Missed Insulin Dose Symptoms in Type 1 and Type 2 Diabetes

If managed well, diabetes is just a health condition. The management of diabetes requires a multi-dimensional approach. Taking timely insulin dosages is one of the key aspects in maintaining stable blood sugar levels. Missing even one dose can lead to negative symptoms and complications; however, if you have missed one, taking abrupt action can do the job. Here, we have highlighted the missed insulin dose symptoms and how to correct them.

In Case of Missing Long-Acting Insulin

Remembering before you sleep: You may find it useful to consume the dose. Check ketones, if they are above 1.0 mmol/L or higher, take 10% of your rapid insulin dose – step-wise guide on ‘The Royal Children’s Hospital Melbourne.’ Remembering the next morning: Seek medical advice immediately.

In Case of Rapid-Acting Insulin (Short-Acting Insulin)

• You realise right after your meal: Take a dose not too little but just slightly less than the normal dose, or get advice from your healthcare specialist.
• You realise close to another meal: Don’t take two doses at once without consulting your doctor, as it may lead to hypoglycemia (low blood sugar).

Interesting Role of Fluid in the Case of a Missed Insulin Dose

As per Janelle Collins on Healthshare, drinking fluids does help reduce some of the discomfort caused by missed insulin doses, especially by addressing dehydration. Drinking water can help flush excess glucose from your system and reduce the risk of diabetic ketoacidosis (DKA), but it doesn’t replace insulin.
While hydrating is beneficial, it’s not a substitute for taking the correct insulin dose. Missed insulin dose symptoms, like high blood sugar, will still need to be managed with proper insulin administration.

Did you know?

Continuous glucose monitors (CGMs), such as Freestyle Libre 2 Plus Sensors, monitor your blood sugar 24/7, most give high or low glucose alerts, and are even compatible with automatic insulin delivery (AID) systems.

What Happens If You Forget to Take Insulin?

Whether you have type 1 diabetes or type 2 diabetes, missing an insulin dose can lead to an increase in blood glucose levels. In type 1 diabetes, where the body produces little to no insulin, skipping a dose can result in a dangerous rise in blood sugar. In type 2 diabetes, though the body still produces insulin, it’s often not enough due to the cells being insulin resistant, and this leads to similar consequences.

If you forgot to take insulin before a meal or skipped a dose entirely, the immediate effects can range from mild symptoms like increased thirst to more severe reactions, such as diabetic ketoacidosis (DKA), especially in type 1 diabetes missed insulin dose.

While taking insulin in moderation and consuming liquids may do the job, in severe conditions, contact your diabetes team immediately.

Here’s a breakdown of common symptoms when you forgot Lantus dose or missed other insulin types:

1. High Blood Sugar (Hyperglycemia):

• Symptoms: Increased thirst, frequent urination, weakness or extreme tiredness, blurry vision. If not treated, as per mayoclinic, the later symptoms include abdominal pain, nausea or vomiting, difficulty breathing, confusion, and even unconsciousness.
• Cause: Missing insulin means your body can’t effectively regulate glucose levels.

2. Diabetic Ketoacidosis (DKA) – Especially in Type 1:

• Symptoms: Nausea, vomiting, fruity-smelling breath, rapid breathing, confusion.
• Cause: If insulin is missed for too long, the body starts breaking down fat instead of glucose, leading to ketone buildup.

According to the Mayo Clinic, DKA is a severe complication of missing insulin, especially for type 1 diabetics.

3. Fatigue and Weakness:

• Symptoms: You might feel unusually tired or weak.
• Cause: Without insulin, your body cannot efficiently use glucose for energy.

4. Increased Hunger (Polyphagia):

• Symptoms: Despite high blood sugar, your body feels deprived of fuel and may signal hunger.
• Cause: Missing insulin hinders glucose absorption by cells, leading to hunger.

5. Dry Mouth and Thirst:

• Symptoms: Dehydration and a dry mouth.
• Cause: High blood sugar levels cause the body to lose more fluids through urination, leaving you thirsty and dehydrated.

If missed insulin dose is not addressed promptly, your condition may get worse. Immediate action is needed to prevent complications like DKA.

What Happens If You Miss a Dose of Lantus?

If you missed an insulin dose or forgot a Lantus dose, it can affect both long and short-acting insulin. Missing it may cause blood sugar fluctuations, leading to periods of hyperglycemia and increased ketone production in the body, especially if multiple doses are skipped.

Unsure what Lantus is? Lantus is a long-acting (24-hour) insulin glargine injection for both type 1 and type 2 diabetic people. Having 100 units/mL, this injection is available in a 3mL prefilled pen for single patient use and a 10mL vial for multiple doses.

Note: In case of missing long-acting insulin like Lantus, you may need to take a correction dose of rapid-acting insulin after checking your blood glucose levels, as advised by your endocrinologist.

What to Do If You Do Not Have Insulin with You?

If you are away from home and forgot to take insulin last night, or you do not have insulin with you, in such cases, the best course of action is:

• Contact a healthcare provider: If you don’t have insulin, ask for advice on how to proceed. You may need to find a nearby pharmacy or health centre to get a dose.
• Consume what improves insulin sensitivity: You may consider keeping pumpkin seeds, almonds, peanuts, cashews, or flaxseeds with you as these foods can increase insulin sensitivity. Moreover, as Healthline says, consuming foods rich in protein, healthy fats, anti-oxidants, and vitamins may also help, e.g., broccoli.

Did you know that even people with diabetes can enjoy cookies? Discover our range of diabetes-friendly cookies designed to satisfy your sweet tooth without spiking your blood sugar.

Does Skipping Insulin Have Long-Term Effects?

Chronic missed doses can lead to long-term complications like neuropathy, retinopathy, kidney damage, and cardiovascular issues. These are serious outcomes that can be avoided by adhering to your prescribed insulin regimen.

Conclusion

Skipping insulin doses can result in result in multiple complications, including but not limited to frequent urination, extreme tiredness, blurry vision, shortness of breath, and even diabetic ketoacidosis (especially in individuals with type 1 diabetes). In case of forgetting your insulin dose, which is common, do not panic, but take immediate action, including calling your doctor (when required). Make sure not to consume double doses, i.e., taking a missed dose close to your second dose – it can lead to hypoglycemia (low blood sugar).

Moreover, maintaining normal blood sugar levels in your body is critical, as prolonged high blood sugar can lead to various complications, including severe ones. CGM sensors are helping people with finger-prick-free (as they reduce the need for finger-prick testing) glucose monitoring. Plus, the latest ones can even be used with automatic insulin delivery (AID) systems such as Ominpod 5 – get a benefits check now with CGM Monitors and receive your supplies without any shipping costs (within the US) at your door.

Disclaimer: This is only for informational purposes and does not substitute your doctor’s advice. Always consult your doctor before taking any medical action.