What to Do if You Run Out of Insulin

Quickly and decisively get insulin from your pharmacy, including OTC NPH and R insulin, or from an urgent care clinic

We have read several tragic examples of people in the United States dying because of lack of insulin or because of an expired insulin prescription, and countless more stories of people skipping injections or meals because of the high price of insulin. We asked Jennifer Smith, a certified diabetes educator with Integrated Diabetes Management, to provide a guide of what do if you run out of insulin. Even if you know this information already, please share this so others know they have options.

Since insulin is vital to the health of people with Type 1 diabetes, it is imperative to have access 24/7. If you run out of insulin or if your prescription happens to be expired, you’ll need to have a backup plan. High blood glucose levels from lack of insulin can lead very quickly to diabetic ketoacidosis (DKA), a potentially deadly condition.

Here are some suggestions for what to do:

  • If you run out of insulin due to prescription lapse, the pharmacy can typically call your physician to get that prescription updated within the same day as long as you call during business hours. Also, a few states have passed laws allowing pharmacists to dispense insulin on an emergency basis from an expired prescription. Make sure you stress to the pharmacist the urgency of the situation, as some aren’t as well trained as others in matters of Type 1 diabetes care.
  • If you have run out and it’s a holiday or weekend, or you can’t get ahold of the doctor, the best option is to have a backup plan for use of over-the-counter NPH and R insulin which can be purchased over the counter at Walmart as part of its ReliOn Brand. This option is available in all states save for Indiana.
  • If there is no way to get insulin due to the time of day or cost, go to an Urgent Care clinic or an Emergency Room. While the medical team there may not know much about your diabetes history, they will understand that a person with diabetes dependent on insulin therapy is in danger without insulin. If you find yourself there, ask for an Endocrine consult and/or to speak with a Diabetes Educator as well as a Case Management Nurse to get the best care and find some assistance to ensure you maintain access to your insulin.

The important thing to do is to act quickly and decisively. Also, if you have someone in your life who you turn to in emergency situations, inform them of your situation as soon as possible. This way, they can advocate for you if you begin to feel ill or become disoriented. And when in doubt, call 911.

Integrated Diabetes Services provides one-on-one education and glucose regulation for people who use insulin. Diabetes “coaching” services are available in-person and remotely via phone and online for children and adults. Integrated Diabetes Services offers specialized services for insulin pump and continuous glucose monitor users, athletes, pregnancy & Type 1 diabetes, and those with Type 2 diabetes who require insulin. For more information, call 1-610-642-6055, go to or write

Jennifer Smith holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a registered and licensed dietitian, certified diabetes educator, and certified trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. She has lived with Type 1 diabetes since she was a child,and thus has first-hand knowledge of the day-to-day events that affect diabetes management.

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