Missed Insulin Doses 

Note: Below are suggestions only - exact management will depend on individual circumstances. 

• Once daily long-acting insulin (e.g. Lantus®, Abasaglar®) - give as soon as missed dose noted.  Time of subsequent doses will need to be changed.  Aim to adjust back to usual administration time.  
• Twice daily Levemir® - give missed dose as soon as noted, and give next dose 12hours later.  Aim to adjust back to usual administration time.  
• Tresiba® - has an administration window of approximately 8hours.  Give as soon as missed dose noted.  If this is outwith the 8hour window, give usual dose and aim to adjust back to usual time of administration. 
• Meal-time insulin (e.g. Novorapid®, Humalog®) - if within an hour of eating, give usual dose.  If >1hour, consider correction dose if capillary blood glucose (CBG) high (see correction doses of insulin). 
• Twice daily mixed insulin (e.g. Humulin® M3) - if <4hours since missed dose, give 50-70% of dose as soon as missed dose is noted.  If >4hours, consider correction dose according to CBGs (see correction doses of insulin).  Do not change time of next dose.

Guideline reviewed: February 2025

Page updated: November 2025