MedAngel’s Founder Amin Zayani shares the fright and subsequent frustrations; what his team learned about the cold chain problem; and how their Startup was born.
I am 29 and I have lived with T1 Diabetes for 10 years. I am not the first in my family with this condition. My younger brother was diagnosed 23 years ago at age 3. We grew up with insulin in the butter compartment of the fridge and the first thing to be packed and double-checked before going on summer holidays was the medical cool bag.
One of the first things you learn is that insulin must be kept in the refrigerator when still unopened, and it will be fine. Nurses, doctors, pharmacists and educators all assure us that the refrigerator keeps insulin safe, and that heat makes it ineffective.
But I learned the hard way that this is not entirely true!
My fridge betrayed me… And yours will stab you too!
I woke up one Saturday morning in August 2013, measured my blood glucose level and it was high. I took a shot of insulin, checked one hour later, and it was still high! So I took a new pen from the refrigerator and injected an even higher dose, controlled it later, and it was still very high!
This was frankly scary. I was lucky that day that I didn’t fall into DKA (Diabetic Ketoacidocis), but guessing that my insulin was no longer good, I still had to get to an open clinic, get a prescription and then find a pharmacy that had it in stock. (Saturday is horrible to have a medical emergency in Germany).
Thinking back, I suspected that something was wrong with the refrigerator. I had recently moved to a new house where I share the fridge with 10 people. With that many people, it is frequently opened and closed. I had a look at the box of my insulin, it said: “Store at 2–8°C (in a refrigerator)”. So I decided to put a thermometer inside to double-check.
How weird: 12℃! My refrigerator was 4℃ warmer than it should be and it was probably like that for months. I checked the thermometer every few hours and was even more surprised: The fridge fluctuates between -2℃ and +12℃ every day!
And I had to throw all of my remaining stock of insulin away!Hundreds of $$$ worth of Lantus and NovoRapid!
You don’t know what happens in your fridge
This situation was equally dangerous and frustrating, so I decided to learn more about this problem and try to find a solution for it. This is what I learned:
1. It’s mainly the cold, not the heat:
Insulin is actually quite resistant to temperature higher than recommended by the manufacturers (they factor-in safety margins).
But completely loses its potency when it freezes!
(You can read more about it here)
2. The fridge is the “frenemy”:
Domestic refrigerators are not suitable for medications storage, both by design and by the way they are typically used. Temperature is only very roughly regulated, thermostats are roughly calibrated, there are no fail-safe systems, and no redundant systems. They are rarely maintained in terms of calibration and gas level checks and very frequently opened and closed. They don’t have a backup power source.
You may trust your refrigerator at home, but it is not suitable for medication storage!
(More about this on the site of the CDC and NIST)
3. It is a MASSIVE problem:
Researchers investigated the conditions of medications storage in the refrigerators of hundreds of patients over three months and reached the conclusion that only 7% of people store their meds in the range recommended by the manufacturer.
93% of patients store their medications outside the recommended range!
(Here is a link to this study)
Why is there no solution?
This is a big problem and it affects many many people, resulting in health complications and wasted medications (not to mention money). There must be a solution to it. Why is there no solution? For a few reasons:
1. Lack of awareness:
Most people living in mild climates are not even aware that their medications must be kept within a certain temperature range. Even professionals are not all properly aware of this important issue (scary testimonial here). Obviously people who live in very cold and hot regions are more aware of the problem.
2. Wrong perception:
When medications go bad, there is no way to find out in most cases! They don’t change colour, or smell, or texture. There is no indicator whatsoever! No red light goes on, no siren, no warning!
We are told to store our meds in the refrigerator and they will be fine.
Many people say: “I never had this problem in 30 years of living with T1 diabetes” even though science and statistics are against them. How can you be so sure that you don’t have a problem if you don’t have a tool to confirm it?
3. Ambiguous responsibility:
There are many people, systems and processes that exist to make sure that the cold chain is tightly monitored and strictly maintained from the moment your medications leave the factory until they are delivered to you at the pharmacy counter. Starting that point it is the patient’s responsibility to take care of it. But with no tools or training! It is an absurd situation where every party limits their liability and sticks exactly within the bounds of their own particular responsibility. So if your insulin freezes in your refrigerator it is not the manufacturer’s, nor the insurer’s, nor the doctor’s nor the pharmacist’s fault. It is your responsibility! Your Problem!
But how do you know if nobody tells you? As long as every one in the chain have their liability limited and covered, no one has any incentive to address this problem.
Let’s create a solution: MedAngel
This was a problem too big and too frustrating for me to ignore. I thought that it was unacceptable that no solution exists. I had basic technical and business skills and decided to create something with the following requirements:
- Reliable and accurate temperature sensing
- Works with the insulin I carry and my stock in the fridge
- Easy and nice to use
- Knows what is safe for my meds and when to alert me
- Affordable (sub $50)
And this is the result:
MedAngel ONE is a wireless bluetooth temperature sensor that is kept with your medications, and that communicates with an App on the phone. The App knows the safe ranges for stored or opened meds and alerts you only when there is a real danger.
The interface is easy to use and understand:
What makes MedAngel more than a simple temperature sensor is the combination of:
- Pharmaceutical know-how (the curated list of hundreds of supported medications)
- Excellent UX and ease of use
- Reliable and accurate technology