I haven't found any discussions, for building and maintaining a 'long term' insulin supply for SHTF.
Storage will probably have to be solar and a small 12V fridge.
I have read of people building a year's supply of insulin, but no mention of how that is accomplished.
There must be many type 1 diabetics (T1D), who face this issue.
Thanks in advance, and good luck to you all.

its my understanding that unless you have a long term solution for power and long term refrigeration for the insulin, you are pretty much SOL for type1...

you can try this https://www.healthcarepackaging.com/markets/pharmaceutical/news/13296208/frugal-diabetics-are-making-their-own-insulin but im honestly not sure how effective it is...

eta: if you want a year worth of insulin, talk to your dr. im sure they could prescribe it and while it would not be covered by insurance, you can pay for it out of pocket...

Do you think you'll need to be away from a Walmart for a year ?

Reason I ask is you can walk into any Walmart and get a vial for $25, zero insurance needed.

I read back in the day on maybe frugal forums it takes a while, they basically just used the minimum and refilled as many times as possible. People had to dance around insurance, I.e the max units per 30 days or whatever prescribed.

here is a post about it linked from there:

https://www.thesurvivalistblog.net/diabetic-survival-tips/

Someone also mentioned Walmart may sell $28 vials no questions asked depending on the state. YMMV not a diabetic.



from old forum post:

One of the greatest challenges facing preppers and survivalists is long term care for a diabetic family member. Nearly half the country has some form of diabetes or is very close to it. Naturally if the SHTF, pharmacies will be quickly emptied of drugs, syringes and pretty much anything usable.
If the diabetic family member is insulin dependent, that makes matters much worse. For one, without insurance the cost of insulin is beyond most families ability to pay for it with some insulin's costing $200-$300 per vial. Even if people can afford a vial per month it still becomes very cost prohibitive, if it is still available at all.


On a recent visit to my doctor, I shared my concern over the cost of insulin since I will be transitioning to Medicare this year. I inquired whether there was an alternative to insulin that would bring the price downin the event Medicare will not pay for it. He asked me if I ever tried Walmart for my insulin needs. I thought Walmart? I know they may be a little cheaper on many things but I didn't think their insulin would be much cheaper than any other pharmacy.


That's when he told me that a 10ml vial of insulin at Walmart here in Michigan is available over-the-counter with no prescription and no questions asked for $28 bucks! My jaw dropped when I had him repeat that to make sure I heard him correctly. He instructed me to go to the Walmart pharmacy and just ask for Novolin R insulin. Novolin R is Novo-Nordisk entry into the fast acting insulin market, and is reportedly identical to the Humulin R I have been taking for the past several years. The Humulin R is near $150 per bottle.


I went to the Walmart and asked at the counter for the Novolin R and actually felt nervous while doing so as if I was doing something wrong. In a moment the counter girl returned with a smile and my vial of Novolin R and was ready to check me out! No prescription, no Id. no nothing. The best thing about it was that she told me I can buy up to four vials at a time. What else is great is that the expiration date on the vial is April 2019 (I purchased it in April 2017.)


If you are fortunate enough to live in a State that allows no-prescription over-the-counter sales of insulin at Walmart or know someone who does, this will be a lifesaver for you and there is no paper trail. The other States still sell it at the same price but a prescription is needed. There are currently three types of Novolin insulin available at Walmart. Novolin R, Novolin N, and Novolin 70/30 which is a combination of fast and slow acting insulin. You can read about each one online to be sure it will work for you. Each blend costs $28.44 per vial here in Michigan. Buying over the counter with no prescription is not available in all States so its best to call your local Walmart to check.


What I plan on doing now is buying insulin, four vials at a time until I build up a sizable inventory, always watching the expiration dates and keeping them refrigerated. Any diabetic prepper would love to have the peace of mind that having 50 or more vials of insulin sitting happily in a refrigerated area for when times get bad. This is your chance to do it at a very reasonable price. Walmart also sells every other needed diabetic care product such as 100 pack syringes for $15, meters for $9, and test strips for about $15 per hundred.
Here is a link to a list of States that allow over the counter purchases of insulin and syringes. It is dated from 2010 so it may no longer be accuratecheck your local Walmart to be sure.

Thanks, for all the ideas!
This thread has just started, and is already very valuable.
My grown son is the T1D, so I will be sharing this info with him.  

https://childrenwithdiabetes.com/insulin/prescription-laws-and-resources/


List current as of 2021

Learn something new every day.

That is bottom of the barrel shitty insulin.

It's literally the exact same stuff.

Bullshit.
It kept my brother alive for the 4 years he didn't have insurance.

read the book one second after

An article from June 1st, 2022:
Insulin May Withstand High Temperatures Better Than You Realize
As stated, insulin may have changed over the years  but this article is promising.

More Data on Insulin Durability
A study from way back in 1972 found that insulin retained sufficient potency for "10 years at 15 degrees C [59 degrees F], 20 months at 25 degrees C [77 F], three months at 35 degrees C [95 F], or 10 days at 45 degrees C [113 degrees F]."
A 2009 study proposed that insulin stored at 25 degrees C (77 degrees F) had an estimated shelf life of 199 days.
A 2012 study found that insulin in a pump can retain potency for 14 days when exposed to a continuous temperature of 37 degrees C (98.6 degrees F).

If you have insurance, your doc should write for extra every month if you ask. Doesn’t take too long to create a surplus.

Yet mfg claim it loses potency after 28 days at room temp.

I know first hand that leaving insulin in a parked car even for three hours in the summer ruined my vial. Lost 100% potency. Had to toss it. Granted it probably got to 120+ in the car.

Dad of a 12 year old rambunctious boy with type 1 diabetes here.

I have a lot of research and planning put into this:

Insulin, storage and preservation
My son uses Novolog (manufactured by Novo Nordisk). It's a short acting insulin and is delivered through the Omnipod (a tubeless pump).  I get (6) 100ml vials delivered every 90 days. based off his image, I've got about a year and half of insulin on hand. While he does not use long acting insulin, I keep 3 months supply of Basaglar on hand in case there's ever an issue with the Omnipod delivery and we need to switch to injections. The Novolog is set to auto-fill through my pharmacy. The Basaglar I fill manually. When I fill his pump, I draw insulin out of the vial and immediately place it back in the fridge. Before I put this plan together he was carrying a vial everywhere he went and it was hitting the 28 day mark before he could finish it. It costs way too much to waste.

I have the insulin split into 2 batches and I pull new vials as needed rotating between the 2 batches. Batch 1 lives in my fridge in the kitchen. Batch 2 lives in the laundry room fridge. On top of each batch is a Yolink Temperature sensor that monitors the fridge temp and if it raises above a certain threshold, it texts my phone. Double redundancy - 2 batches and monitored. If a fridge fails, I'll know and won't lose a whole batch.

If I encounter a power outage, I have a small AC/DC powered cooler that will fit the both insulin batches. It's powered by a 400w Goal Zero or a 500w Jackery battery. Both of these can be charged via a solar panel. Running the cooler in eco mode at 40F, I can get 28 hours out of those batteries before they need a recharge. I can rotate them as needed. And if for some reason those fail, I have a backup gas generator. I've used the cooler on road trips to keep his insulin cool and it's worked great.

Supplies
We have a plan for his supplies. I mentioned he uses the Omnipod pump. This is a tubeless pump that delivers 3 days worth of insulin. We have the "eros" version which is under system. The pump is driven by a device that uses a radio frequency to communicate to it. Its like 90s era cell phone technology. In the 6 years since his diagnosis, the original controller failed once and the company overnighted a new one to us. When it reached its end of life, I got a new one in 3 days. It runs on AAA batteries. It has an internal battery that can't be changed. I was having his pumps auto-filled as well and I have a year's worth of them on hand. I'm slowly working through them until I get down to 3 months left, then I sill switch him over to the Omnipod 5 version, which works with his Dexcom CGM. It's hard to explain what they do together if you don't live this stuff day to day.

Anyway, I keep a variety of supplies on hand - 2 extra glucose monitors, as many test strips as insurance will allow me to have, tegaderm patches (his Omnipod sits on top of one), overmatches, lancets, syringes, alcohol wipes, keytones test strips, glucose tabs, electrolyte drinks and mixes, Unisolve adhesive remover, Q-tips, I'm sure there's more. I have 3 big tubs of this stuff that gets inventoried monthly. Some of these things are auto-refilled via pharmacy or Amazon. But I have lots of redundancy built in.

I mentioned Dexcom CGM - this device monitors his blood glucose in realtime and sends alerts to a receiver or his phone, my phone and my wife's phone if he's too low or too high). It's a liberal lifesaver. Insurance allows me to keep a 3 month supply on hand. If you're lucky you can build a 4th month, if you stay on top of the order dates. I wish there was a way around it. We've run out a couple of times (the sensors may fail, he can damage them, or pull them off). A box of 3 is $330 at Costco with no insurance. I've done it a couple of times. They also need a transmitter. It clips in and lasts about 90 days. I have 2 on hand.

The electronic stuff (insulin pump, controller and CGM) all have a shelf life b/c most have internal batteries. And speaking of batteries, I keep loots of AAA and AA and 2032 on hand as his devices use this too.

Food
This is where it gets fun. AsI build up preps, I have to figure out how to prep low-carb food. if we and up in any kind of catastrophe (see Pandemic) and things get scarce, the lower carb he eats, the less insulin he uses. The less insulin he uses the further I can stretch it (to a point). Did I mention he's a picky eater? So stacking up rice, flour, pasta, yeah I have that, but I also have lots of freeze fried veggies and canned meat.

Ultimately, if we end up in any kind of economic collapse, a real pandemic, societal breakdown, war, zombie apocalypse, undead rising from the graves or alien invasion, I know what happens once the insulin runs out or I no longer have a way to keep it temperature controlled. I pray I never see that day.

There's some pretty promising research on the horizon that could offer a cure. And there's stuff on the market now (see pump/cgm looping) that is almost next best thing to a cure. Almost.

OP - hope this helps. Feel free to DM me if you need to (or anyone else for that matter). I give this stuff daily thought.

See any info here will be helpful, it's 14 page thread.

https://www.survivalistboards.com/threads/1-2-3-home-made-insulin.33479/

Even if it were as you say, the choice between that and, oh say, being dead seems clear.

I’m an insulin Type 2. Short of the end of the world I could travel, even on foot, to an area where the insulin supply isn’t disrupted in a few days. But I keep at least three months on hand.

Am mentioned, safe storage is the biggest issue. At home I have backup power to augment my solar. On the road I’m still figuring it out.

As to home made insulin, that’s seems very risky to me.

The best way to describe Omnipod and Dexcom working together is that it is as close to having a working pancreas as you can get.

A CGM and insulin pump aren’t perfect but they are a hell of a lot better than what was available a decade ago. And the technology is getting better and better.

For clarity-there are different types of diabetes.  About 5% of diabetics are Type 1.  It has nothing to do with what you eat or how you exercise.  It's an autoimmune disease where your immune system ests the cells in your pancreas that produce insulin.

All type 1 diabetics require insulin.  I'm a late onset T1.

The insulin from Walmart isn't "bottom of the barrel".  It works just fine.  I've been using it for years.

They have N, R, and 70/30 with a four bottle limit of each so you can get a total of 12 bottles at one time.  Then go back the next day and do it again.  $24.88/bottle.  They also sell syringes over the counter.  Around $16.00/hundred.  Syringes are also available from Amazon.

Dosing N and R is about equal to Novolog and Lantus.  It's also legal OTC in every state except maybe Alaska.

Expiration dates are almost two years out so you can build up a decent SHTF supply of insulin and syringes quickly.

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@MarkMustang: Thank you, for sharing your great management system - and offer of help.
I will visit my son today, and make sure he reads what you wrote.

To all the others who have shared thoughts and information:  thank you as well.
Collectively, we are sharing life-saving information!
If you really want answers to challenges, ask preppers.

@nozzle - Happy to help. Type 1 diabetes sucks, it's damn near impossible to predict and presents a lot of challenges. I just try to pass on what I've learned to help others.

One thing I forgot. The devices make it stupid easy to dose insulin. You plug in a blood glucose reading and add carbs if you are eating and away you go. The first time my son's Omnipod controller died, I had to manually work the computations. The problem is they were all on the device and had changed a few times since we moved from shots to pump.

Now I have a binder with information - the insulin:carb ratio, correction factors, a chart that details insulin on board.instructions on how to calculate and administer a dose, check for keytones, etc. If for any reason all the devices suddenly fail, I have a way to manually dose him. That binder also has all of my knowledge in it, so if a meteor falls out of the sky and lands on me, that knowledge isn't lost. I keep a backup of it at my parent's house.

I would recommend reading this book, but not for this reason…

I had a request to add some more info here, specifically around insulin storage:

I have my son's insulin split into 2 batches (batch A and batch B). As I get new insulin supply in, I divide it among the batches:

Both batches look like this:
(3) 100ml vials Novolog: expiring 9/2022
(3) 100ml vials Novolog: expiring 3/2023
(3) 100ml vials Novolog: expiring 9/2023
(3) 100ml vials Novolog: expiring 3/2024
(3) pens of Basalglar long acting insulin (expiring 2/2023)

As I get new insulin supply in, I divide it among the batches in equal portions. As needed, I draw vials in alternating fashion - A, B, A,B, etc.

Batch A is stored in the kitchen fridge. Batch B is stored in the secondary fridge (currently in laundry room). These rooms are on different circuits on the breaker panel.

Fridge temps fluctuate between 35F and 40F (I think it's dependent on the time the compressor is running and how often the door is open. The insulin manufacturer says to keep it refridgerated between 35F and 46F. And that if it freezes, it'll go bad. We don't keep a vial out and let it reach room temperature. We used to do that but changed that with COVID. Now when I need to fill an insulin pump, I take the vial out, draw out the insulin and immediately place it back in the fridge. I haven't tracked how long it takes to deplete a vial.

When he needs to travel and needs to take a vial with him, I either bring the portable cooler or a small container with ice packs. It just depends on where he's going that determines what we do. The last time I used an ice pack, the temp in there got to 60F so we just let it get to room temperature and finished it out.

Now for the backup plan, all the insulin goes into that 1 cooler, so there's a hole in my prep there. I'm not sure how to fix that. Right now I'm trying to determine if I get another cooler + goal zero type battery, get a bigger battery setup (Delta EcoFlo Pro) or build something myself.

Bottom line: the goal is to use all the insulin we buy, and get the most out of the shelf life.

@Ncmulching - my DM's don't seem to be working, so I'm tagging you here.

Take a look at the 4AllFamily insulin transport container. You can use a biogel or the USB powered cooling unit. I’ve used it traveling by car and train. The jump pack I keep in my truck kept it running for over 4 days.

Not the largest capacity by it will keep several weeks worth of insulin properly cooled for me.

@MarkMustang I did get a message from you.  Thank you for the reply. My 10 year old has an appt this Tuesday at a pediatric specialty clinic for his diabetes.  Getting an omnipod is the main thing that I want to discuss.  We have been managing with the insulin pens and have using the dexcom for 3 months now.

@Ncmulching - I'd recommend Omnipod. In the years he's been on it, we've been able to consistently lower his A1C. It ranges between 6.4 and 7.1. That alone makes it worth it.

What we like:

• Tubeless. I've accompanied him to some events where kids with Type 1 get together and I've seen a number of tubed pumps get pulled out. I have no experience whatsoever with a tubed pump, so it could just be rambunctious kids. And it's not like Omnipod doesn't get ripped off. But it's nice to stick it on and let him go.
• Ability to custom deliver insulin. Need to split a bolus depending on protein/fat/carb meal makeup? That's easy. need to turn off or reduce basal insulin because he's doing athletic stuff? That's easy. need to see how much insulin was delivered 2 meals ago? That's easy. Want to see data trends over time and make adjustments to make glucose levels less spikes? That's easy.
• Half awake b/c you got a Dexcom alarm for the 3rd time in as many hours and it's 4am? The Omnipod does calculations based on what you input (this is a risk reduction thing for me).
• It's small enough I can travel easily with a backup pod + materials to change it (it fits in a ziplock sandwich bag).

Things I don't like:

• The PDM (1st gen eros version) is 90's cell phone technology. The Dash (2nd gen android version) I have no experience with. Omnipod 5 (current gen) I think is still an android bad controller. Specific to the 1st gen eros version, the programming learning curve is a little steep. I've had buttons fails b/c of multiple presses. Battery life (two AAAs) is ok. When the internal battery fails, it's toast as the internal battery is soldered to the board.
• I can't get a backup controller. Well, I can if I pay a lot out of pocket. But a plan b would be nice.
• The adhesive sometimes irritates him. I mostly solve that with a tegaderm patch first, then the Omnipod, then a tegaderm overmatch. It helps, but he itches it. Oddly, Dexcom never itches him.
• The PDM makes you reliant on the calculations. And when it breaks if you don't have a plan then you have to figure it our (reference my above post about a binder)
• Even though Omnipod deliver fast acting insulin only, I still have to keep a small supply long term insulin off the PDM fails.

Unknowns:

• Omnipod 5 is a closed loop system. The pod talks to Dexcom and the reading from Dexcom work with the paid to adjust basal insulin on the fly. What makes me nervous is Dexcom has a margin of error of 30 points. And sometimes the reading are more off than that.  So if he's at a finger stick glucose reading of 60 and Dexcom thinks he's at 125, it could be giving him more insulin than needed, and setting up a hypoglycemia emergency. I have no idea how they account for that. I have enough 1st gen Omnipods on hand too last the rest of the year, so I have time to figure it out.

To my point about about redundancy and plan b, my son's PDM malfunctioned tonight. Upon changing the batteries it reset itself. This means the internal battery is dead.

5 min on the phone with Omnipod and I'm getting a new one by Tuesday. But for 6 hours this evening I have to manually calculate the insulin dosage.

At least it's under warranty.  

All this is what we do for our 10 year old type 1 diabetic daughter. We have the tandem pump and dexcom g6. Our big difference is that she has severe Celiac's disease so I have to prep and store gluten free items.. Makes food prepping very costly as things like gf flour , pastas, soups etc. are $$$$.

I spend many hours at night thinking of ways to keep her alive should our 1 year of supplies run out.
I wish I could take it all for her.

I've used the walmart reli-on generic brand of N and R for years and years. Been a type 1 diabetic since age 5, now 51. My A1C hovers around 5. Excercise and watch what you eat. A lot of my friends are in the medical field and I hear shit all the time people coming into the ER with blood sugar of 800 and shit. Drinking a lot, half drunk, eating whatever.

At age 51 I've never claimed insulin on insurance in my life. Always pay for it, prior to the reli-on coming out I paid cash for humulin N and R.

I keep a year supply on hand give or take. My other home is in a hurricane area. I have had insulin unrefrigerated for 2 weeks give or take with no serious issues if you keep it in the shade. Hurricanes, backpacking, working for the US Forest Service and other things.

Best thing ever happend is at age 5 I went to the mathodist childrens hospital in Houston (I'm from Baton Rouge) and they purposley upped my sugar and then brought it down multiple times to see how it would feel. After a while I could tell what my blood sugar was very accuratly. I checked it but it was very very rare for my sugar to test out greater or less than 5 on what I thought it would be.  Few hiccups as a teen, guessing hormones but it was very minor. I now have a continous blood glucose monitor and really my A1C has not changed in the 2 years of using it, hovers around 5.

Supply:  you are on your own.  I have no input.

Storage:   I lived off grid for much of my life.  If I had a diabetic family member, I would be buying a small, propane powered refrigerator.    As a kid, we had a 1940's Servel, a giant monster of a thing.  Propane ran the fridge, lighting, and stove.  The basic 4 foot tall 100lb torpedo tank would give us coverage for about 75 days.  Refrigerator only, it would have likely been more like 90 days.    A smaller, newer, more efficient unit would go longer, on less fuel.  

A LP fridge is about stone ax simple.  A closed refrigerant loop, some valving, and a burner (I know, counterintuitive).  If you get them completely level, keep the fuel running, and DONT frig around with the "thermocouple" that drives the unit, they run FOREVER.   And unlike some electric RV refrigerators, and LP unit will often get "holy shit, everything in here is frozen" level cold....     They take a while to cool, but stay cool really well.  If you want to ensure the supply does not freeze, start the unit on a low setting, and let it run for three or four days without opening a door.  Then check internal temps.  These LP units arent great for normal "I swing on the fridge door every  twenty minutes" living.  All that door opening challenges them.  But if you put stuff in there to store, shut the damn door, and don't open it every six minutes, that shit will be COOOOLLLDDDD for ever

Back during WWII, there was a Jewish couple named Saxel that escaped the Nazis and ran to Hong Kong, just 8n time for the Japanese to invade. The wife was a Type 1 diabetic. They had a small medical book that gave them the information to make insulin. They used animal pancreas and extracted the insulin from those. They managed to keep the wife alive and eventually started giving it to other diabetics. It's an interesting story:

https://www.uh.edu/engines/epi3065.htm

Thanks for sharing.

Type 2, but my endo wrote me a scrip that is basically for 300% of what I use "Just in case" according to her.

$20/ every three months. Backup supply stored in long-term foam containers that take ice packs if needed.

I cycle it through as I use it.

I found this article on insulin types, very informative:
REGULAR (R) INSULIN: WHAT YOU NEED TO KNOW
Hope you are all having a good summer.  

I just wanted to say thank you all for sharing your info, tips and experience. I just came across this thread today.

My son is 18 and was diagnosed with Type 1 two years ago. So many of your concerns and thoughts are mine as well.

Thanks again.