As many as one in four diabetes patients have had to skimp on their insulin for financial reasons, raising concerns about the potential health risks associated with insulin rationing.
 
But what happens if a person with diabetes cannot access or afford insulin? How long can they go without insulin before putting their health at risk?
 
In this article, we'll explore the potential danger and complications of going without insulin for both type 1 and type 2 diabetes and discuss what steps can be taken to ensure access to this vital medication.

Related article: Does Insulin Need to Be Refrigerated? How to Store it Correctly?
 
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How Long Can a Type 1 Diabetic Go Without Insulin?

Insulin is a hormone that regulates blood sugar levels in the body. People with type 1 diabetes do not produce insulin, while those with type 2 diabetes may have insufficient insulin or resistance to its effects. Therefore, how long can a person with diabetes go without insulin depends on their type of diabetes, but also other factors such as insulin sensitivity, weight, diet, or physical exercise, to name a few.
 
The risks of going without insulin are much higher for people with type 1 diabetes, as it can rapidly cause diabetic ketoacidosis (DKA).
 
Diabetic ketoacidosis (DKA) is a severe and life-threatening diabetes complication that occurs when the body produces high levels of blood acids called ketones. It happens when there is a lack of insulin, which causes the body to break down fat for energy instead of glucose. As fat is broken down, ketones are produced, which can increase blood acidity.
 
DKA most commonly occurs in people with type 1 diabetes but can also occur in people with type 2 diabetes in rare cases. DKA can cause dehydration, vomiting, confusion, coma, and even death if left untreated.
 
If a person has recently been diagnosed with type 1 diabetes, they may still have residual insulin in their body, which can keep them going for a few days or even a week before developing DKA.
 
However, some type 1 diabetics, particularly children and teenagers, rely so heavily on insulin injections that they may experience DKA symptoms in less than a day.
 
How long a person can survive without insulin also depends on the type of insulin they use and its duration of action (long-acting vs. fast-acting insulin), as well as their diet, carbohydrate intake, and physical activity. But generally, a type 1 diabetic is likely to start experiencing signs of DKA within 24 to 48 hours at most.
 
Related article: What Happens if You Miss a Dose of Insulin?

Diabetic Ketoacidosis symptoms

As mentioned above, diabetic ketoacidosis is very serious and must be medically addressed in an emergency. If you have type 1 or type 2 diabetes, seek immediate medical attention if you experience symptoms of DKA. They include but are not limited to the following:

  • 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 

Related article: How to Tell if Your Insulin Has Gone Bad?

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How Long Can Type 2 Diabetics Go Without Insulin?

First of all, not all type 2 diabetics require insulin. However, those who do need insulin to manage their blood sugar levels should never stop taking it without proper medical guidance.
 
For people with type 2 diabetes and insulin therapy, going without insulin can lead to hyperglycemia.
 
The main risks of skipping insulin doses in type 2 diabetes and prolonged hyperglycemia are long-term diabetes complications such as kidney and eye damage, heart disease, or peripheral neuropathy. Although these damages may not be immediately apparent, they are happening and can have life-threatening consequences in the future.
 
Symptoms of hyperglycemia include blurry vision, frequent urination, extreme thirst, weakness, and headaches. If left untreated, hyperglycemia can take days or weeks to develop, potentially fatal, even in type 2 diabetes.
 
Related article: What to do if you run out of insulin?

What if you Can't Afford insulin?

If you or someone you know with type 1 or type 2 diabetes has difficulty affording insulin, it is important to speak to a healthcare professional as soon as possible to get help and support. As mentioned above, lacking insulin can be life-threatening, especially for people with type 1 diabetes.
 
If you are unable to afford insulin, there may be a few options available:

  • Speak with your healthcare provider: Let them know that you have financial difficulty buying insulin. They can work with you to find more affordable options or alternative treatments.
  • Look for assistance programs: Many assistance programs are available to help with the cost of insulin. Some organizations offer free or discounted insulin to people who meet specific criteria. You can search for these programs online or ask your doctor for recommendations.
  • Contact your insulin manufacturer: Some insulin manufacturers offer patient assistance programs that provide free or discounted insulin to people who cannot afford it. Contact your insulin manufacturer to find out if they have any programs you may qualify for.
  • Consider switching to a different type of insulin: Your healthcare provider may be able to recommend another type of insulin that is more affordable for you. However, never switch insulin without your doctor’s advice.
  • Look for discounts: Many pharmacies offer discount programs or coupons for insulin. Check with your local pharmacy to see if they have any discounts available. 

Related article: How to Calculate Your Insulin Dose Correctly?

It is important to remember that insulin is a life-saving medication, and finding a way to obtain it is crucial if you have insulin-dependent diabetes.
 
We hope this article has shed some light on the risks of going without insulin for people with diabetes. We invite you to share your thoughts and experiences in the comments below. Let's continue the conversation on improving access to affordable insulin and support for people with diabetes!
April 17, 2023

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