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How Diabetics in Developing Countries Cool Their Insulin

In a 2016 study by Life For A Child (LFAC), an IDF program delivering care for children with diabetes worldwide, researchers collected alternative cooling devices from a number of countries and compared their effectiveness in a “clay pot Olympics.” Dr. Graham Ogle, the lead author of the study and general manager at LFAC, had the idea for the experiment after a site visit in Khartoum, Sudan.

Besides clay pots, the researchers looked at a gourd from Sudan, a goatskin filled with water from Mali, a bucket filled with wet sand from Ethiopia, and, as a control, a FRIO cooling wallet manufactured in the UK.

“The senior pediatric endocrinologist there took me to the home of a family with a young boy with diabetes,” he explained. “They were squatting in a half-built house with no windows or electricity. It was very hot that day, and almost every day in summer. The boy stored his insulin in a plastic bag in a small clay pot under a large clay pot which was wrapped in hessian [burlap]. The large clay pot was filled with water, and was porous so the water slowly leaked out and collected in the hessian and then dripped into the smaller pot, cooling the insulin.”

Besides clay pots, the researchers looked at a gourd from Sudan, a goatskin filled with water from Mali, a bucket filled with wet sand from Ethiopia, and, as a control, a FRIO cooling wallet manufactured in the UK.

All of the traditional devices included in the LFAC study used evaporative cooling, which has been used to cool food and water for thousands of years. As the water in one of these devices evaporates, it absorbs heat from the surrounding air, thus lowering the temperature inside the device. Clay pots, which are usually semi-porous, encourage evaporation.

By measuring the change in temperature inside the devices over the course of four days, the LFAC study found that the most effective device was the suspended goatskin from Mali because of its large surface area, which permitted more water to evaporate more quickly. Two porous pots without lids from Sudan and Ethiopia also performed well. The FRIO wallet, made of polyester and super-absorbent crystals, worked about as well as the top-performing traditional devices, not any better. The non-porous devices, such as the gourd and the glazed and cemented pots, were much less effective than the others.

Researchers then modeled how the devices were likely to perform in the hottest months of the year in various countries. They concluded that the top-performing devices were capable of keeping insulin at or near standard room temperature in all of the different climates studied except in regions where high humidity would limit the effectiveness of evaporative cooling.

In Karachi, Pakistan for example, the average humidity is 91.3% with an average daily maximum temperature of 32.7 C/90.9 F. Too wet and too hot.


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