For diabetics, insulin is like fuel for a car. Without it, the body struggles to regulate blood sugar levels, leading to serious health complications. Imagine a car running out of gas on a highway—scary, right? That’s how it feels for someone with diabetes facing the prospect of running out of insulin.

The consequences are dire: organ damage, coma, even death. It’s not just about feeling a bit off; it’s about life and death. Yet, many diabetics find themselves in situations where access to insulin becomes challenging, leaving them wondering how long they can manage without it.

In this article, you will learn about insulin and its significance for people with diabetes. You will also find out how long type 1 diabetics can survive without insulin, ways to prevent or slow down diabetic ketoacidosis, the duration for which type 2 diabetics can go without insulin, and what steps to take if you miss a dose of insulin.

Key Takeaways

  • Insulin is critical for diabetics as it regulates blood glucose levels by allowing glucose to enter cells and provide energy. Without insulin, type 1 diabetics can face life-threatening conditions like diabetic ketoacidosis (DKA) within 24 to 48 hours.
  • Regular monitoring of blood glucose levels and consistent insulin administration are vital to prevent and manage symptoms of high blood sugar and DKA. This includes recognizing early symptoms and understanding how to adjust insulin during stress or illness.
  • Being well-educated about diabetes and its management, including how to handle potential emergencies and regular care routines, is crucial for preventing severe complications.
  • For type 2 diabetics who require insulin, not taking it can lead to hyperglycemia, which over time might cause severe health issues like vascular problems, organ damage, and nerve damage.
  • If an insulin dose is missed, it should be taken as soon as remembered unless it’s close to the next dose. Always consult healthcare providers for personalized advice and keep monitoring blood sugar levels to manage them effectively.

What Is Insulin and Why Is It Critical for Diabetics?

Insulin Injection Pens

Insulin plays a critical role in regulating blood glucose levels, serving as the key that unlocks cells to allow glucose from the bloodstream to enter and provide energy to the body. For individuals with diabetes, this process is disrupted either due to insufficient insulin production (as in Type 1 diabetes) or due to the body’s inability to use insulin (as in Type 2 diabetes) effectively. In Type 1 diabetes, the immune system attacks the insulin-producing cells in the pancreas, leading to a lack of natural insulin and necessitating external insulin supplementation for survival.

On the other hand, Type 2 diabetes often involves insulin resistance, where the body’s cells become resistant to the effects of insulin, requiring higher insulin levels to maintain blood glucose within a healthy range. Thus, insulin therapy is crucial for managing blood sugar levels in both types of diabetes, but the underlying mechanisms and treatment approaches differ between Type 1 and Type 2 diabetes.

How Long Can Type 1 Diabetics Go Without Insulin?

A woman experiencing nausea

For people with type 1 diabetes, insulin is absolutely essential for survival. Without insulin, type 1 diabetics can start to show signs of diabetic ketoacidosis (DKA) very quickly, typically within 24 to 48 hours. DKA is a serious condition resulting from the buildup of ketones in the blood when the body starts breaking down fats instead of glucose for energy.

The real-life implications of missing insulin doses can be severe and immediate. Since their bodies cannot produce insulin, even a short delay can lead to DKA, which can escalate rapidly and may require emergency medical treatment to prevent serious complications, including coma or death. A study found that patients with type 1 diabetes who experience more than 2 diabetic ketoacidosis episodes have a 4 times greater risk of death within 5 years.

Symptoms of diabetic ketoacidosis include:

  • Frequent urination
  • Excessive thirst
  • High blood sugar levels (hyperglycemia)
  • High levels of ketones in the urine or blood
  • Nausea or vomiting
  • Abdominal pain
  • Weakness or fatigue
  • Shortness of breath
  • Fruity smelling breath
  • Confusion or difficulty concentrating
  • Loss of appetite
  • Loss of consciousness

These symptoms reflect the body’s response to the severe lack of insulin and the acid buildup, and they should be treated as a medical emergency. Hence, type 1 diabetics must manage their insulin intake carefully and consistently to avoid these dangerous and potentially life-threatening complications.

What Can You Do to Prevent or Slow Diabetic Ketoacidosis?

To prevent or slow the progression of diabetic ketoacidosis (DKA), it’s crucial to manage your diabetes meticulously. Regular monitoring of blood glucose levels is essential, particularly during illness or stress, which can increase sugar levels and risks of DKA. Consistently take prescribed insulin doses to ensure blood sugar remains within the recommended range. Recognize early symptoms of DKA. Keeping a supply of ketone test strips can help detect early ketosis, allowing for prompt intervention.

Stay hydrated, as dehydration can exacerbate DKA. If you’re running low on insulin, don’t let it run out completely! Stretch it out, prioritize the use of long-acting (basal) insulins and contact healthcare providers for guidance on managing insulin and carbohydrate intake during this period. Being educated about DKA and its management is also fundamental in preventing serious complications.


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How Long Can Type 2 Diabetics Go Without Insulin?

Senior woman suffering from hypoglycemia

For individuals with type 2 diabetes, the necessity of insulin can vary greatly depending on the progression of their condition and their body’s ability to produce and respond to insulin. Not all type 2 diabetics require insulin; many manage their blood sugar levels through diet, exercise, and oral medications. However, those who do need insulin use it to supplement their body’s insufficient production or to combat insulin resistance.

When insulin is required but not administered, the risk of hyperglycemia (high blood sugar) increases significantly. Over time, unmanaged high blood sugar can lead to a series of serious and long-term complications. These include:

  • Vascular problems: Damage to large and small blood vessels can lead to heart disease, stroke, and problems with blood circulation.
  • Organ damage: Consistently high blood sugar levels can lead to kidney disease (nephropathy), potentially requiring dialysis.
  • Eye issues: Diabetic retinopathy, which can result in blindness, is a significant risk.
  • Nerve damage: Peripheral neuropathy, which can cause pain and numbness in the extremities, can lead to infections and possible limb amputations due to poor wound healing.

In cases where type 2 diabetes progresses to a point where insulin is essential, skipping doses or not taking insulin can result in acute hyperglycemic complications. These conditions might not appear as immediately life-threatening as diabetic ketoacidosis (common in type 1 diabetes) but can still be very serious. Symptoms of severe hyperglycemia include:

  • Blurry vision
  • Frequent urination
  • Extreme thirst
  • Weakness
  • Headaches
  • Fatigue

If left untreated, hyperglycemia can develop over days or weeks and can become life-threatening, requiring immediate medical attention. Therefore, it’s crucial for those type 2 diabetics who are prescribed insulin to adhere closely to their treatment plan to prevent these complications.

What to Do If You Miss a Dose of Insulin?

Woman injecting insulin pen into stomach

Forgetting to take your insulin dose can lead to higher blood sugar levels. While it might not be an emergency right away, it could cause issues if it becomes a habit. Here’s what you should do if you’ve missed your insulin dose:

  • Take It as Soon as You Remember: If it’s still several hours until your next scheduled dose, take the missed dose as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and just take your next dose at the scheduled time.
  • Consult Your Diabetes Care Team: Always have a conversation with your healthcare provider about what to do in case you miss a dose. They might have specific recommendations based on your individual health needs and treatment plan.
  • Monitor Your Blood Glucose Levels: Keep an eye on your blood glucose levels after missing a dose. This can help you understand how missing a dose affects your body and helps in managing your glucose levels effectively.

Final Thoughts

Insulin is a vital lifeline for individuals living with diabetes, and understanding how to manage it effectively is crucial for maintaining health and preventing severe complications. Both Type 1 and Type 2 diabetics face serious risks if insulin therapy is not administered properly. For Type 1 diabetics, the absence of insulin can quickly lead to diabetic ketoacidosis, a dangerous condition that can escalate to life-threatening levels within hours. Type 2 diabetics, while they may not always require insulin, can still experience severe hyperglycemia and other complications if their insulin regimen is not followed.

Proper management includes regular monitoring of blood glucose levels, understanding how to adjust insulin during different situations such as illness or stress, and knowing what to do if a dose is missed. Education on the symptoms of both diabetic ketoacidosis and hyperglycemia is essential, as early detection is key to preventing emergencies.

Ultimately, successful diabetes management is a blend of proper medical guidance, diligent self-care, and comprehensive education. By adhering closely to their prescribed insulin regimens and staying informed about their condition, individuals with diabetes can lead healthy, active lives despite the challenges posed by this chronic condition.

FAQs About Insulin

How long can a diabetic dog go without insulin?

Diabetic dogs usually need two insulin shots each day and a change in diet. While a dog might manage without insulin for a day or so without immediate harm, it’s crucial to treat this as a regular part of the dog’s daily care.

How long can a diabetic cat go without insulin?

Diabetic cats can typically go up to 36-48 hours without insulin. It’s often safer to skip a dose than to give too much and risk low blood sugar, which can be dangerous.

What is the maximum amount of insulin per day?

For people with type 2 diabetes who are very overweight and have high insulin resistance, daily insulin needs might range from 200 to 300 units. Generally, they might need about 1.0 to 2.0 units of insulin per kilogram of body weight each day.

Is it OK to take insulin 4 times a day?

People with type 1 diabetes must inject insulin every day, often up to 4 or 5 times per day. There are different ways to inject insulin ranging from a syringe and needle, to an insulin delivery pen, to an insulin pump.

What is the best time to inject insulin?

The best time to take insulin is about 30 minutes before a meal. This timing helps the insulin to work effectively as your body begins to process food and glucose levels start to rise.


Santos, S.S., Ramaldes, L.A.L., Dualib, P.M., Gabbay, P.M., & Sá, J.R. (2023). Increased risk of death following recurrent ketoacidosis admissions: a Brazilian cohort study of young adults with type 1 diabetes. Diabetology & Metabolic Syndrome, 15, 85.

Novo Nordisk. (2022). What if I miss a dose of insulin? NovoCare® Diabetes Education. Retrieved from