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Why is your fridge a frenemy of your insulin? Amin Zayani explains in a talk with Diabetes in Control Publisher Steve Freed during the ADA 77th Scientific Session in San Diego.
Amin Zayani is the founder and CEO of MedAngel. He works with his team of engineers, pharmacists and designers on improving drugs safety for patients who live with diabetes and rely on temperature sensitive drugs like insulin.
Transcript of this video segment:
Steve Freed: You mentioned about heat. What about cold?
Amin Zayani: Cold is really the one overlooked problem because we also call refrigerators the “frenemy”, because you think you protect your insulin from the heat by putting it in the refrigerator and that may be even worse than getting it out of the refrigerator. The science behind it is very straightforward. Insulin is a protein and it degrades when it’s exposed to heat. The fast version of a protein degrading is when fry an egg in a pan. The proteins lose their structure and they have a different structure. This is what happens slowly when insulin is exposed to heat. So, starting the moment you take insulin outside the refrigerator, it starts to slowly degrade. The higher the temperature is the faster this process becomes. This is a very well-known problem. All educators, all clinicians educate patients properly about this. Most patients are very aware of this problem. This is why there exists a multitude of cool bags and other solutions to keep insulin cool. The overlooked problem is the freezing problem. The refrigerator at home is not made to store medications. Refrigerators in the pharmacy are regularly maintained. They have super accurate and redundant thermostats and regulation mechanisms. They are operated by professionals who take protocols and they’re really very closely monitored, maintained, and operated. The refrigerator at home is made to keep cheese, or butter, or eggs, or milk from going bad but the way the regulation is very rough. So it can fluctuate, it does in fact fluctuate greatly. Sometimes it goes below freezing temperature for quite a long time. In fact, in a recent study made by a few Dutch hospitals and universities, it’s been proven that 25% of patients accidentally freeze their medications in the domestic refrigerator. In fact, 93% of patients do not store their medications in the domestic refrigerator as it is recommended by the manufacturer. So what happens when insulin is exposed to freezing temperatures is that the solution becomes crystals and these crystals break the protein of insulin completely. So if insulin is frozen, it completely and totally loses its effectiveness. This is why we call the refrigerator the “frenemy”.
Steve Freed: So, let’s say it does freeze. What exactly happens on your cell phone?
Amin Zayani: There are two cases. So either you are around this refrigerator and the temperature is dropping very fast so you get an instant alarm, because the sensor is connected to the phone and it will give you an alarm that it’s getting too cold too fast. What you do is either you fix the setting on the refrigerator. You take it out of the refrigerator. But if you’re not around and this happens in your absence, then the next time you are around the sensor and let’s say you go home and near your fridge, the sensor connects with the phone, it will sync all of the data it was monitoring in your absence. In fact it has enough memory to store up to 7 days of data. You will know how long was the exposure and how cold was the temperature. With this information you can make an informed decision about whether to discard it or not.