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
It is a matter of life and death if you run out of insulin. If you have completely run out of insulin and are unable to obtain it, the safest thing to do is seek medical attention from an urgent care clinic or go to 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 run out. People forget to renew them; we’re all human after all. People in the United States require new prescriptions every year, even if they have a chronic disease, such as 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
Do not, under any circumstances, keep your pain to yourself. Inform your friends and family that you’ve run out so that you can brainstorm solutions together.
Maybe someone can lend you money so you can buy insulin over the counter. Perhaps you have a friend of a friend who has insulin-dependent diabetes and has a vial or pen to spare.
Use social media to express your need, and the diabetes online community (found on Twitter under the hashtag #insulin4all) can also assist you. Crowdfund funding and ideas to ensure that you have access to 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, known as Novolin ReliOn Insulin (available in Regular, NPH, and a 70-30 mixture of the two), was developed in the 1970s and 1980s and can be used in a pinch to potentially prevent diabetic ketoacidosis (DKA).
Regular insulin is a more traditional substitute for fast-acting insulins such as Novolog or Humalog. NPH insulin is a more traditional substitute for long-acting insulins such as 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 distinction is that NPH insulin is typically administered every 12 hours, as opposed to Lantus or Tresiba, which are both administered once daily.
Because of these distinctions, it is critical that you closely monitor your blood sugar levels while using it.
It’s best to develop a game plan for these types of insulin with your doctor before you need it, as part of your emergency preparedness. To learn more, consult your doctor.
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 should ever be in. Hopefully, implementing these strategies will help you if you find yourself in this situation in the future.
About Christine Fallabel
Christine Fallabel has been living with type 1 diabetes since 2000. She works in public policy, helping people with diabetes have better access to health insurance, affordable medication, and to fight disability-discrimination in the work and school environments. She earned her Master of Public Health from Temple University. In her spare time, she enjoys hiking with her husband in the mountains of Colorado, tinkering with her DIY Loop insulin pump, and vegan cooking.