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Old 24-07-2012, 04:38   #1
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Insulin supply in the Pacific

Does anyone know if insulin (Lantus and Novorapid) are readily available in the poorer countries between Panama and New Caledonia?

If not, how do Type 1 diabetics manage their supplies for the long term?
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Old 24-07-2012, 11:47   #2
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Re: Insulin supply in the Pacific

Well we're heading towards panama in a few months, and my dad is a diabetic. He talked to his doctor before we went on this trip and they gave him an extended supply of refrigerated insulin. However my dad changed his diet and lifestyle with a primal diet (no carbs no sugar, only high fat and protein) so he doesn't take insulin anymore which is a relief. The insulin loses some of its potency after a while but its better than nothing! I don't know if panama or any of the other countries surrounding have insulin, but I would stock up before heading that way on what you can. Talk to a doctor here before leaving. Even if they did have it in panama you would have to jump through hoops to get to the doctors to get some.
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Old 24-07-2012, 12:23   #3
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Re: Insulin supply in the Pacific

That's great you dad is managing his type 2 diabetes so well, but type 1s are stuck with insulin managment.

When we lived in Panama and my type 1 dad visited he was able to purchase insulin in the city. Shouldn't be a problem to stock up there.

Crossing to New Caldonia? Make sure your refrigeration system is top notch and has back up sysyems and take extra so if some vials fail you have additional fall backs.

Man. Would not want to be out there and have the insulin go bad or run out. Take more than enough....
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Old 24-07-2012, 12:49   #4
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Re: Insulin supply in the Pacific

novorapid,levermir etc penfills are available in french polynesia,and new cal but you better be sitting when you get the bill!
100 euros for a box of 5x3ml penfills!!!!
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Old 24-07-2012, 12:57   #5
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Re: Insulin supply in the Pacific

"You can store unopened Lantus at room temperature for up to 28 days."
And longer when refrigerated. So part of the solution would be to choose an insulin with an equal or longer storage life, and to refrigerate it or at least keep it cool in the bilge. Then break out your itinerary, ask those makers about distribution in those specific ports you plan to visit, and if they don't have it, look into air freight or express deliveries. Supplies for "vessels in transit" are often delivered without tariff, and a cooler filled with dry ice and meds might do the trick at a reasonable price.
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Old 24-07-2012, 13:01   #6
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Re: Insulin supply in the Pacific

In the aged-care homes I worked in we kept unopened insulin dark and cool (unrefrigerated) much longer than 28 days...it is certainly do-able. This was in regulation-mad Germany, too.
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Old 24-07-2012, 13:06   #7
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Re: Insulin supply in the Pacific

I would be uneasy about that *room temp* guide. Possibly the temps in a boat where the insulin could be stored might not what the manufactures consider room temp...

Be safe. Keep it cold. Refrigerated it has a long shelf life. Un refrigerated...hard to say if that 28 day would hold true in the tropics.

Quote:
LANTUS should not be stored in the freezer and should not be allowed to freeze. Discard LANTUS if it has been frozen.
Unopened Vial/Cartridge system/SoloStar disposable insulin device:
Unopened LANTUS vials, cartridge systems and SoloStar device should be stored in a refrigerator, 36F – 46F (2C – 8C). Discard after the expiration date.
Open (In-Use) Vial:
Vials must be discarded 28 days after being opened. If refrigeration is not possible, the open vial can be kept unrefrigerated for up to 28 days away from direct heat and light, as long as the temperature is not greater than 86F (30C).
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Old 24-07-2012, 20:57   #8
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Re: Insulin supply in the Pacific

Thanks all.
Yes, am aware of all the refrigeration and storage issues we've been at this game a while now.
Probably airfreight is the best option. Who knows how well the cold chain has survived third world handling.
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Old 24-07-2012, 23:23   #9
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Re: Insulin supply in the Pacific

Before I did my TransPac tested how long insulin would last without refrigeration here in Hawaii. Left insulin out for as long as 45 days. Saw no degradation in potency for at least that long. Day time temps were high 80s. With refrigeration, insulin lasts a long time. Pharmacy screwed up and sent me more than a six month supply of Lantus at one time, it was good to the end kept at 38 degrees.

Problem with shipping it in is if it gets left on the airport apron in the middle of the day. Temps can easily go over a 100 degrees with the sun beating off the concrete. Don't think that would be good for it. My old supplier of insulin (Informed Rx) via the mail sent it out in styrofoam coolers inside a box with ice gel packets. Ice packs had definitely thawed by the time it got here from FLA but the insulin was fine. Might want to see if you can find one of those online pharmacies that will have this packaging as they supply a lot of drugs needing refrigeration through the mails.

FWIW, understand that freezing is what will ruin insulation almost immediately. If you've got refrigeration, be sure you can control the temp to keep it above freezing.

Insulin is not cheap. Don't remember what mine costs but was shocked when the insurance company started sending out informational billings. Glad I've got insurance.
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Old 25-07-2012, 06:45   #10
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Re: Insulin supply in the Pacific

You could also consider a small Pelletier Effect thermoelectric cooler as a backup for your insulin. A decent one will hold the temperature stable 40-50 degrees below ambient temperature and a small one kept around just in case the onboard refrigeration crashes mid-transit might not be a bad idea.
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Old 28-07-2012, 14:52   #11
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Re: Insulin supply in the Pacific

Even just a swamp cooler would get the unrefrigerated temp down significantly.
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Old 28-07-2012, 19:07   #12
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Re: Insulin supply in the Pacific

The horrible thing is that it costs Lilly $1.36 a vial for manufacturing costs of Humulin from tailored E Coli. It's the product of a recombinant strain of E Coli that produces a human insulin analog as part of it's waste.



Quote:
Originally Posted by roverhi View Post
Before I did my TransPac tested how long insulin would last without refrigeration here in Hawaii. Left insulin out for as long as 45 days. Saw no degradation in potency for at least that long. Day time temps were high 80s. With refrigeration, insulin lasts a long time. Pharmacy screwed up and sent me more than a six month supply of Lantus at one time, it was good to the end kept at 38 degrees.

Problem with shipping it in is if it gets left on the airport apron in the middle of the day. Temps can easily go over a 100 degrees with the sun beating off the concrete. Don't think that would be good for it. My old supplier of insulin (Informed Rx) via the mail sent it out in styrofoam coolers inside a box with ice gel packets. Ice packs had definitely thawed by the time it got here from FLA but the insulin was fine. Might want to see if you can find one of those online pharmacies that will have this packaging as they supply a lot of drugs needing refrigeration through the mails.

FWIW, understand that freezing is what will ruin insulation almost immediately. If you've got refrigeration, be sure you can control the temp to keep it above freezing.

Insulin is not cheap. Don't remember what mine costs but was shocked when the insurance company started sending out informational billings. Glad I've got insurance.
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Old 26-03-2013, 07:38   #13
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Re: Insulin supply in the Pacific

Why wouldn't it be available in the pacific as Melanesian and Polynesians have some of the highest incidence of diabetes in the world?
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Old 26-03-2013, 07:56   #14
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Re: Insulin supply in the Pacific

Mark, .. might probably be better phrased as.... the worlds highest incidence of untreated diabetes. You are probably correct that in the capital cities of the region, insulin will be available.

A small separate solar panel and a Peltier Effect fridge is our solution. That and a 12 month supply pretty much covers all contingencies.

Thanks for advice everyone.
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