My wife has insulin-dependent diabetes and we are traveling to France next month for 10 days. Insulin keeps longer if it stays cool. <BR> <BR>Has anyone had to keep insulin or anything else cool for an extended period while in Europe and what did you do? <BR> <BR>thanks <BR> <BR>Hans

First, I'd find out from your pharmacist (not your doc probably; I'm one, and I'd have to call the pharmacy to find out) what the optimal temperature for storage is. It sounds like you may already know, and a lot of people probably keep it in the fridge. But I'd find out, for instance, whether you can keep it on ice, since that may be a decent option for the plane trip, in a couple ziplock baggies, or, alternatively, one of those drink/food small insulated cooler-type things. I'd bring it into the cabin rather than in checked luggage (along with a limited supply, at least, of her usual meds, which is good advice to all travelers, since lost luggage is always a potential problem). To avoid having to transport it overseas at all, you might look into whether insulin can be purchased over the counter in France, as it can be in the US--if so, also whether you can get the same formulation that she currently uses, ie NPH, lente, etc. To transport it on dry ice, you may have to make special arrangements with the airline, and it might be too cold. After you arrive, if you're staying in a ritzier hotel (ie, one with a minibar/fridge), you're probably all set, and can put store the insulin in the fridge. If you're staying in a smaller hotel, perhaps they'd let you put it in the hotel refrigerator (many places have some type of breakfast option, so I imagine they'd have something)--obviously, I'd make sure you leave the metal seals, etc. on the vials until you're ready to use them, and package the whole thing up in a clearly marked (eg, Medicine for Madame Smith, Room 100) but non-see through container (eg, a small Tupperware). If you choose this option, make sure you don't leave the syringes with the insulin--in the wrong hands, these always have market value. I should think this option should also be relatively safe, as there's probably limited access. If you're staying in a B&B type place where there's a communal refrigerator, I'd probably be a little more wary, just because it might get misplaced, lost, etc. <BR> <BR>You sound like you're prepared, but make sure you bring all the accessory supplies you anticipate needing (fingerstick strips, syringes, alcohol swabs)--the strips, for instance, for her particular machine may be difficult to find should you run out. Have a list of medical conditions, medications and doses (again, good advice for any traveler) written or typed out, preferably with the generic names of the medicines, which are the same in every country, rather than the trade names, which may not be. This and a medical bracelet can save a lot of time in an emergency in a foreign place. <BR> <BR>Finally, there was a recent posting with some websites with information for people requiring special medical assistance--it's under "disabled traveler in Paris," and I've tried bringing it to the top for you. Otherwise, last response on 3/16, so you'll have to go a while back. <BR> <BR>If you have other general questions, post them here and I'll answer if I can. Hope this has been helpful.

Thermos bottle with water and ice; you can replenish ice at a restaurant or cafe or at your hotel.

Hans <BR> <BR>I've travelled all over Europe with insulin and the usual associated supply e.g. syringe and needles and not once have had a problem. <BR> <BR>I usually keep my spare bottles of insulin in either the hotel room fridge or, if there isn't one, use the one in the hotel bar (folks are always very accommodating). Once and only once, I've run some cold water into a glass and placed the bottles there ‘head up’. That was a desperate measure though and was only done as the heat was excessive and there were absolutely no other cooling facilities. <BR> <BR>When you are visiting France in April you will probably not get the high temperatures found in mid-summer. <BR> <BR>A cool-bag should also be considered as that’s an excellent way to transport of the insulin whilst travelling e.g. on the aircraft. <BR> <BR>Also, there have been major changes to the manufacture of insulins over the last few years, which actually may help your wife. If she is using the new style pens then what follows are the instructions from the insulin box:- <BR> <BR>'Store at 2 to 8 degrees C. Do NOT freeze. Insulin cartridges in use must not be stored in a refrigerator. Cartridges in use or carried as a spare may be kept at ambient temperature (e.g. in the pocket or handbag) but should not be exposed to excessive heat or sunlight' <BR> <BR>If your wife is still using a syringe then I'd keep all of the insulin including that in use inside a refrigerator. The boxes for bottled insulin also recommends storage between 2 and 8 degrees C and must NOT be frozen. <BR> <BR>As md suggests do NOT under any circumstances have the insulin or other supplies placed in the hold of the aircraft. Always carry it in your hand luggage. <BR> <BR>Also as md suggests find out the generic name of your insulin. NPH, Lente, Insulatard will probably be available but under a different name. The manufacturer of the insulin has been a help to me in the past and has freely given the name of their insulin as sold in Greece, Italy, France etc. Good idea to contact them. <BR> <BR>Lastly, the advice re carrying a bracelet identifying you as diabetic is essential. If you do not have one then get a card for your wife’s purse giving information about dosage, that she is diabetic and what to do in an emergency. Contact your country's national diabetic association as it may provide cards suitably translated into the language of the country you are visiting. <BR> <BR>Email me if you need further information. <BR> <BR>Bill <BR>

Dear Hans, <BR> <BR>I am a insulin dependent diabetic, and have been for the past 24years. I think that the easiest answer is to buy an Insulin wallet. They come small and large, many have a blue ice packet included that will keep your insulin cool if you are out in hot temperature or if you need to leave it in a car. Insulin wallets can be found at most drug stores or Wal-Mart. All Diabetic magazines have ads for them. <BR>Lastly unless insulin gets over 90 f. it is fine. People love to put it in the fridge but it is perfect on the shelf. I think that coolness may have been more important in the past (30+ years ago) when insulin was not as pure as it is now. It may keep longer in the fridge, but look at the experation date, it is most likely years from now. I'm sure that you will use all the Insulin up before then. <BR> <BR>I thought that the other responces sounded way to complex. <BR> <BR>Scott

Scott <BR> <BR>Good idea about the travel wallet. Didn’t have those when I became insulin dependent 37 years ago and it’s great now to see that some of the old problems about keeping the bottles cool when traveling have been solved. <BR> <BR>Unlike you I don’t think the other messages are complex. They mentioned all the things a diabetic should be aware of when traveling. <BR> <BR>Having been on insulin for a lonnnng time (I’ve passed the 30+ years mentioned in your post) I make sure my insulin reserves are kept in a refrigerator and my working supply at room temperature. Expiry date has nothing to do with it. Insulin stored outwith the recommended temperature loses its strength. <BR> <BR>Hans’s wife should follow the instructions that come with her insulin. I’d be happy to place a bet that they say to store the reserve at refrigerated temperature. <BR> <BR>Robin <BR>

I'm a German pharmacist and I'm sure you won't have any problems. <BR>Temperatures below 30 Celsius are no problem - not for storage of course, but for travelling. The only thing, which could happen under too high temperatures and too long time, is, that the insulin doesn't work as strong as before. But if you measure your bloodsugar regularly, you can give more insulin in the right time. The food is different to yours in the USA. Many of my customers don't need as much insulin in the USA as they need at home. So it is verry important, that you measure your bloodsugar! <BR>I've sold special insulin cool bags in my pharmacy for Mecca pilgrims! In Germany we don't have these temperatures. If you plan long cartrips, you could buy a bag in every pharmacy you'll see. <BR>dry ice --- too cold <BR>fridge --- no problem in every <BR> hotel, everybody will help you <BR>syringes -- no problem! <BR> "wrong hands" are allowed to buy them in <BR> every pharmacy for low <BR> money <BR>If you mail me the names of your insulins (and other medicine) I'll write you the names of the appropriate German medicine. <BR>