If you live with insulin-dependent diabetes, you know that insulin is a lifeline and that having 24/7 access to this life-saving and life-sustaining medicine is absolutely crucial.
But there are times when you may run out: for instance, if you’re traveling and you didn’t pack enough, your insulin spoiled in hot weather, your last bottle of insulin shatters, your prescription has expired and you can’t reach your physician, or even if you’ve been rationing your medications due to cost and you don’t have any left.
This is a terrifying reality for many people who take insulin: a recent Yale study reported that over 1 in 4 people has rationed their insulin due to cost alone in the United States.
This article will outline what you should do if you find yourself in a situation where you’ve run out of insulin.
Seek help immediately
Running out of insulin is a matter of life and death. If you have completely run out and cannot get insulin, the safest thing to do is to seek medical attention from an urgent care clinic or visit your local emergency room.
While doctors there will not know your exact treatment plan, medical professionals can help get you immediate insulin in the form of an IV (this is especially crucial if your blood sugars are skyrocketing, putting you at greater risk for diabetic ketoacidosis).
Once you are stabilized, you can proceed to get a more longer-term solution in place.
Call your pharmacy
Insulin prescriptions lapse. People forget to renew them; we’re only human. People in the United States need fresh prescriptions every year, even if they live with a chronic disease, and that includes people with diabetes.
If you have a prescription for insulin that is over a year old, it cannot be filled anymore, and the standard operating procedure is an appointment with an endocrinologist for blood work, and check-up, and a fresh prescription.
If this is not an option, call your pharmacy, who can most likely call your doctor for you to renew the script seamlessly, as long as you call the pharmacy during their normal business hours.
If the pharmacist cannot reach the physician, but you live in Ohio, Florida, Arkansas, Arizona, Illinois, Wisconsin, Idaho, Oregon, Pennsylvania, South Carolina, Tennessee, Colorado, Indiana, Kentucky, Oklahoma, Utah, or West Virginia (as of 2019), you can take advantage of legislation that has passed called Kevin’s Law, where a pharmacist is able to distribute up to 30 days of a medication under emergency authorization from an expired prescription (usually once per year).
Be sure to stress the urgency of the situation to the pharmacist and refer to the statute when trying to access this benefit.
Tell friends and family
Whatever you do, do not keep your suffering to yourself. Let friends and family know that you’ve run out so that you can think through solutions together.
Perhaps someone can loan you money to buy insulin over the counter. Perhaps you have a friend of a friend who lives with insulin-dependent diabetes and can spare a vial or pen.
Utilize social media with your need, and the diabetes online community (found on Twitter under the hashtag #insulin4all) can help you as well. Crowdsource funding and ideas to make sure that you can get insulin as soon as possible.
Use ReliOn insulin as a last resort
While not ideal (and sometimes this can even be dangerous), if you cannot crowdsource, reach your physician, or get emergency medical attention, Walmart does sell human insulin for $25 per vial without a prescription and without insurance.
This insulin was developed in the 1970s and 1980s and is called Novolin ReliOn Insulin (comes in Regular, NPH, and a mixture of the two called 70-30) that can be used in a pinch to potentially ward off diabetic ketoacidosis (DKA).
Regular insulin is an older alternative for fast-acting insulin like Novolog or Humalog. NPH insulin is an older alternative for long-acting insulin like Lantus or Tresiba.
However, these insulins act differently than more modern, analog insulins, and food and carbohydrate counting must be carefully calibrated to the insulin (instead of the other way around), and many people struggle when making the transition to this form of insulin.
One example of the difference is that NPH insulin is usually taken every 12 hours, in comparison with Lantus or Tresiba which are both usually taken once daily.
Because of these differences, it’s important that you closely monitor your blood sugar while using it.
It’s best to create a game plan for these types of insulin with your physician before you need it, as part of emergency planning. Talk with your doctor to learn more.
How to guard against running out of insulin
While this scenario is not 100% preventable, there are some strategies you can implement to help prevent this situation from happening to you. These include:
- Always pack triple the amount of insulin you will need for a trip or vacation
- Utilize mail-order-pharmacies that allow you to receive 90 days supply of insulin at once, instead of refilling a prescription every 30 days
- Invest in insulin vial protectors to prevent shattering if you drop your medicine on a hard surface
- Have an emergency plan in place with your doctor for how to use Walmart insulin if you’re ever in a pinch
- Know exactly where your nearest Urgent Care and Hospital are (both at home and at vacation destinations), should you ever need immediate assistance
- Keep up to date on your insulin prescriptions
- See if you live in a state with Kevin’s law or other patient protections in statute
- Save up an emergency fund for insulin money, if you ever need to pay out-of-pocket for a vial
- Keep your insulin cool while traveling, to prevent spoilage
- Cultivate a support system of friends, family, and fellow diabetics who can potentially help you out if you’re ever caught in this situation
Running out of insulin is a terrifying, life-threatening situation that no one ever deserves to find themselves in. Hopefully implementing these strategies can both help you if or prevent you from finding yourself in this situation in the future.
If you take 29 units of lantus insulin and if your pen ends up only having 16 units left but you have another lantus insulin pen that has 20 units left on it can you use both pens to make up the difference on the amount???
Yes, you can inject insulin from different pens, what’s important is that you get the total amount that your doctor has prescribed
Hi can long term use of insulin cause belly fat. If been injecting inti belly for about 15 years.
Do you have any suggestions or specific exercises you recommend to flatten belly
thank you
Unfortunately, you can’t spot reduce, so you’d have to lower your overall body fat to reduce your belly fat
I was in Europe during May 2022, and my cousin and I went on a day-long trip to Napoli and the Tower of Pisa. Unfortunately, I had changed my insulin pump sensor that morning, and after about an hour on the drive to our first stop (planning to get home after 8:00 pm), I realized with horror that my pump was not working, likely due to the sensor bending when inserted. I watched, horrified, as we rode the bus, as my BG went higher and higher, eventually getting to 300 and rising. Since we were in a foreign country, and on a road trip with 40 unknown people, there’s no way I could really stop the bus and get off, return to my hotel and get a new sensor. I told my cousin, who is a Type II diabetic on morning and evening NPH. She had not taken her morning NPH, and kindly offered to give me her syringe and bottle of NPH to take what I needed. The good news is that I recalled how much NPH I used to take on a daily basis prior to getting a pump, and I quickly injected that amount. Since I had no Humalog insulin, I could not eat all day as the NPH acted only as a basal. However, the great news is that my BG dropped to about 140 and stayed there the entire day. I was certainly very hungry when we finally got back to our hotel (ended up being around 9:30 PM), but my cousin sure saved the day. Yes, she went without insulin during that day trip, but her sugars did not get above 120 so we were good.
Your cousin did indeed save that day! I’m so glad that worked out and that you knew how to use the NPH. I hope you had a great trip and enjoyed a delicious meal once you got back to the hotel
Just realized I’m at the bottom of an NPH bottle and the pharmacy’s closed. Pharmacy is closed tomorrow too because it’s New Year’s Day. You know what? Oh well. What doesn’t kill you only makes you stronger.
If you completely run out of insulin and can’t find a pharmacy go to the emergency room or an urgent care clinic
I have no insurance help me I need insulin
I would recommend you go through the patient assistance programs (go to the manufacturer’s website for the insulin you use, or look up the “no insurance” option in the list in this article https://diabetesstrong.com/how-to-save-money-on-insulin-with-copay-cards/) another option is to discuss Walmart insulin with your doctor. If you already have a prescription for Novolog you can pick up the Walmart ReliOn NovoLog for $73/vial.
Finally, there are pay-it-forward Facebook groups that you might want to check out
This article is a much needed one. Diabetics depend on insulin and this article helps them with a plan-of-action to take steps to arrange for it.
Good One!
Yes it is. But what happens when China erupts and you can’t get insulin? That’s what I want to know.
We are so incredibly blessed in Australia. Our insulin is heavily subsidised by our government. And all of our consumables are free or close to, needles, strips, and also CGMs up to 21yo (lobbying for over 21s) We certainly are a lucky country. Wish it was the same worldwide.
I agree, everyone should have access to insulin
I’d like to know how diabetics can get better insurance in ALL states and NOT be charged $900 for a vial of insulin! My daughters fiancé has T1 and has been on Obamacare. She decided to improve her coverage since her deductible was $12000! She chose another and got a call. Turns out that call wasn’t even from Obamacare. For some reason Medicaid NC called her -after not telling her they won’t cover ANY of her meds.She came from a state that covered it All. It was too late, they did her transfer and she lost her med coverage- all they cover is ob/gyn, birth control!!!!!
The call from Medicaid caused her to be kicked off her insurance. She thought she was answering ?’s about her new insurance that she just signed up for. It wasn’t until after the final ? That the lady said who she was and what she did. She said it was Too Late now to make any change, bc it was going to show up in the system and cause a problem
Thank you. Very helpful and informative.
Thanks for this article. Haven’t faced this situation fortunately but very good to know. Very informative.. didn’t know these possibilities like Kevin’s Law or the NPH and Regular at Walmart which I used to live on