Happy Healthy Story 4

         AIR TRAVEL AND LONG DRIVE

                

                    

                    Maintenance of  insulin in cold storage enables to maintain its native potency.

        Small story:

                            We often become upset when things are not going as per our expectation. When it comes to executive managers it will become furthermore visible and results in irritation. We came across such an incident with insulin.

A 52 year old senior executive manager in a multinational company came for an opinion regarding his glycemic management. He was a known diabetic for around 15 years. He was on ral anti-diabetic drugs and one time insulin glargine at bedtime. Insulin glargine is a long acting insulin that has action  for 24 hours and it is one of the best in long acting insulin types. 

His father and grandfather also had type 2 diabetes. After observing his father and grandfather he also became more disciplined towards intake of a properly balanced diet and doing regular ecercise. He was jogging for at least 45-60 minutyes in a day. His glycemic control was never an issue and used to have optimal control.

Last month he had a foreign trip to the United States. After returning from his trip  He was very upset in view  of deranged sugar level which were well controlled previously.

I have started an inquiry to know where things went wrong. As it was a foreign trip, first I expected it might be due to diet and exercise - related changes. He said that he did not deviated from his routine dietary discipline and was doing regular exercise almost every day. Second I asked about any deviation from intake of medicine and I came to know from his there was no such thing. In fact, he took the medication for two months in order to prevent a shortfall if any delay happens in the return journey. Then I enquired regarding insulin injection technique, site rotation, and finally about storage.

Yes, Then I got my valid point. Though, he maintained insulin storage as  per protocol while he was in flight to the United States and during the entire stay but he did not maintain a cold chain of insulin on his return journey.

It was a 400 km long drive to the airport on his return journey as he was gone to see some countryside tourist  areas. He kept his insulin box in the dashboard of a car while he was traveling. While on a return flight journey as he bought costly electronic gadgets and some personal stuff, he kept his medicine box including insulin into baggage. Before sending it to baggage he took the insulin as per his schedule.

Here the mistake was a broken cold chain of insulin. The first mistake was he kept his insulin box in a car dashboard and the second he sent this box into baggage on the return flight. At both points, the temperature will be more than the room temperature which spoils the insulin. Because of exposure to high temperatures insulin has lost its potency. As he was using this same insulin after his after his trip, sugars were not coming under control.

I explained i detail and he understood his mistake. He purchased a new insulin cartridge and started using that. After a week, sugars became streamlined.

While o travel, maintenance of the cold chain is very important. Before travel, we cam discuss with our doctor regarding best available options to maintain the cold chain in order to maintain insulin's native efficacy. Carrying an insulin box along with an ice pack on a journey and keeping it in the refrigerator once we reached our stay. Another way is keeping some ice cubes in a
tea flask and keeping an insulin pen/bottle om this flask will maintain the temperature. Before putting an insulin pen or bottle into the flask, tie it with thread and keep this thread long so it comes out of the flask and the cap of the flask will be closed. Bu doing this temperature will be maintained and easily we can remove the insulin pen or bottle by pulling the thread. 

Maintenance of insulin's temperature is vital to keep its potency.