I’m 25 and got diagnose shortly after going to MEPS…well needless to say it ended that life long dream of serving.
My conern is Insulin. Insulin if kept cold will last for over a year, but once the air seal is broke it last 28 days. It still works after that but it’s not as effective. Does any one have diabetes that preps for SHTF or nature diesaters…etc. I am type 1 so my panceas does not work (in case you didn’t know the difference).
I’m not diabetic, but I’m a medical student and these sorts of topics are most interesting to me. I’m interested to know how you know the insulin is still good but less effective when past dates. Did you run a test on that? I’m not contradicting, I’m curious. I have no data or knowledge on insulin shelf life. I suppose if I dig I’d find it, but I’m not likely to fit that into my academic to-do list at this point.
My typical line of thinking on med preps is that meds are typically good past their exp dates if stored in favorable conditions. If a liquid, look at it, if the color or translucency hasn’t changed I say try it if its all you got. IV fluids are a prime example. As an Army medic I’ve had supply shortages before and used expired fluids without consequence. If I have in date supply I choose that every time but if like you said, SHTF, I’ll try what I got unless I know it goes “bad” after expiring.
Tough break on the diagnosis. As you know there’s absolutely nothing you could have done to prevent Type I. Do the best you can to stock up on your insulin, unfortunately there isn’t a good substitute or alternative. You just gotta have it. If SHTF lots of people will be in tough spots with conditions like this. I wish I had a solution.
As a future physician, if SHTF happens, I’ll be expected to handle all comers…it will be difficult with a lot of medical conditions to say, “I wish I could help.” I actively prep/plan with this responsibility in mind. A carpenter and mechanic aren’t much good without their tools, MD’s aren’t either a lot of times.
Generally, the 28 day rule is due to sterility concerns, not stability. Diabetic patients are puncturing the vial under conditions that are not aseptic, therefore there is a time limit of 28 days to limit the possibility of growth of microorganisms. Manufacturers probably aren’t publishing additional data that you are looking for because of this.
Here is an interesting article, http://care.diabetesjournals.org/content/26/9/2665.full
If you are in a situation where you have to stretch the limits on insulin, I would make sure to research aseptic technique to limit contamination concerns, monitor glucose knowing that the insulin could be losing potency, visually inspect vials for turbidity and particulates prior to each use.
Another strategy would be to use the pens rather than vials. They are smaller volume, so you are more likely to use them up prior to expiration.
Well buddy I’m sorry to hear about your diagnosis, and I’m really sorry to hear that you can no longer serve in the military if that is your dream.
But if I can offer one bit of comfort it is: Beyond the strict rules of the military, don’t ever let Anyone tell you that there is something you can’t do as a Type1 Diabetic. If your A1C is under control, you learn your disability and you always prepare for the worst case scenario there isn’t anything you can’t do that a
“normal” human could (other than process sugar on your own of course)… 
I can picture you rolling your eyes at me right now, as well as the other members of this forum that are reading this. It’s cheesy I know, it sounds like a half truth, or some greeting card bullshit, but it’s true.
I’m married to a Type1 Diabetic. My mother in-law (died of brain cancer last year) was a Type1 Diabetic. My father in-law is a Type1 Diabetic. Her family is one of a few odd cases in the U.S. where there are that many Type1’s in one family unit. What I just told you is exactly what my wife’s mother told her when she was diagnosed at 14, and she lives that mantra every day. My wife gave birth to our healthy son, she managed her insulin on her own throughout the birth, and labor (we did not allow doctors or nurses to determine doses and our OB respected that due to how in control she is). You can do anything with this disability if you are dedicated enough (just like in life before your diagnosis).
My wife was one of the healthiest pregnant women in the Hudson Valley when she was pregnant with my son. I have seen my wife do a lot, and there isn’t a doubt in my mind that a Type1 Diabetic that is disciplined enough could serve in our military. But there is still a lot of stigma attached to the disease due to how it is only been recently that modern medicine has allowed people to manage the disorder so effectively. My wife has been dealing with the societal stigma every day for over half her life. You will deal with it every day too. It can be more debilitating then the disease itself if you let it be.
My wife and I are survivalists and we prep, and I am going to tell you a cold hard fact: You are at a really high risk of dying in a SHTF, a REALLY high risk. You’re also at a major disadvantage in a minor or prolonged emergency.
Your life line is now the following things before anything else: Your Insulin. Your ability to administer your insulin. Baring you administering your insulin your partner/friend’s ability to manage your insulin. Your ability to notice when you have high blood sugar without testing. Your ability to notice when you have low blood sugar without testing. Your ability to treat reactions before they get bad. Your ability to treat reactions when they get bad. Your partner/friend’s ability to treat reactions when they are too bad for you to treat. Everything else regarding “prepping” needs to come after this list from this day forward.
Have you had your first insulin reaction yet (Low Blood Sugar)? How did you treat it, how long did it take, what were the signs that made you notice it was happening? (These are the questions you need to be asking).
Start intelligently playing around with foods, work with your nutritionist and learn how to count your carb intake and what specific carbs do to your blood sugar. What spikes another diabetics blood sugar may only raise yours slightly. And vice versa. (ie you may be able to eat a peach and be fine, but for some friggen reason fifteen cherries will shoot you to 350+).
Here are some other things we suggest:
Get a pump (if you’re not on it already) and learn how to manage your own bolus, and basel (sp) adjustments. This will take a LONG time to master (especially the basel, which may take years as your learn the disease).
Talk to your doctor about also learning how to manage your diabetes using syringes and a fast and slow reacting insulin methodology (two types of insulin taken at different times throughout the day). For my wife it was Humolog (fast acting) and Lantus (long acting). Yes it’s two insulins but: If your pump breaks you have a non electronic back up that will save your life. Also pumps aren’t water proof (well one is I think but I still wouldn’t trust it) so if it gets wet as a result of an accident, bye bye insulin. Pumps require tubing, and inserts. I think it’s around four separate polymer pieces you have to replace each time you change your pump sight. With a syringe based injection all you need is a syringe and the insulin.
(side note on the syringe system: Keep your syringes in a HARD case. We went on a trip once 70 miles down the road. My wife’s syringe broke. We were very very glad a pharmacy was open).
Buy Glucose Tablets. Have them in your car. Have them in your bug out bag. Have them in your room until you learn your reactions. Have them in your every day carry bag. Glucose Tablets are measured doses that you can learn to manage as opposed to candy which is less predictable.
I don’t know if you have a partner but if you do you need to get a Glucagon Shot for your first aid kit and it needs to come with you if you ever bug out or evacuate. This is a syringe that can be administered to you when you are having an extreme, life threatening insulin reaction and it will quickly raise your blood sugar and stop the reaction. There is also a gel you can buy that is sucrose based and transdermal so if another party can get it into your mouth it will absorb through the inside of your cheeks and calm (but not completely cure) a reaction.
Keep an emergency supply kit with enough pump supplies and syringes for an extended emergency. These are expensive so it may take you a while to build them up. My wife suggests keeping one in both cars and at work. But this may not be possible for you at this time as that is a lot of money to put down.
REALLY IMPORTANT: Buy a Frio Pack, hell buy three of them and keep two moth balled. This little gem has allowed us to live off the grid for as long as three weeks without having to reactivate the chemical, and will last for much much longer if reactivated (they will last for upwards to 5 years). What this pack is, is a pouch with a water activated cooling agent that keeps your insulin cold. All you do is throw them in water and let the beads saturate. Three days, packed in a pack in 90 degree heat and the inside of the frio pack will still be cool enough to preserve your insulin (that’s as long as we have tested under those extreme conditions but traveling under normal conditions we have seen up to 3 weeks without a need to rewet).
Don’t worry too much about the life of insulin after you break the seal. You will use it well before it goes bad if you follow a specific habit of never opening two bottles of the same insulin at once. If you keep your insulin cool in hot climates and use it to treat as your doctor prescribed you will be on to the next bottle before that bottle goes bad. The problem is not an open bottle going bad when it comes to insulin, the problem is having enough insulin on hand to treat for the long term. Currently we have a year on hand. ONE YEAR. Think about that for a second, that is not very long. That is the most insulin we can get legally without committing insurance fraud. The sad truth of the matter is that the doses will have to change in an emergency, but we will also be way more active… If you want to start talking about what happens after the point of running out, well it isn’t easy.
I know this is a lot and I’m sorry to bombard you. I could write to you for hours about this issue. There are probably a few Type 1s on this site and I bet they would be willing to chime in with their experiences too.
Good luck buddy and you can PM me if you ever have any questions. My wife is a firm believer in helping people with Type1 learn how to deal with it. If I don’t have her talk to you directly I will relay any questions you have to her and share her insights. Reach out and ask for help when you need it, we’re here to offer all we can!
Excellent information, Definitely a sticky!
Thanks for the wealth of knowledge. I went straight to the pump as well on the continous gulose monitor. When I was diagnose my a1c was 14.9 after three months I had it down to 5.7. And it has been between 5.3-5.8 ever since. I only eat organic iteams and for the most part the only cabrs I eat is apple and banana.
I have def felt my lows and can tell when I get them. Long term I’m not sure if I will still feel them. But I really don’t feel it until I’m high 40’s low 50’s, how I combat is honey/soda.
I do keep supplies on hand at work/in cars and in each room of the house, just in case. I do have a gulueagon (sugar shot).
I do no let anything slow me down if anything I push my self harder (in a good way). With my diet of high fats and low carb intake I’ve notice I have WAYYY more energy than when I had a moderate carb diet. I was also not eating nearly as healthy as now.
I just curious how people would keep their insulin cold.
Thanks again!
Look into the frio pack technology I told you about. It’s the way to go. Water activated, does not require electricity and can be reactivated multiple times. In ten years we have only needed two of them.
I’d think injectable insulin would be part of my BOB, not a pump.
It’d be safer. A pump malfunction can be quite devastating. You can go into DKA within a matter of hours.
Being diabetic, your kind of linked to civilization. . . . Unless you can grow your own insulin.
You don’t need a prescription to buy certain kinds of insulin btw.
Social stigma with diabetes mellitus type one?
FWIW: My wife’s injection sight failed once when we were helping my mother shovel her house out of 8 feet of snow after one of the big NE storms that hit in the last several years…
She went into diabetic shock within an hour and started vomiting, and almost went into shock. Within in an hour.
In regards to the insulin without a prescription? Please provide me with a source as I have never seen ANYTHING like that.
Regarding social stigma: Yes, absolutely. Most people think that diabetics can’t do several things they can do. Most of it is born out of ignorance. They also assume that you are a danger to their business, or that they may be sued if they serve you the wrong food. Not to mention the unwanted health/diet advice from idiots.
But also one thing we experienced on the East Coast is that most people don’t even realize there is a difference between 1 and 2. Especially as a husband/boyfriend of a Type 1 we see it a lot. I will tell people who haven’t met my wife that she is diabetic. Then when they meet her this is a moment of shock that I don’t have an obese wife, but rather a slim, hot, in shape wife that often times looks better then the person who made the judgement… The East Coast has done so much “public outreach” about Type2 that they have made people more ignorant about Type1.
Mac’s info is right on. Holds true for type 2’s that are on insulin. One thing I must say is learn your lows and highs. Some diabetics can get extremely violent when they experience low sugar. Have a partner that you trust observe you also as there will be times when the blood sugar is very low and you will feel normal. Shakes (hands) are also a good indication of low blood sugar. One last thing is to make sure you get plenty of sleep as this will help you to regulate your blood sugar more normally.
Store brand 70/30 (NPH and regular insulin) can be bought without a prescription. I think regular insulin too, but I’m not sure. A vial of Walmart brand is like $27 a vial.
Its not Lantus and Humolog, it is a bit more difficult to manage.
Good call on all of this info. My wife knocked her high school history teacher out in Britain when she had a reaction. She punched him square in the jaw.
I love my wife but she is stubborn about her symptoms. For those of you that are not diabetic but have a family member, do watch for the shakes in the hands and learn how to ask effectively about a reaction. My wife isn’t violent with me but she likes to know she’s in control and me seeing first doesn’t always jive with her.
To Texas:
Ummmm, I will look into that as a back up plan in an emergency but it sounds pretty sketchy and unregulated. I would use it in an emergency but NOT as a substitute. Where did you come across this knowledge if you don’t mind me asking? Do you mind sharing how effective these “over the counter” substitutes are? What is there shelf life? Are they GMO insulin, or bovine?
It may vary slightly from state to state, but several regular insulin products (Humulin R or N, Novolin R or N, and the 70/30 insulin) may be purchased at a pharmacy without a prescription. They can’t bill insurance without a prescription though. They are FDA approved recombinant insulin, just like any other. They have fallen out of favor since long acting Lanutus/Levemir and short acting insulin therapy has gained popularity(for good reason).
I was diagnosed with type 1 when I was 8 years old. (I walked into the ER with 1157BG Dr thought the test was an error and kept testing me, he is still amazed I was conscious.) I have used a lot of different types of insulin, I am currently on a pump with Humalog. although I am using a pump I have a lot of syringes in storage for SHTF.
As far as insulin and SHTF I use a little more than one bottle per month so I am prescribed 2 bottles per month. the issue is that I use to not get the prescription filled until I started getting to the end of the second bottle. My insurance company saw that I was repeatedly not filling my prescription each month and would tell the pharmacy to only give me one bottle instead of 2. when that was happening I would have none for emergency back up.
now I have a reminder on my phone that every month on the 20th I fill the prescription no matter what, that way I have backup and the collection is growing. I keep it all in the fridge and I write on each box the date I picked it up so I use the older bottles first so they don’t expire.
I do the same with test strips. get more each month if you need it or not, if you use exactly 1 bottle per month have your Dr prescribe 2. I have had lots of conversations with my doctors about SHTF, bug out, and prepping. some think I’m weird some think its funny others think its a great idea, but they all give me what I want, and if they don’t, I get a new Dr.
you may want to talk to your Dr. about a backup long lasting insulin because if you are on a pump with Humalog and the pump dies you will need to inject a small amount every 2 hours until your pump gets fixed or replaced.
I have been diabetic for 24 years and I always worry about losing sensitivity to highs and lows, its going to happen some time I just hope I see it coming. one of my major issues is lack of sleep. I sleep around 5 hours a night give or take, I would love to get more but thats another story, when I don’t sleep enough I have a harder time feeling lows because I just think I am so tired.
another issue is alcohol. dietitians and Drs love to tell me how alcohol will affect my BG and from my experience everyone is different no matter what they say. I do know I have never consumed enough to completely black out and do crazy drunk stuff simply because I can’t. I have to be in control of myself at all times or I’m dead.
I despise the feeling of a low BG, its a lot like being trapped in your own body and you don’t have full control of it. you can scream for help and people just look at you like something is wrong with you but they don’t know what to do so they walk away.
you need to educate people around you, friends, family, coworkers, anyone you deal with regularly. its better to tell them what you do when you are low or high. everyone is different, there are lists of how a diabetic person shows lows but for example, my hands don’t shake, I do get really angry and quickly violent when I get low enough.
get use to saying the same things over and over. I have heard so many times “if you pass out on the ground I give you a shot of insulin right?” people really know very little about diabetes, I have had people in the south refuse to give me syrup at a waffle house because it will kill me on the spot, the irony is I was a little low and needed the extra carbs.
I wanted to be a marine scout sniper, I wanted to be an astronaut, I wanted to be a helicopter pilot but those things I am not allowed to do. other than a few things there is an open world to explore.
My primary job is making films, tv shows, and commercials. I travel the world and do more than most people will in a lifetime, make sure you plan ahead.
I was stuck in the middle of nowhere Mexico when a tropical storm hit and washed the road away. I had planned to stay for weeks when I was scheduled to be there for 5 days, 8 days later we made it out and now its a funny story to tell.
Diabetes will change your life in so many ways, stay on top of it but don’t let it consume you. It can make you feel sad angry and alone if you let it, just remember there already is a cure (stem cells) and you are easier to cure if you have fewer complications when it is allowed to be used again.
feel free to ask me questions or if you want to talk to someone in the same boat as you PM me, I am going to try to get at least 4 hours of sleep now.
Country Devil,
My wife and I travel a lot too and I’m wondering how you keep your insulin cold when you travel? Maybe there is a better solution then what we are using?
Also you ever had the TSA try and remove your pump to look at it? She did once, I thought my wife was gonna knock the lady out, especially because she was five months pregnant at the time.
That’s illegal for then to have you remove it since it is a medical device.
Sent from from your Sister’s bedroom.
They didn’t remove the injection sight, but they removed the pump from it’s clip, held it, and went to press buttons before my wife’s body language suggested they should do otherwise.
I don’t know how often you fly, or if you’ve flown since you’ve been diagnosed but “illegal” is not a word the TSA hears. In fact if you bring that up they remove you from the line and put you in a small class room where you will sit until they decide to give you a full body search (something that has also happened).
The TSA does not respect laws put in place to protect the disabled. I am not sure if there are any lawsuits challenging their blatant refusal to respect these laws, but there should be.
I haven’t flown since being diagnosed but I would respectfully advise them it’s them to touch unless they are diabetic care taker or doctor.
Sent from from your Sister’s bedroom.
And like I said you’ll be taken into a room away from general populace and held until they deem it necessary to approve you for passage.
It’s not like my wife gave the woman permission to touch her pump, she just reached down, grabbed it, an pulled if off her belt.
I do not keep my insulin cold when on the road. I have been told Humalog does not really need to be kept cold as much as kept from heat. I use to have a freezer pack from BD (I think) that had a formed ice pack that would hold 2 bottles then it had its own foam insulated case. that was when I was using N (I think, white cloudy stuff) if there was not a fridge in a hotel room I have used the fridge in the kitchen, I think most hotels I stay in these days have one in the room.
I hate the TSA (trombone swallowers anonymous?) I usually make it a point to empty my pockets and not travel with a belt with a lot of metal I keep my shirt over my pump and act like its not there. I have a medtronic pump, guess there is not much metal in there cause it does not set off the detectors. sometimes TSA sees the pump as I am emptying my pockets and they ask about it, that means I get the extra search, sometimes they wipe it with the bomb sniffing cloth, I have also had to wipe my hand on it then the cloth was wiped on my hand then put in the sniffing machine.
I am always looking for the TSA to **** up in front of me, I think they can tell cause I smell their fear. I had one guy try to grab my pump immediately after I said its a medical devise, I swatted his hand away put my finger in his face and said “you don’t ****ing touch my pump” he stepped back and kind of locked up for a sec then said “oh, sorry”
I use pelican cases a lot, I keep an 1120 with me all the time packed FULL of diabetic supplies, nothing makes your heart skip a beat like dropping a bottle of insulin and it smashes on the ground.