Out and About with Insulin - MDI

I started insulin in November 2020, and at the time was working 100% from home due to COVID restrictions. Now that we are starting to go back to work (and leaving the house more often in general), I find myself wondering about how other people transport their insulin.

I’m doing MDI (my doctor didn’t recommend a pump mainly due to me being sensitive to adhesives) and so I need to take my insulin pens and needles with me. I live in a hot climate and keeping it cold isn’t trivial. I’m using a makeup bag and 2 small ice packs, but yesterday when I arrived home after being out of the house for 11 hours, the pens weren’t even cold anymore (and of course the ice packs had melted).

So - a couple questions here:

  1. What do you use to transport or insulin when you’re out for the day? Specific recommendations welcome.
  2. If you are doing injections and are around other people (like coworkers), how private are you about your insulin usage? Meaning would you just take out your pen and a needle in front of everyone?

Thanks!

@Leah10, I have been on a pump for well over 15 years but did MDI for a long time before that. I never hesitated to take out a pen and shoot insulin in front of others. Some cringed, but most got used to it as I shot right through my clothes. Since I did not change needles each time, that was not an issue. In hot climes, a Frio is the way to carry insulin. Frio makes different ones for different uses. A cold water soak is what makes a Frio work. If you will be out for a very long time, maybe two Frios would do the job for you, changing over to a fresh one in mid day? Everything else is cumbersome to deal with as you have found.

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Thanks! I’ve never heard of a Frio, and I’ll look it up now!
I was wondering about injecting through clothing. The needle is so thin I didn’t know if it would get bent / work properly.

I am MDI and carry everything in a beautiful leather bag which receives frequent compliments. As a male, the bag has a loop and is attached to my belt and it carries everything. Cell Phone, Pendiq Digital Insulin Pen, spare needle, meter, strips, money, credit cards, sweedish fish to take if going low, and many other items so really carries the works. The challenge is to find a bag that holds and protects the longer pens, especially digital pens.

Since the leather is very thick, my pen stays away from my body which is what in the past has caused my insulin pens to get warm when in a shirt or trouser pocket. My insulin has never gone bad due to outside temperatures reaching in the high 90’s.

I inject anywhere and have never had an issue except in a park once in Shanghai where someone came up to me and gave me a long lecture on how doing drugs is bad for you. In an airplane, if I can’t easily lift a corner of my my shirt to inject, I just inject right through my clothes. I used to ask surrounding seatmates if they mind if I inject while in my seat and not once has anyone balked, so I stopped asking several years ago.

If possible, I don’t make this an overly obvious scene but otherwise I inject anytime, anywhere and think nothing of it. It takes time to build that level of confidence so just take it one step at a time and you will find yourself getting bolder and bolder where you inject in public.

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Ya, those thin BD needles do bend from time to time and do start to fail after 50 injections or so but just bend them back to as straight as possible and they will work fine. If you do need to bend them too often, however, they will break so I will only straighten a needle 5-6 times before replacing it.

Don’t buy too many Frio’s. We tend to use them a lot when we first get them but then realize they become more pain than they are worth over time and then we ditch them. The biggest determining factor is how fast you go through 1 pre-filled pen or cartridge if using a digital pen. If you will use it entirely in a period of a week to 10 days, heat should not be an issue. If it takes you several weeks to go through a pen, then you will find that the insulin starts to degrade after 2-3 weeks or longer depending how long it remains in extreme heat. That is something only you can test.

PS: I have been MDI over 30 years

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I’ve never had a pen needle break. But I changed needles maybe half way through a pen and shot only through a light layer of clothing such as a summer weight shirt or panties. Never through jeans or a coat. I never primed the pen either, considering it a waste of insulin. A bit of air doesn’t hurt you and the dose pretty much adjusted, too.

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I always use a new needle, my insurance covers them. - I have prefilled pens (Toujeo for basal and NovoRapid for bolus)

It is not an insurance issue for me and needles are so cheap that I would not even mind buying them out of pocket. My offices are located all over the world and going through airport security in some small airports in remote countries, they will not allow more than 3-4 needles total in your luggage. Since my overseas trips tend to last about 3 weeks, that is what drove me to reuse pens a few decades ago.

Oh that’s an interesting point. Due to COVID I have yet to travel with insulin & its accoutrements, so I didn’t know they could made an issue about needles! When my son was on growth hormones, he had a doctor’s letter saying he needed his medication and needles and he never had any problems, but that was about 9 years ago. Maybe they’ve gotten more strict since then?

Most of the world is OK, third world countries are sometimes unpredictable.

Just a note about Frio: I have used them very successfully when traveling. If you kind of over-soak them, they will keep insulin cool even when kept in the car in 90+degree heat for, literally, a day or two. If you’re keeping it with you in a purse or in your desk drawer, you shouldn’t have to soak it more than once every two-three days.

As for “shooting up” in public…just go for it. I’ve been on a pump for years but was on MDI for a few years before the pump. The ONLY time I got in trouble was when I was taking my shot in a ladies’ bathroom, and a little girl (about 7?) came in, turned right around, and went and told her parents there was a lady doing drugs in the bathroom. Manager comes in (by which time I was the only person in there), asked me if anyone else had been in there, and when I realized what was happening, I started laughing. Showed her my insulin bottle and she started laughing, too.

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@Ruth4
I shot insulin in the ladies’ room only once and never again. It was awful because it was so dirty. But no one asked me about it. After that I always did my shots unobtrusively in the dining room. The only comment came from my companion once and it was a shudder. I told him to get over it and then proceeded to wave my hand and by accident spilled my glass of water all over him. Heh heh heh heh! :astonished: :rofl: :rofl: :rofl:

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This is a very personal decision some people are more discrete than others. As far as coworkers, you kind of need to read the crowd. If there is someone squeamish about needles, be considerate of that.

But you should never be asked or feel you need to hide in the bathroom to inject.

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  1. I use an insulin pen and carry it in my pocket or in my work backpack. I never leave it in the car. So my insulin pen is either in my pocket, in my backpack or on the kitchen counter. I dod own a Frio but have never felt the need to use it so far.

  2. In the beginning (2018 for me) I would go to the bathroom for my shot before eating. After a few months and reading others thoughts I just do it where I am anytime I need. I do sometimes take a shot through my shirt but thats the limit of being discrete. I’m pretty fast so I’m not sure how often anyone clocks that I’m doing. I used to warn my co-workers the first time but now I don’t. No one has ever said anything to me about it. Diabetes is already enough of a burden, so when/if your comfortable take your shot etc… when you need to.

MDI, I’ve thought many times about getting a pump but I’m not eager to have another device attached to me 24/7 (already have a Dexcom). Since I have very good control I don’t expect to switch to a pump anytime soon. I think for most people a pump leads to better control but its not for everyone. I think the Dexcom CGM is much more important for good control.

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Reading others comments on the pen needles. I normally change my needle once per-day so I use it 3-6 times before replacing. I’m sure I could use it more but insurance supplies enough to change on ever shot. I do notice after 3-4 uses they have dulled enough that the shots can be slightly more painful. A new needle I find causes less of a pinch.

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@Willow4
I usually just shot through my clothes. The only reason I had gone into the ladies’ room that time was because I was with my aunt who had a problem with me doing it in public, even when it was under the table and no one saw. I also used to have to check my bg and do my shots in the bathroom whenever I was at her house. But after that incident, I had a few choice words to say to her, and never again “hid” my diabetes care.

Good for you! She needed education. To be injecting in unsanitary and public public restrooms is a total no-no. I hope she understands now.

A question you didn’t ask but I’ll answer anyway:

When your current short-acting pen gets down to 10 units or so, put it in your desk at work.

Because someday you’ll forget to bring in your insulin from home.

Then cycle through.

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Nope…she never understood. We, however, were supposed to watch her test her blood pressure twenty times a day and be concerned. Don’t ask. She was a wonderful aunt to me when I was young, not so much as I got older and challenged her on anything. But she passed away in 1998…I’m still trying to forgive her for a few things she did. She certainly wasn’t all bad, in fact, she was mostly a great aunt, which is why it actually hurts me to still feel resentful towards her.

Hopefully I can let go of these feelings one of these days.