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A box full of cartridges, mainly used for filling and administering insulin, stands on a table in Mainz, Rhineland-Palatinate, on Jan. 25, 2023. Image credit: picture alliance/Getty Images
  • New research shows that insulin can be stored unrefrigerated for months without losing its potency.
  • Guidelines already show that insulin can be stored at room temperature, but the new data goes in-depth on specific temperature ranges.
  • For best results, insulin should be kept out of direct light and not allowed to get too cold (below freezing) or too hot (above 25°C, or 77°F).

New research shows that insulin can retain its potency for months when stored at room temperature – findings that could be a game-changer for people with type 1 diabetes who are unable to refrigerate their insulin reliably.

A review recently published by the Cochrane Collaboration analyzed the effects of different temperatures on insulin, finding that unopened containers of certain types of human insulin could be stored at temperatures of up to 25°C, or 77°F, for up to six months, without losing a significant amount of potency.

Research leader Dr. Bernd Richter from the Institute of General Practice, Medical Faculty of the Heinrich-Heine-University in Düsseldorf, Germany, told Medical News Today that the findings help clarify some of the guidance surrounding the storage of insulin and could be a boon to people without access to refrigeration.

Richter points out that current guidelines state that insulin can be stored at room temperature, but this guidance can be confusing, as “room temperature” can mean different things to different people in different regions. For instance, a person living in a cold weather climate versus a person living in an equatorial region.

“It seems official regulations focus western-style living conditions, where room temperature would not pose a problem,” Dr. Richter explained.

“Moreover, sound guidance on extreme conditions that many people with diabetes may face are completely lacking. What surprised us was that we could find only one small, older clinical study investigating higher temperatures, which seems odd given that millions of people with diabetes need this kind of information,” he added.

The data has implications not just for people without refrigerators but also for those whose refrigerators might not be reliable. Richter notes that pockets of some fridges actually get too cold, below the freezing mark, which affects the potency of any insulin stored within.

If insulin is stored outside of a refrigerator, there are a few steps that can be taken to preserve its potency. Richter says it should be kept out of direct light and not allowed to get too hot or too cold.

“[Insulin] should be kept in dark, protected areas if rooms are available, or in simple cooling devices such as clay pots.”
— Dr. Bernd Richter

“In normal circumstances, unopened insulin should be kept at around 4°C (39°F) in fridges, and in-use insulin at room temperature. However, our review provided new data for people living under difficult conditions, meaning that insulin could be used for prolonged periods of time and higher temperatures without a significant loss of activity,” said Richter.

He said that the findings have brought up new questions that could be the focus of future research – for instance, studying the effects not just of temperature but also motion.

“For example, people using insulin pumps wear them close to their body, which leads to a higher temperature, and they’re more or less continuously moving,” he explained. “We also need data on people living in cold climate conditions finding ways to protect insulin from freezing.”

Richter concluded that the research also highlights the importance of finding data for other temperature-sensitive compounds and drugs, such as antirheumatic medications.

“People in difficult living conditions, such as those lacking access to healthcare, or those affected by climate crises or living in war-torn areas, urgently need this information,” he said.

Anyone who has type 1 diabetes knows full well that insulin is an absolute necessity. By lowering blood glucose in people whose bodies cannot regulate glucose independently, insulin is a reliable and effective way to treat type 1 diabetes.

Dr. Louvens Romain is a doctor of family medicine at Community Health of South Florida, a nonprofit healthcare organization with locations ranging from Miami to the Florida Keys, and also works with the group’s PAMPER program for diabetes.

Dr. Romain, who was not involved in the study, told Medical News Today that insulin is an important piece of the puzzle when it comes to living with type 1 diabetes – but understanding the condition requires some education.

“Physicians need to educate patients on the symptoms and the signs they should be aware of that tell them they’re having a hypoglycemic reaction. That is why it’s crucial to always tell your patient that they need to be eating to get glucose into their body and they should always carry a glucose tablet,” he explained.

Challenges in accessing insulin

Dr. Romain added that he works in a community with low-income patients, which can create challenges in accessing insulin.

“It can be really challenging for the patient, particularly if they don’t have insurance. I try to get a sense of how patients are living, because lots of people forget that type 1 diabetes is a serious condition. The complications that can occur are serious and need to be taken into account,” he said.

“It’s important to understand the right foods to eat and get sufficient exercise, because type 1 diabetes—any diabetes in general—can lead to myocardial infarction, which is a leading cause of death for patients with diabetes. It’s all about educating the patient on how important it is to get the condition under control so we can prevent those complications from occurring,” Dr. Romain added.