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. 2022 Dec;54(1):1118-1125.
doi: 10.1080/07853890.2022.2067355.

Efficacy of alternative cooling devices used for insulin storage without refrigeration under hot-humid environment

Affiliations

Efficacy of alternative cooling devices used for insulin storage without refrigeration under hot-humid environment

Supang Taerahkun et al. Ann Med. 2022 Dec.

Abstract

Background: Insulin is temperature sensitive as high temperatures reduce its potency. Refrigeration for insulin storage is still needed but households in remote areas do not have refrigerators. Also, the electricity supply is usually affected by natural disasters. We aim to examine the temperature-reducing efficacy of cooling devices in hot-humid conditions.

Methods: Five cooling devices, (1) earthen jar filled with water, (2) earthen jar filled with soil, (3) two clay pots, gap filled with wet soil, (4) two clay pots, gap filled with wet sand, and (5) commercial cooling wallet were used in this study. External and internal temperatures were monitored by the temperature logger between October 2019 and September 2020 in Narathiwat, Thailand. Cooling efficacy was assessed by average absolute temperature reduction and relative cooling effect.

Results: Mean external temperature and humidity were 27.3 ± 1.5 °C and 78.2 ± 7.1%RH. The mean differences between the external and internal temperatures were; device (1) -0.1 ± 0.6 °C (p = NS), (2) 0.0 ± 0.8 °C (p = NS), (3) -1.7 ± 0.9 °C (p < .0001), (4) -2.0 ± 0.9 °C (p < .0001), and (5) -1.8 ± 0.9 °C (p < .0001). Device no. 3, 4, and 5 achieved a constant temperature reduction. The most efficacious device was device no. 4 with a relative cooling effect of 63.6% better than the cooling wallet (57.7%, p = .003). All devices were more efficacious at lower humidity levels.

Conclusions: Traditional low-cost devices, such as clay pots, reduce storage temperatures to or close to room temperature in hot-humid climates. This study provides some guidance for insulin storage in hot-humid environments.

Keywords: Diabetes mellitus; drug storage; hot temperature; insulin therapy; temperature.

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Conflict of interest statement

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

Figure 1.
Figure 1.
Illustration of cooling devices.
Figure 2.
Figure 2.
Mean external temperature in 12-month period.
Figure 3.
Figure 3.
Temperature reduction achieved by each cooling device.
Figure 4.
Figure 4.
Temperatures in each cooling device and external temperature.
Figure 5.
Figure 5.
Relative cooling effect for each cooling device.

References

    1. Bahendeka S, Kaushik R, Swai AB, et al. . EADSG guidelines: insulin storage and optimisation of injection technique in diabetes management. Diabetes Ther. 2019;10(2):341–366. - PMC - PubMed
    1. Heinemann L, Braune K, Carter A, et al. . Insulin storage: a critical reappraisal. J Diabetes Sci Technol. 2021;15(1):147–159. - PMC - PubMed
    1. Khurana G, Gupta V.. Effect on insulin upon storage in extreme climatic conditions (temperature and pressure) and their preventive measures. J Soc Health Diab. 2019;7(1):6–10.
    1. Shnek DR, Hostettler DL, Bell MA, et al. . Physical stress testing of insulin suspensions and solutions. J Pharm Sci. 1998;87(11):1459–1465. - PubMed
    1. Vimalavathini R, Gitanjali B.. Effect of temperature on the potency & pharmacological action of insulin. Indian J Med Res. 2009;130(2):166–169. - PubMed