Diabetes kit for extreme trekking conditions

Back in September, I posted about diabetes on a mountain following my trek in the Atlas Mountains in Morocco in very hot conditions. For Kilimanjaro, I'll have similar conditions the first few days, but as we get higher, it'll get much colder, and the final few days will be at sub-zero temperatures, not only at night, but in the case of the summit attempt, during the day as well. This poses lots of additional problems for medical equipment and medications which don't like cold conditions. So I have to consider not only how to keep my insulin cool when it's hot, but also how to keep it from freezing when it's cold, and how to store my pump, blood glucose meter, spare insulin and batteries in the cold.

My only previous experience of serious sub-zero temperatures was a week's walking in the Austrian mountains where the daytime temperature reached down to almost -30 degrees C on a couple of days. However, the big benefit there was that we were staying in a heated house at night and we didn't have to transport kit with us each day, only our daypacks, so things like spare insulin didn't need to be carried in cold temperatures. I found there that carrying my pump and meter in an inside pocket were sufficient, and I had no problems with insulin in the tubing freezing as it was also underneath my clothes. This time, I intend to use a SpiBelt (as mentioned in the other post) for my pump, but I have a new mechanism for the meter and so on, as I don't like carrying a lot of things in my pockets. Inspired by some of my friends on the Mountains for Active Diabetics group (a bunch of pancreatically challenged nutters from all over the world who like to push their bodies to the limit), I decided to devise and make my own thermal medical bag. When I say "make", I mean I said to my mum over Christmas: "You like sewing, don't you? Would you like to make me a birthday present?" and she agreed. My first stop was David Panofsky's IDEA bag (pictured above), but since I like having my meter on the SpiBelt, and I don't like carrying too much round my neck, I decided to simplify it a bit and just have one compartment for everything.

Since my mum lives several hundred miles away, we discussed over email what the bag should comprise, and she hunted out some old fleece material. Being nervous about getting it right, she first designed a prototype made out of an old nightie. She was going to use an old glasses neck cord, but I thought that since it was going to bear some weight, it might be more comfortable to have a flat neckstrap, and I dug out an old conference badge holder with a flat strap which was softer. I cut off the ends and sent it to her, and she made the prototype pictured. I then had to figure out how long to make the straps. It turns out that because my rucksack has a very high waist belt, the bag needs to sit above that, so it needs to be quite high up. On the other hand, it needs to be below the level of the chest strap (which luckily is also quite high up). I pinned the straps in place and sent it back to her. She dug out an old fleece and made up the final bag. We also found that if you put the velcro right to the edges of the bag, it's hard to undo, so she made the velcro strip a bit smaller so there's room to get your fingers into the gap (important when it's cold and you have gloves on!). She then sent me the final product, and I must say I'm quite excited! Here's how it turned out. And I have the original prototype to use as either a liner or just to separate items in the bag. I'll use the bag not only in the day while walking, but also at night to keep the items warm in my sleeping bag with me. Oh, and obviously, I'll be wearing the bag under my clothes (on top of the base layer) not as in the picture! We're planning a long walk in the Yorkshire Peaks this weekend in sub-zero conditions, so perfect time to test it out!