I have a 5-year old daughter with type 1 diabetes. We travel extensively by car. During long road trips, we have problems with our NPH insulin going bad. Is there a preferred method of protecting the NPH insulin in high-vibration environments, or should we just expect to have to purchase additional NPH on any long trip?

You have presented an interesting challenge regarding insulin storage and travel. I am assuming that when you describe your daughter’s N insulin “going bad” you are saying that it clumps, will not mix properly, and her blood sugars go out of whack. If this is the case, I would suggest a couple of things that you may or may not have already tried.

First, carry the insulin in an insulated case stored in a cool (not on ice) environment. Using a “cool pack” is preferred since the insulin is fragile and should be kept away from freezing.

Second, never leave the insulin in the car when the temperatures can reach over 86 degrees. The inside of cars can be well over 100 degrees in a very short time.

Third, if your problems continue, I would suggest you leave your vials at home and carry an insulin pen along. Pen cartridges come in 150 units and the new disposable Humulin N Pen carries 300 units. You would have less waste if you did have continued problems of the insulin going bad.

The last possibility, if your daughter is experiencing blood sugar problems during travel, is to consider that many people respond to changes in their environment, foods eaten and timing changes related to travel, and the excitement of a trip by blood sugars going out of control. If this is the case, your daughter might benefit from a variable insulin treatment plan during travel, one that would better match the travel environment. This is something to discuss with your healthcare team and diabetes educators.

KS