Running out of insulin is a horror scenario that scares anyone with insulin-dependent diabetes, whether type 1 or type 2.
Diabetics who rely on insulin to lower their blood sugar levels find themselves in a life-threatening situation if they do not have access to their medication.
So what can you do if you run out of insulin? What are the best, quickest and safest responses when insulin is running low?
Cases in which you may run out of insulin?
The situations in which you could run out of insulin are numerous and difficult to predict. Most of them you may not have even thought of. But in most cases you can avoid them if you know in advance where exactly the "dangers" lie. Here are the most common situations in which you can find yourself without insulin:
Your insulin prescription has expired
In Germany, most prescriptions for chronic diseases are valid for 7 days - a maximum of 3 months. If your prescription for insulin is older than this, it can no longer be redeemed and pharmacies will not be able to supply your medication.
You will need to make an appointment with your doctor to be examined and to get a new prescription before you can receive new insulin.
Your insulin has gone bad
Insulin is very sensitive to temperature changes and extremes. Remember that unopened insulin vials, pens or cartridges must be stored at refrigerator temperature - between 2°C and 8°C.
Once opened or out of the refrigerator, your insulin will be stable for about one month at room temperature between 13°C and 26°C. If these storage recommendations are not properly followed, your insulin may go bad. If your insulin has gone bad , you should throw it away immediately.
Your last insulin ampoule just broke
Another common scenario where you accidentally run out of insulin is if your last insulin vial breaks. Insulin vials are made of glass and are very fragile.
If they fall to the ground, they can break and destroy the last drops of your life-saving medicine. That's why it's recommended to buy a silicone insulin vial protector that offers shatter-proof protection.
You run out of insulin while traveling
Traveling with diabetes , and especially with insulin, requires good planning and organization. You should always pack about twice as much insulin as you will need for the duration of your trip.
Divide the amount by two and pack them in separate bags. This will help prevent 1) running out of insulin because you didn't pack enough and 2) your bag with all your insulin being stolen.
You have no insulin left because you have no money left
Surveys have shown that one in four diabetes patients under-purchased insulin because of the high cost. This is a very common situation that can lead to you running out of insulin before you can get a new supply.
No more insulin: what to do?
If you run out of insulin, the first thing you should do is stay calm. Stress and anxiety can raise your blood sugar levels significantly, so panicking here would definitely not be helpful. Depending on the emergency, there are several steps you can take:
Seek immediate help to avoid diabetic ketoacidosis
If your blood sugar spikes, your situation can be life-threatening and you need to get insulin immediately. The main risk in this case is diabetic ketoacidosis, a serious diabetes complication that occurs when the body lacks insulin.
The most common symptoms of ketoacidosis are excessive thirst, frequent urination, nausea, fatigue, shortness of breath, or confusion. If you experience any of these symptoms, if your blood sugar is high, or if you have ketones in your urine, you need to get an urgent supply of insulin.
In this case, you will need to 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 sugar before finding a longer-term solution to get new insulin at home.
Call your pharmacy even if your insulin prescription has expired
Unless you are in a life-threatening situation as described above, the first response when you run out of insulin is to call your pharmacy. If your insulin prescription is still valid, there should be no problems and you can pick up new insulin the same day.
If you run out of insulin because your prescription has expired, your pharmacy can still help you. If you call during business hours, the pharmacy can call your doctor and have your prescription updated the same day. After business hours or on a holiday, you should go to an emergency room instead.
What should you do if you run out of insulin while on vacation or traveling?
That depends on where you are. If you live in the United States and normally get your insulin from a national pharmacy chain, chances are good that the local branch will find your prescription on file. If the pharmacy is unwilling to supply your insulin because it's "too early" for renewal, call your insurance company and ask for authorization first.
If it doesn't work (even though it should!), or if you're traveling internationally and still can't find insulin, go to any hospital. Every hospital has insulin that can help you, at least temporarily.
As a last resort: use over-the-counter insulin
As a last resort, you can use over-the-counter insulins, which are available at Walmart and other pharmacy chains. The vials cost about $25 and you don't need a doctor's prescription. However, these insulins are different from your prescribed insulin. They work differently, have different peak levels and effects. You should only use over-the-counter insulins as a last resort and for a limited time before seeing your doctor.
Share your experiences and advice with us! Have you ever run out of insulin? What did you do?
