually let their insulin stay at room temp now (which is generally not as extreme as where you are) but it can still be done cold. It might be a bit more painful, and I think I had to more bubbles, but it’s do-able.
thanks Dorie, yes it is a small world. One of the things I do for work is keep medications (at our factories and research facilities) at the proper temperature. Insulin is among the toughest “keep refrigerated” type product on the market, It can take a lot of punishment before it deteriorates compared to other medicine.
An additional device I bought is a water bottle looking tube with a pack in it that freezes at fridge temperatures. In 80deg F temp it will keep insulin at 38deg F for 72 hours. It is TSA approved as long as the pack is in a solid state, aka “frozen” from your fridge.
@gmershon, engineered PCM (phase change materials) are designed to “freeze” (actually change from liquid to solid) at a predetermined temperature. I don’t usually pay a lot of attention to PCM with a freezing temperature of about 3 to 4C but it would be perfect for insulin. My pharmacy ships with frozen gel (-10C) and I suspect they sometimes inadvertently freeze my insulin. Shipping and storage of temperature sensitive materials is how I pay my bills!
Thank you very much to all for your answers. The main my concerns are strips and sensors now. There are persons who live in tropical countries or who were more or less long period in tropical countries, in conditions where the temperature in their flat is more than 30 all day long and humidity is high. Now I have 32-33 C, also humidity is more than 70 % and I do not know how I may cope with this. I receive in Italy strips and sensors for a half of year. The problem is to store them. I see as all my monitoring tools have begun to spoil. I myself have diabetes from 1966, I always could cope with situation. I never keep strips in refrigerator. Yesterday I put all my strips in the thermal bag and put that bag in the refrigerator. I know that it is not recommended to keeo strips in refrigerator, as well as it is not recommendetd to store strips at more than 30 C. I do not understand well why. After 24 hours I found that all strips in the box with Russian strips Satelite, which are packed individually, died. They show now 1-2 mM, while the same strips, which were not in refrigerator show glucose normally. German and italian strips seems did not fail. But I do not know surely how they fail, for example my Ukrainisn strips of low quality showed the same value ( for example 13.2) at any level of glucose in the blood when they failed. Did anybody from you keep strips in refrigerator? Why is this not recommended, because of high humidity or changes of the temperature from high to low? I do not know what is worse , to keep strips at temperature more than 30 C or keep them in refrigerator. Is there any third way? I can decrease the temperature in the room where my strips are situated only for the time when conditioner is switched on, then it very quickly returns to previous high levels, probably because of the type of the building. My friend with diabetes lives in a good stone building and she does not have these problems. What do you advise once more? Is anybody who lived in hot countries during a long time?
Thanks, I use patches from the day when my Freestyle Libre 3 sensor failed. I do not know the reason exacrly, it could be swrating. But Freestyle libre 2 senslrs which I receive in Italy fsiled by other reasons, which I do not understand. Maybe everything is of bad quality, and reader, and strips. I cannot calibrate reader by strips, it gives lower values all time. Or may be they influenced by high temperature, humidity. I put know sensors to the thermal bag with a small cooler, but i am not sure that it will change anything.
Elena @Elenasa1, I have lived in subtropical Florida, USA for 25 years and didn’t have problems with insulin, strips, or sensors - and I spend a significant time outside every day. The outside temperature right now in the shade is 33.7 and that is the frequent temp for 4 months of the year, and humidity is rarely lower than the 75 - 90% range.
Up until I was in my 80s, I would spend about 6 - 7 hours three days every day bike riding, mostly in the sun where temps would ge significantly higher than the shade 34C. I’m not aware if the insulin in my pump reservoir deteriorating, and the strips with meter packed in my black bike-bag didn’t fail. During that period, I was using Contour Next strips and One Touch Verio strips.
The only “failure” I’ve experienced is with over-heated BGM when left in a parked car - I’d need to let the meter cool before getting a good reading. A similar thing would happen to my meter when cross-country skiing - the meter would not work below some certain temperature. I’ve only been using CGM for 7 years and the Florida heat doesn’t appear to hurt them - I do take a 5-6 mile walk in the heat most days as well as sitting outside reading for a few hours.
Elena @Elenasa1 I have not used any of the Libre sensors; I’ve used Dexcom G5, G6, and currntly G7. With the G5, I needed to use a skin-prep to prevent my constant sweating from knocking them of. I used "Smith & Nephew IV Prep, successfully. The G6 was wonderful, only two lost to being knocked off during 4 years, and never needed an over patch - I still have an unopened package. My “secret” for keeping them on tightly: before applying, I wash the area with clear water [getting off any shampoo resido and any gell wash and then vigorously rub dry with a course towel - removing all layers of dead or ageing skin. I do the same now with the G7, but the overpatch supplied with each sensor MUST be put on tightly - one failure so far in six months.
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Brainstorming here. While it is expensive to run your a/c system throughout the day there are small units that fit on a tabletop and cool the immediate area or a whole room. Maybe something like this would work - you could keep it and your supplies in your bathroom as those rooms are smaller and easier to keep cool, although some find they work well in larger spaces.
To be honest I’ve never used one of these myself but I do have a tabletop fan right by my favorite spot and it keeps me comfortable even when it’s in the 90s (30s where you are) and our a/c is set at 78 (25) so something like this might be worth trying.
The maximum quantity we can get here is a 3 month supply - is it possible for you to get smaller orders at least until you find a method that works?
Hi Elena, I just want to say that your strength and objective approach regarding our disorder is remarkable. What you must go through to even get supplies is more challenging than I could imagine. You are straightforward and driven to accomplish what you need to. I am inspired. You seem so exotic, and undeterred by every day control considerations. I am an old timer as well, but what I have to do to survive is nothing close to what you must be going through. But what makes you special is you approach this as if it’s the only choice you have. I would like to talk with you more just to hear your stories not about diabetes, but about what you’re doing and where you live. Give me your review of the scenery! John
Hi Elenasa,
Oh my, Palermo gets hot! I was there for about a week. My family has a sailboat and we sailed a lot in Spain, France, Italy, and Croatia in the summers. In hot weather I keep all my temperature sensitive supplies — insulin, blood sugar strips, and ketone strips in the fridge when I was storing them. I never noticed any issues with my strips after being in the fridge at about 2-5 degrees Celsius. But perhaps your strips are different. You could test one bottle in the fridge and see what happens.
If you’re worried about the strips in the fridge you could wrap them in a towel or something insulating and place them in the pockets on the door of the fridge or as near to the door as possible. That way they stay a little bit warmer than if you put them in the back of the fridge.
When I am using my strips/insulin, I put them in frio bags or insulated lunch boxes with an ice pack. Of course the ice pack would melt after a day or two, but I would switch the ice pack with one that had been in the freezer. I never had issues, only when I left my supplies out in direct sun.
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