How Long is Too Long W/O Insulin?


I’m frustrated, and I’m hoping some of my lovely blog-followers can chime in with their two cents, because I’d love to hear more opinions on this.

The question is: how long can a type 1 diabetic go without any insulin before it poses the risk for serious harm?

I ask because over at Tudiabetes.org there is a discussion going where someone was asked not only to fast from food before lab work, but also asked to fast from insulin.  As in, come to get your lab work done having taken no insulin for 6-8 hours prior.

I commented that this was ridiculous and could put a person’s life in danger, and that this person might find it in their best interest to search out a new doctor or lab.

…to which this person, who apparently doesn’t really want help or advice at all, told me that he was ‘ROFL’ at me and that I am essentially being ridiculous; that it would take ‘a whole bunch of days’ without insulin before any genuine/serious harm could occur.

I said it wasn’t safe based on personal experience. When I was an idiot undergrad not taking care of myself I skipped injections sometimes. And look where that got me….A1cs in the double digits, DKA 3 times, and on those days I felt like crap because my BGs were between 400 and infinity.  In addition, last year in February my boyfriend had to take me to a Chicago ER while I was visiting him down there because I went into DKA very unexpectedly. It seems my pump wasn’t delivering some/all of my insulin for several hours…but it couldn’t have been all day because the early part of the day my BGs were fine.  So after just a few hours with little or no insulin…I was in DKA.  DKA that landed me in the ICU for two horrible days. (I still owe my boyfriend big time for that one…he slept sitting up in a horrible chair for two nights, at my side…and we’d been dating only 2 months at that point…what a guy!)

So, DOC…what do you think? Is it safe to willingly go 6-8 hours without any insulin (including basal)?

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4 thoughts on “How Long is Too Long W/O Insulin?

  1. Ken says:

    I am very disappointed in that thread over on TuD, which makes me sad because TuD is otherwise a great place for info and support. If you look at the scientific aspect of what insulin is and does, I would have to say that for type 1 diabetics, almost any amount of time without insulin is cause for concern. The brain of course doesn’t need insulin to convert energy, but practically every other cell in our bodies do, deprived of a means to get that energy, bad things start to happen in short order. I am not aware of any hard numbers or science to back up my theory of course, but i suspect it’s also due to a small bit of randomness, as is which cell was least fed, which ones need new food now, etc. I’m still mad that other poster did not apologize to you. In an alternate world, he might have broken knee caps by now… or at least a new limp. =)

    • Ken,

      He did end up apologizing…half heartedly…and then went on to further defend himself and say that people with pumps have given up quality of life, blah blah blah. It’s getting a bit weird, and I’m trying to avoid the thread (or at least the parts involving talking to him).

      Thanks for the comment!

  2. OK I will start by saying everyone is different and has different insulin needs. (Now that my disclaimer is out of the way) I would have to say I’m with you on this. When I was in my early 20’s and totally uneducated about diabetes, I took some quacks advice to “not take my insulin” since I could not hold food down. Less than 24hrs (more like 8 ) I was in ICU in a coma for 4 days. So I feel it only takes a few hours totally w/o insulin before you’re asking for trouble. Maybe this person can go that long b/c they have Lantus on board, who knows. I would never go “a whole bunch of days” w/o insulin let alone a whole bunch of hours. Don’t let this person question what you know, especially about yourself.

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