Running out of insulin is a scenario that frightens every person living with insulin-dependent diabetes, whether type 1 or type 2. Diabetics who rely on insulin to lower their blood sugar levels face a life-threatening situation if they don't have access to their medicine.
So, what to do when it happens? What are the best, fastest, and safest responses to running out of insulin?
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Cases where you can run out of insulin?
Situations where you might run out of insulin are numerous and hard to predict. You may not even have thought about most of them. But in most cases, knowing in advance where exactly the “dangers” are allows you to prevent them from happening. Here are the most common situations where you can find yourself without insulin:
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Your insulin prescription has expired
In the United States, most prescriptions for chronic diseases are valid for a year. If your prescription for insulin is older than a year, it can't be fulfilled anymore, and pharmacies won't be able to deliver your medication. You need to book an appointment with your medical team for a check-up and a new prescription before you can get new insulin.
Your insulin has gone bad
Insulin is highly sensitive to temperature changes and extreme temperatures. Remember that unopened insulin vials, pens, or cartridges must be kept at fridge temperature – between 36°F (2°C) and 46°F (8°C). Once opened or out of your fridge, your insulin is stable for about a month at room temperature between 56°F (13°C) and 80°F (26°C). If these storage recommendations are not followed properly, your insulin can go bad. If your insulin had gone bad, you should dispose of it immediately.
Related article: Clear vs. Cloudy Insulin, Why it Matters!
Your last vial of insulin just shattered
Another common scenario where you accidentally run out of insulin is when your last vial of insulin shatters. Insulin vials are made of glass and they're very fragile. If dropped on the floor, they can break and ruin the last drops of your life-saving medicine. That's why it's recommended to get a silicone insulin vial protector offering shatter-proof protection.
You’re running out of insulin while traveling
Traveling with diabetes, and even more so with insulin, requires preplanning and good organization. You should always pack about twice as much insulin as what you would need for the duration of your travel. Divide the quantity by two and pack it in separate bags. This would help prevent that 1. You run out of insulin because you have not packed enough of it, and 2. Your bag gets stolen with all of your insulin.
Related article: How to Keep Insulin Cold While Traveling?
You’ve run out of insulin because of money
According to Yale, one in four diabetes patients has skimped on insulin because of its high cost. It's a very common situation that might lead you to run out of insulin before you can get delivered some more.
Related article: How to Calculate Your Insulin Dose Correctly?
What to do when you run out of insulin?
The very first thing to do when you run out of insulin is to keep your calm. Stress and fear can considerably increase your blood glucose levels, so it definitely wouldn’t help if you're panicking here. Depending on the emergency of your situation, you can take several steps:
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Seek immediate help to avoid diabetic ketoacidosis
If your blood sugars are skyrocketing, your situation might be life-threatening, and you need to get insulin immediately. The main risk here is diabetic ketoacidosis, a serious diabetes complication occurring when your body is lacking insulin. Ketoacidosis' most common symptoms are excessive thirst, frequent urination, nausea, fatigue, breath shortness, or confusion. If you experience any of these symptoms, if your blood sugars are high, or if you have ketones in your urine, finding insulin is urgent.
In that case, you must go to an urgent care clinic or your local emergency room. The medical team will provide you with IV insulin to lower and stabilize your blood sugars before you find a longer-term solution to get new insulin at home.
Related article: What Happens if You Miss a Dose of Insulin?
Call your pharmacy even if your insulin prescription has expired
If you're not in a life-threatening situation like above, the first response to running out of insulin is to call your pharmacy. If your insulin prescription is still valid, there should be no problem and you'll be able to pick up new insulin the same day.
If you're running out of insulin because of a prescription lapse, your pharmacy can still help. If you call during business hours, the pharmacy can call your physician and get your prescription updated within the same day. If it's out of business hours or during a public holiday, you should go to an emergency room instead.
For diabetics living in Ohio, Florida, Arkansas, Arizona, Illinois, Wisconsin, Idaho, Oregon, Pennsylvania, South Carolina, Tennessee, Colorado, Indiana, Kentucky, Oklahoma, Utah, or West Virginia, the State laws allow pharmacies to deliver insulin from an expired prescription under certain conditions.
What if you run out of insulin on holiday or while traveling?
It depends on where you are. If you are in the United States and usually get your insulin from a national chain pharmacy, chances are the local outlet will find your prescription on file. If the pharmacy is not willing to deliver your insulin because it's "too early" for renewal, call your insurance and ask for approval first.
If it does not work (even if it should!), or if you're traveling internationally, and you still can't find insulin, go to any hospital. Every single hospital has insulin to get you sorted, at least temporarily.
As last resort, use over-the-counter insulin
As a last resort, consider using over-the-counter insulins sold at Walmart and other pharmacy chains. Vials cost about $25 and you do not need a medical prescription. However, these insulins are different from your prescribed insulin. They act differently, have different peaks and effects. You should only use over-the-counter insulin as a last resort and for a limited time before you seek your doctor's advice.
Share your experiences and bits of advice with us! Have you ever run out of insulin? What did you do?