Managing Diabetes During a Power Outage

A power outage can interrupt diabetes care long before you run out of medicine. A phone may lose charge, meals may change, and a pharmacy may close. The aim is to keep your prescribed treatment, glucose monitoring and access to help working together, not to improvise a new treatment plan.

If someone is unconscious, having a seizure or unable to swallow safely, call local emergency services now. Give nothing by mouth. Use their prescribed glucagon if available and you know how to use it.

Start with your personal care plan

Bring your diabetes kit and written care instructions somewhere accessible. Check your glucose as your plan directs, confirm which supplies still work, and note how much medicine you have. Contact your pharmacy or diabetes team early if storage, refills or delivery supplies are uncertain. Do not wait until the last dose to ask for help.

Continue prescribed insulin as directed. Do not ration it, stop it, switch brands or change concentrations on your own. If meals, illness or activity change, use the instructions your diabetes team has given you and seek advice when those instructions do not cover the situation. People who do not use insulin still need a plan for their own medicines and monitoring.

Insulin storage depends on the exact product

Losing refrigeration does not mean every insulin supply immediately becomes unusable. Storage limits depend on the insulin, its container, whether it has been opened and its temperature history. An unopened refrigerated expiry date is not the same as an in-use or unrefrigerated discard date. There is no single room-temperature time limit for every insulin product.

Read the label for your exact vial, pen or cartridge, including its strength and use state. Novo Nordisk's Tresiba storage guidance, for example, differs from the broad storage summary on the FDA emergency page. Do not transfer another product's allowance to your own. Ask a pharmacist or manufacturer to clarify a label you cannot interpret.

Write down when the product was first used, when it left refrigeration and any known temperature exposure. Follow its rules about refrigeration during use. Putting it back in a refrigerator is not a reason to restart its discard clock. Keep the packaging or a readable label photo with your supplies.

Protect insulin from direct sunlight, heat and freezing. If using an appropriate cooler, keep insulin separated from ice or frozen packs so they cannot freeze it. Protect medicines from floodwater. Do not bury medicine or assume an improvised evaporative cooler will maintain the required conditions. A temperature record helps a pharmacist assess an exposure; it cannot prove that insulin still has full potency.

If storage limits may have been exceeded, contact a pharmacist, clinician or manufacturer with the product name and exposure details, and arrange replacement promptly. Do not automatically throw away your only life-sustaining supply and go without treatment. The FDA's disaster medicine guidance describes emergency use of unrefrigerated life-sustaining medicine until a new supply is available. This is not a guarantee of potency and does not override the instruction not to use insulin that has been frozen. If insulin has frozen and no usable supply is available, seek urgent medical help to obtain treatment.

Keep monitoring and delivery working

A charged phone is useful, but it is not your whole diabetes backup. Pack equipment matched to your treatment and make sure a helper can find it:

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  A glucose meter, compatible unexpired strips, lancets and spare batteries, including a meter backup if you normally use a continuous glucose monitor (CGM).

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  CGM supplies as applicable, plus compatible charging cables and a charged power bank for the phone or receiver, following device instructions.

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  Your prescribed medicines and compatible delivery supplies, such as needles or pump consumables, with copies of prescriptions.

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  Ketone testing supplies if included in your care plan, fast-acting sugar and prescribed glucagon that is in date.

A phone power bank is not automatically suitable backup power for a pump or refrigerator. Follow each device's instructions. Before an outage, use our no-interruption power outage kit check to check access to ordinary supplies and phone charging. Do not turn off medical equipment or refrigeration to rehearse.

Pump users need a written clinician-designed plan for an interruption and safe restart, with the correct prescribed backup insulin and delivery supplies ready. Do not invent a pump-to-injection conversion or restart schedule. If the pump fails and you lack a usable plan or supplies, contact your diabetes team urgently; seek urgent medical care if you cannot maintain essential treatment.

Pack meals as well as low-glucose treatment

Keep drinking water and familiar shelf-stable foods that fit your personal meal plan and can be prepared with the resources available. A blackout is not a reason to begin a restrictive or ketogenic diet. Food choices do not replace insulin, and avoiding carbohydrate is not a universal emergency strategy.

Keep fast-acting sugar, such as glucose tablets or regular juice, separate from routine meals so it is easy to find. Sugar-free drinks do not treat a low. If you are awake and can swallow safely, follow your personal low-glucose treatment and recheck instructions. The American Diabetes Association's low-glucose guidance explains why fast-acting carbohydrate matters. Children's treatment amounts need an individual plan from their diabetes team, not an adult rule copied from the internet.

Ask the care team about prescribed glucagon before an emergency. Make sure a trusted helper knows where it is and how to use that specific product. Check its expiry date along with the rest of the kit.

Recognize when you need emergency care

Severe low glucose is an emergency. Unconsciousness, a seizure, severe confusion or inability to swallow safely needs emergency help. Call the local emergency number, which is 911 in the US. Give no food, drink or oral sugar when swallowing is unsafe. Give prescribed glucagon if available and you know how to use it, while arranging emergency help.

Diabetic ketoacidosis (DKA) also requires immediate medical care. Warning symptoms can include vomiting, abdominal pain, rapid or heavy breathing, fruity-smelling breath and confusion. Do not wait for a particular glucose number before seeking help for these symptoms. Follow your personal sick-day and ketone plan, but do not try to treat suspected DKA with food changes or cooling tricks. The ADA's DKA guidance treats this as a medical emergency.

If ketones stay high or worsen, or you cannot keep fluids down, seek emergency assessment now through an emergency department or local emergency services. Do not wait for a routine callback. If essential treatment is unavailable, seek urgent help to obtain care.

Leave before essential care fails

Identify a destination where you can access treatment and any required storage, charging and assistance. Confirm what a shelter or host can actually provide, arrange transport, and tell shelter staff about diabetes and medication needs on arrival. Do not assume that every evacuation center has suitable refrigeration or replacement pump supplies.

Keep a portable record of medicine names and strengths, allergies, prescriptions, care instructions, pump settings if relevant, and pharmacy and care-team contacts. Wear medical identification. Review expiry dates and product-specific use clocks regularly, replacing supplies before they become unusable rather than discarding insulin on an arbitrary monthly schedule.

Use the household blackout checklist for broader home planning, alongside rather than instead of your diabetes kit. Before an outage, confirm three things: who can advise you, where usable supplies can be obtained, and how you will get to care if staying home is no longer safe.