I’m going to be travelling for around 6 weeks in Nov/Dec, leaving from Dallas, visiting Iceland and England with stops in Boston and New York on the way out/back.
As I’ll be gone for around 1.5 months, I’d like to take 2-3 months of meds to be safe/cover all eventualities.
I won’t have access to a refrigerator during our flights/travel and during the days in Iceland (we are driving the ring road for 17 days, staying in different hotels/AirBNBs each night). Once we get to England, we will have constant access to a refrigerator for the remaining time. I’m not worried about it getting particularly hot during the days, given that the average temperature in Iceland at that time of year is 32-36f.
I’ve been trying to figure out a way to keep my insulin ‘refrigerated’. Having read various posts on here about the performance of unrefrigerated insulin beyond the 28-day ‘limit’ suggested by the manufacturers (which seems to kick in as soon as the insulin comes to room temperature the first time, even if it’s subsequently refrigerated again), I’m wondering if I’m overthinking/worrying too much.
I would be able to refrigerate the insulin any night we’re staying in an AirBnB and would ask about getting a fridge in my room when staying in hotels, but it would almost certainly reach room temperature during our flights from Dallas to Boston, Boston to Iceland, Iceland to the UK, UK to Iceland, Iceland to New York and New York to Dallas.
Do you guys think I’d be OK if I were to just refrigerate the insulin as much as I can, or should I try to work something out? I take fairly large doses, so will be carrying a lot of pens (90u of Tresiba nightly, 1mg Ozempic weekly and 80-160u of Fiasp per day) which makes trying to keep it all cold even harder.
I don’t think it needs to be refrigerated at all. I survived college without ever putting it in the fridge. There are a bunch of threads here showing un-refrigerated insulin use.
I would avoid using a hotel fridge. It might accidentally freeze it. You can still use frozen insulin (there are also threads on FUD that show that!), but frozen insulin does get a bit jacked up. It works, but not as well.
I suggest just leaving it at room temp in the hotel. In the car if it gets very hot you could put it in a cooler, but that is probably not necessary either.
Enjoy your trip and don’t worry about it too much. Just bring some spare vials of everything.
And welcome to FUD!
EDIT:
My post is in reference to rapid insulins for the most part, like Humalog and NovoLog. There may be some people who have experience with unrefrigerated Tresiba. @Sam?
I use Fiasp, Tresiba and Ozempic. I know that Fiasp is basically Novolog (which I was on before) with some extras to make it act quicker, so assume that it would react to temperatures similarly.
Any insulin will be fine that long without refrigeration as long as it’s handled reasonably…
I absolutely second the recommendation not to put it in hotel fridges… that’s asking for trouble. If you’re really worried about it you can take a small lunchbox cooler and some gallon ziplock bags and add ice to the cooler every day or two…
Another voice, for keep it unrefrigerated and don’t look back. But if something does happen to it, insulin is available in Iceland and England over the counter for a very reasonable price. So your backup plan can just be to purchase some along the way if needed.
Hi @RChesterton! I agree with everything @Eric has said about storage and have learned that here myself. I used to carry mini-refrigerators everywhere I went but have since ditched the habit. Having used Fiasp for a bit over the summer, I would throw in the fact mine (and I could’ve been doing something wrong), did get a little cloudy even though my Novolog didn’t. I carried them both in my bag, which was OFTEN kept in a very hot location, but only the Fiasp turned cloudy. It was certainly nothing to sound the alarm over, but it was interesting. I should make it clear though that I kept it that way for a couple of months with frequent high heat scenarios. And lived to tell the tale. I think getting it somewhere cool from time to time probably is adequate in your case. Sounds like an incredible trip. Hope you have a great time!
I travelled twice for 6 month on a shoe-string through SE Asia without refrigeration. Just kept it at the coolest possible place in the dark and had no issues. The biggest issue in some places were not the unrefrigerated insulin but the supply of syringes. Always have the most officially, stamped, and stamped again, note of your doctor with letterhead and another stamp that you are in need of those if you are still using them. The same for pens if going to a concert or sporting event. You will at one point encounter the ignorant.
Thanks for all the replies, that certainly puts my mind at ease.
I’d be interested to hear any experience anyone has had with Tresiba or Ozempic, but it certainly sounds like I’ll be OK with the Fiasp.
Great points about not using hotel fridges - makes perfect sense. Thanks.
I’ve traveled before with insulin, so know the drill (letter from doctor, let TSA know immediately before they start asking questions etc) and am originally from the UK, so I’m fine with everything there from a ‘procedural’ perspective. All of my insulin is flextouch pens, so no syringes, but even the tiny needles we use on those can raise eyebrows/invite questions, I know (I once spent nearly an hour at Hong Kong immigration explaining it, even WITH a letter from my doctor)
I’d considered the idea of just trying to keep half of it at refrigerated temperature using a small lunchbox type cooler, however I’m going to struggle for space - airline carry on allowances keep getting smaller and between all of the insulins/pills/dexcom sensors etc that I will need to take, both mine and my wife’s carry ons are going to be full without trying to fit a cooler in too!
Not sure if this applies to international travel, but I thought for at least domestic flights medical bags containing supplies did not count towards your cary-on limit? Might want to check with your airlines to see what their rules are.
I agree with everyone else. DO NOT use the hotel fridges!
frio bags might help keep it close to room temperature when hot.
I think your inclination to not refrigerate is good. Also where you are traveling has both mail and pharmacies and diabetics, so in case of disaster I know that you could get more of the lifesaving juice.
Personally I’ve had repeated instances in the last year where hotel (high end places, like five times) fridges have frozen our food. Solid. Wrecked it. I would never ever put insulin in them. Freezing is a bigger problem than getting warm.
EH flies a lot of the time, near and far (heading to Hungary Tuesday, been around the world for a month a few years ago) and don’t refrigerate. Also I nuked the insulin on a recent backpacking trip by leaving it in the direct sun for hours, and it was fine - we filled a pod and it worked.
We also don’t ever let the TSA know. My partner (the dibe) can’t be bothered to slow down at the check point and he’s never had a problem. I guess I might take a copy of RX and a doctor’s note, but it’s been so many years since we’ve done that, I don’t bother anymore. No boxes, just ziplock bags, or lately a reusable, non-transparent packing cube, full of tons of diabetes stuff. No one has ever looked. I’m sorry Hong Kong hassled you! That sucks! (Now that I’ve said this we will get bitten in the ass next week. Just wait. Universe, leave us alone please.)
Theoretically the diabetes equipment is medical and you might get it through as a separate allotment but I wouldn’t count on it. Some of those gate agents are cruel.
My one piece of advice would be to split the insulin between two bags (in case of loss or theft) and never put the insulin into a piece of checked luggage. The belly of the plane can freeze. Don’t want that.
What a great trip you’re going to have! Keep us posted on how it goes!
I’m not sure if a separate bag of insulin would be allowed in addition to our carry on/personal items. I’ll check further.
I’m already taking a CPAP separately, only so far I can push them! lol
I don’t think I’m going to need Frio bags, I’m more concerned about it freezing than getting too hot, in terms of temperature extremes (winter in Iceland is certainly not going to be warm and England won’t be much better).
I’m going to have to let TSA know so they don’t make me go through the body scanner with my Dexcom. Also, I read that it’s best to ask that they don’t send my Dexcom spares through the x-ray, although I’ve also read a lot of reports of people having no issue with that.
I plan on splitting all of the meds (roughly) evenly between 2 of our carry-ons for the reason you mention. I’d never check insulin. Partly in case of freezing but also loss - I’d feel much safer with it near me (and also it’s probably more valuable than any of the electronics/camera gear I’ll be taking lol).
EH has been through the body scanner plenty, no issues with the Dex and Pod. Same with X-ray. However I understand being gone for months being a concern. If it all goes bad - you’re hosed.
If you are going to worry about x-ray, it would be the Dexcom transmitter that could/would have the problem if one was to arise. The x-rays shouldn’t do anything to the sensors.
Having used Fiasp for a bit over the summer, I would throw in the fact mine (and I could’ve been doing something wrong), did get a little cloudy even though my Novolog didn’t. I carried them both in my bag, which was OFTEN kept in a very hot location, but only the Fiasp turned cloudy. It was certainly nothing to sound the alarm over, but it was interesting. I should make it clear though that I kept it that way for a couple of months with frequent high heat scenarios. And lived to tell the tale. 
