Tayside Diabetes MCN Handbook


Out of Hours Insulin Requests

What should be advised if someone runs out of insulin out of hours?




First reference Hyperglycaemia in the Community guidelines in MCN Handbook


Type 1 diabetes


No long acting insulin (Lantus, Levemir, Tresiba, Humulin 1, Insulatard)

  •  Source long acting insulin within 24 hours of last long acting insulin injection via pharmacy/GP
  • Short acting insulin (novorapid, humalog, apidra, actrapid, Humulin S) can be administered in small doses 4 hourly until long acting insulin is sourced as required
  • Refer to Sick Day Rules
  • Check blood glucose and ketones, drink water


No short acting insulin

  • Reduce carbohydrate intake until insulin sourced and attend pharmacy as soon as possible and / or GP for prescription


 Type 2 diabetes

  • Source insulin within 24 hours via pharmacy / GP
  • Reduce carbohydrate intake
  • Check blood glucose, drink water
  • Refer to sick day rules


Pancreatic Pathology

  •  As Type 1 info


 Type 1 Pregnant

  • Admit to hospital


Gestational Diabetes

  • As Type 1 info



Information on alternative insulins, if patients usual insulin is not available, can be found in the MCN website