30 studies, every one cited on the page where it is used. Your power just went out. Your insulin has been warm for eleven hours. Do you throw it away? The peer-reviewed answer is almost certainly no — and getting this wrong costs people hundreds of dollars and, occasionally, far more. What's inside — 45 pages, seven parts Part I · The threat model. The five ways insulin supply actually fails, ranked by how often they happen. Spoiler: it isn't the hurricane. It's the January deductible reset. Plus the DKA clock — exactly how much margin you have. Part II · Storage and the cold chain. The Geneva evidence in full, with its limits stated honestly. A master reference table of in-use periods for 13 named insulin products — and the planning insight buried in it about which insulins are far more forgiving without refrigeration. Where heat genuinely does destroy insulin. Why freezing is the silent killer, where it actually happens, and how to spot it. How to build a pot-in-pot evaporative cooler that works — and the measured data showing how weak it really is, so you don't rely on it too heavily. Part III · Building the buffer. How to calculate your true daily consumption, how much reserve to hold, and how to accumulate it legally and openly with your prescriber. The quarterly rotation routine that stops a reserve quietly becoming a shelf of expired vials. Part IV · When supply breaks. The five-rung escalation ladder. The pharmacist emergency-refill laws that exist in at least 21 US states — and the exact wording to use at the counter. Every legitimate low-cost route: the $35 manufacturer caps, Medicare, patient assistance, ReliOn, Civica. Human insulin as a fallback, with the published evidence on switching and a frank account of why it needs a clinician. And the data on why rationing costs more than it saves. Part V · Crisis protocols. Sick-day rules and the blood ketone decision tree. Hypoglycaemia and glucagon. The specific lines that should end the deliberation about whether to go in — plus your legal right to emergency treatment regardless of ability to pay. Part VI · The home-manufacture question. The most-searched question on this subject and the worst answered. What insulin actually is, the eleven-stage industrial process, and precisely where every home attempt fails. An honest account of what the Open Insulin Project has and hasn't achieved after a decade. Part VII · Seven printable worksheets. 72-hour evacuation kit. Supply calculator. Fill-in emergency information card for your wallet. Power-outage protocol. Rotation and inspection log. Why you can trust it 42 cited sources. Peer-reviewed clinical literature, manufacturer prescribing information, and published guidance from the American Diabetes Association, ISPAD, Médecins Sans Frontières and the Diabetes Disaster Response Coalition. Every factual claim carries a numbered reference. 13 original figures built from the actual published data — not stock illustrations. Where the evidence is strong, this guide says so. Where it's thin, contested, or drawn from a setting that may not match yours, it says that too. This is education, not medical advice. It does not replace your prescriber or emergency services Format Instant PDF download · 45 pages · US Letter, prints cleanly on a home printer · Readable on phone, tablet and desktop · Worksheets designed to be printed and filled in by hand, available in both PDF and EPUB formats for convenient reading on any device.