Insulin is a protein that is easily "spoiled" if exposed to extreme temperatures, especially heat. When insulin is exposed to very hot or very cold temperatures for too long, even just 60 minutes, it can break down very quickly to the point of becoming ineffective. The longer the exposure to extreme temperatures, the less effective the insulin becomes, which can result in loss of blood glucose control over time. If insulin gets warm, it can break down and no longer have the same strength or efficacy. This means that while it may still deliver some therapeutic relief, it will not work to the degree expected. As a result, people with diabetes will not be getting the dosage they expect, leading to higher blood sugars in acute scenarios and over time. If insulin spoils from too hot or too cold temperatures, it becomes less effective at managing blood sugar, and when this becomes noticeable in blood sugar, it is recommended to swap that vial or pen out for a new one. The tricky thing about insulin that has been quickly destroyed by hot or cold temperatures is that it cannot be detected until blood sugar levels start to spike. Therefore, it is important to be mindful of when and where insulin is kept, especially during hot weather or in emergency situations where refrigeration is not available.