ArticlePloS one2021
Heat-stability study of various insulin types in tropical temperature conditions: New insights towards improving diabetes care.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Thermal stability and storage of human insulin.The Cochrane database of systematic reviews · 2023Pooled it
- The Effect of high temperature on the stability of basal insulin in a pen: a randomized controlled, crossover, equivalence trial.BMJ open diabetes research & care · 2022Trial
- World Humanitarian Day: Why humanitarian settings need more research, not less.PLoS medicine · 2026Article
- Towards the development of an insulin degradation test.bioRxiv : the preprint server for biology · 2026Article
- Towards the Development of an Insulin Degradation Test.Journal of diabetes research · 2026Article
- Exploring humidity effects on polycrystalline human insulin-ligand complexes: preliminary crystallographic insights.Journal of applied crystallography · 2025Article
- Impact of insulin storage and syringe reuse on insulin sterility in diabetes mellitus patients in Mwanza Tanzania.Scientific reports · 2025Article
- Quality of insulin obtained from hospital and community pharmacies in Mwanza Tanzania: A cross-sectional study.PloS one · 2025Article
- Investigating Real-World Stability and Sterility of in-Use Insulin-An Urgent Public Health Concern. In Sub-Saharan Africa.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Biodegradable polymeric insulin microneedles - a design and materials perspective review.Drug delivery · 2024Review
- Burden of Disease in Refugee Patients with Diabetes on the Island of Lesvos-The Experience of a Frontline General Hospital.International journal of environmental research and public health · 2024Article
- Living with and managing type 1 diabetes in humanitarian settings: A qualitative synthesis of lived experience and stakeholder tacit knowledge.PLOS global public health · 2024Article
- Microfluidic Delivery of High Viscosity Liquids Using Piezoelectric Micropumps for Subcutaneous Drug Infusion Applications.IEEE open journal of engineering in medicine and biology · 2024Article
- Article
- Protocol to Assess the Biological Activity of Insulin Glargine, Insulin Lispro, and Insulin Aspart In Vitro.Methods and protocols · 2023Article
- Efficacy of alternative cooling devices used for insulin storage without refrigeration under hot-humid environment.Annals of medicine · 2022Article
- Diabetes Technology Meeting 2021.Journal of diabetes science and technology · 2022Article
- Chronic NCD care in crises: A qualitative study of global experts' perspectives on models of care for hypertension and diabetes in humanitarian settings.Journal of migration and health · 2022Article
- Addressing Challenges in Insulin Storage: An Ethical Dilemma among Physicians.Indian journal of endocrinology and metabolismArticle
- Global Warming and Endocrinology: The Hyderabad Declaration of the South Asian Federation of Endocrine Societies.Indian journal of endocrinology and metabolismArticle
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burden to the management of people with diabetes. According to pharmacopeia unopened insulin vials must be stored in a refrigerator (2-8°C), while storage at ambient temperature (25-30°C) is usually permitted for the 4-week usage period during treatment. In the present work we address a critical question towards improving diabetes care in resource poor settings, namely whether insulin is stable and retains biological activity in tropical temperatures during a 4-week treatment period. To answer this question, temperature fluctuations were measured in Dagahaley refugee camp (Northern Kenya) using log tag recorders. Oscillating temperatures between 25 and 37°C were observed. Insulin heat stability was assessed under these specific temperatures which were precisely reproduced in the laboratory. Different commercialized formulations of insulin were quantified weekly by high performance liquid chromatography and the results showed perfect conformity to pharmacopeia guidelines, thus confirming stability over the assessment period (four weeks). Monitoring the 3D-structure of the tested insulin by circular dichroism confirmed that insulin monomer conformation did not undergo significant modifications. The measure of insulin efficiency on insulin receptor (IR) and Akt phosphorylation in hepatic cells indicated that insulin bioactivity of the samples stored at oscillating temperature during the usage period is identical to that of the samples maintained at 2-8°C. Taken together, these results indicate that insulin can be stored at such oscillating ambient temperatures for the usual four-week period of use. This enables the barrier of cold storage during use to be removed, thereby opening up the perspective for easier management of diabetes in humanitarian contexts and resource poor settings.
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