September is an unpredictable month for weather. While it may bring pleasant temperatures for some parts of the country, we’ve seen how it can also herald heat waves, wildfires, and hurricanes. All manner of patients can be affected by hot weather and natural disasters, but diabetic patients are especially at risk. Diabetes can be a challenging condition to manage even in best-case scenarios. High temperatures, power outages, and evacuations only make it harder.
That’s why a little preparedness can go a long way. Start here with our suggestions and make a plan for your health.
Do: Learn how to store insulin
As of 2018, approximately 7.4 million Americans used insulin to control their blood glucose levels. Because insulin is made of proteins, it can become ineffective at certain temperatures.
The FDA says that insulin vials or cartridges can be left unrefrigerated for up to 28 days, as long as they remain between 59 degrees and 86 degrees Fahrenheit. They warn that insulin exposed to temperatures over 86 degrees will begin to lose effectiveness. But if your power has gone out due to a storm or you’ve had to evacuate your home, you may not have access to a refrigerator or reliable shelter for a considerable period of time.
If possible, invest in a reusable cooling case. Choose one that uses evaporation instead of freezer packs for cooling. In a pinch, use an insulated bag or lunchbox with an ice pack, bag of ice, or frozen food. Just be sure not to place your insulin directly on frozen materials. Freezing and thawing also reduces the effectiveness of insulin.
In general, avoid leaving insulin anywhere it could be subjected to temperature extremes. For example, don’t store it in your car or put it in luggage that will be transported in the cargo hold of an airplane, bus, or boat. If at home, remember that window sills can get quite hot, and the back of your refrigerator may be too cold.
There may be situations when a patient has no choice and must use insulin that has been exposed to heat or freezing. In this case, the patient should monitor their blood glucose far more carefully than normal.
If you’re unsure whether your insulin is safe to use, ask your pharmacist for guidance.
Don't: Stop taking your insulin
Natural disasters usually don’t give much warning before they hit. You may have had to evacuate your home without your medications. Adverse conditions may have ruined your medication. Either way, don’t give up! It’s important to take your prescriptions consistently, especially if you use insulin.
First, talk to your doctor or your pharmacist. Ask if you have a refill available. If it’s too soon for a normal refill, ask if you are eligible for an emergency refill. Be your own advocate: describe your situation and what has happened to your medication. Typically, if your state has declared a state of emergency due to a natural disaster or the pandemic, you should be able to get an emergency refill waiver.
If an emergency refill waiver isn’t available, call your health insurance provider. Again, describe in detail what has happened, and ask about your options. There may be special exemptions for patients in your situation.
Do: Investigate manufacturer programs
Storms, wildfires, and the pandemic have affected the employment and insurance of many patients, making prescriptions even harder to obtain. If the price of your insulin is an obstacle, seek out patient assistance from the companies that produce it. Three pharmaceutical companies manufacture insulin: Eli Lilly, Sanofi, and Novo Nordisk. All three provide savings programs and PAPs to help patients afford their medication.
Eli Lilly allows uninsured and commercially-insured patients to fill their monthly prescription for only $35 through The Lilly Insulin Value Program. The Lilly Cares Foundation can help certain patients get up to a year’s supply of free insulin.
Similarly, Sanofi offers assistance through a Sanofi Rx Savings Program for commercially-insured patients and the Insulins Valyou Savings Program for uninsured patients. The Sanofi Patient Connection also helps eligible patients access up to a year’s supply of free insulin.
Novo Nordisk’s NovoCare program helps patients stay on therapy by offering discounted insulin. They have also adapted their patient assistance program to better serve patients who have lost their insurance due to COVID-19-related changes in employment. Patients without employment are eligible for a free 90-day supply of insulin products. The program will check in at the end of the 90 day period to determine if the patient is still eligible.
Don't: Forget about other supplies
While obviously insulin is key, remember you’ll need other supplies to manage your diabetes.
Good items to include are:
- Syringes and needles
- Insulin pump supplies, if needed
- Extra glucose meter and test strips
- Lancets and lancing device
- Ketone test strips
- Glucagon kit, glucose tablets, or candy
- Alcohol wipes
- Batteries for meter or pump
- Hard plastic bottle or case for used sharps
Don’t forget to sort out some means of keeping your insulin at a consistent, moderate temperature, whether that’s an evaporation-cooled case or simply an insulated bag.
Place these supplies in a waterproof bag or box and keep it somewhere you’ll remember to look in an emergency.
If you’re starting to think about how to manage your health in adverse conditions, ease into it with a simple list. Note down the names of your prescriptions, the doses you take, the doctor who prescribed them, and the pharmacies that filled them. You can even use a free service like Rx on the Run to easily complete a medical information card that you can keep in your wallet.
Any patient can benefit from disaster planning, but it could be the difference between life and death for a diabetic. Keep track of your prescriptions and how they should be stored. Pick up your refills in a timely manner and keep taking your insulin as prescribed. Create an emergency kit. We hope you won’t need your emergency supplies, but it’s better to be prepared!