How long could a T1 diabetic survive without taking any insulin or adhering to any dietary restrictions?
QuestionYou might not even make it long enough for the dehydration take you out. My one and only time in DKA was when I was diagnosed at 12. My mom thought I had the flu. After a couple of days they finally took me to the ER. The last thing I remember is telling the ER nurse that my sides hurt and then I blacked out (went into a coma). Woke up the next day in ICU. It turns out the reason my sides were hurting is my lungs were shutting down.
Oh shit... now that makes that one time in the ER even scarier. To describe what it felt like to breath in, I would say that I felt like the inside of each of my ribs had a hot poker and every time I filled my lungs it would touch the hot poker. I would hold my breath as long as I could just to not feel that
I've gone dka about 6 or more times in my 19 years of diabetes but I've never fainted wtf
When I was diagnosed as a 12 year old, I passed out the second I was carried into A&E. The Doctors were going to check for Diabetes regardless, but it was my mum who immediately asked them to check my BG - she remembered her Diabetic sister having the same symptoms.
Straight forward and direct, I like that! I think this is the best answer to a pretty easy question.
Jesus now that will help give me the kick in the ass to shoot my basal in the am if I forget at night glad you’re ok
That's what happened to me. Within 12 hrs, I was puking and close to passing out.
Likely less than that, but from the electrolyte imbalance that is the big issue in dehydration. When your bg is sky high, potassium binds to all the extra and without insulin to move bg and bound potassium out of blood into cells, serum potassium would quickly get too high as well. Fun fact- potassium is the lethal part of lethal injection. Potassium > 6.0 = 80% risk of death. Potassium levels too high or too low result in severe muscle weakness to the point of paralysis- limbs first, then moving into your organs, eventually leading to your heart stopping bc the muscle is too weak to keep beating.
(I also have Addisons, and we have massive sodium deficiencies/too much potassium, so much that it seems we are more tolerant of higher potassium than those without that deficiency. Highest my potassium has been is 9.2, somehow even then no irregular heart rhythm, but it was getting result hard to breathe, so likely my diaphragm was reaching that state of extreme weakness. My legs, arms and almost neck were already temporarily paralyzed.
The zombie apocalypse is not going to be easy on us diabetics
We are going to make excellent zombies
Get familiar with your local pig farms.
Rabbit will do in a pinch as well, but probably should write a t1 book for the apocalypse
Please expand. How would you harvest it?
Hahaha hahaha I just looked it up, read about blenders, and then this: it takes TWO TONS of animal pancreases to make 8 OUNCES of insulin. We're fucked.
Doing some google fu would be significantly better than my explanation.
Do a deep dive and see if you can actually get some hands on experience at a local university.
Always remember day Z, there’s hope.😂
Personally, I’d be feeling unwell within hours and likely need to go to the ER within 3 days
I think I’d be dead in 3 days or less from dka untreated
Yeah true, I’d actually probably need to present to ER within 24hrs I reckon
Everyone gave good answers so I'm wondering why you're asking--curiosity or are you T1 who needs assistance? If the latter, do you have access to any support or resources? Can you reach out to someone if you need help? There's no shame in asking whether it's help for medical access, or insulin, or food or counselling/therapy.
Hope you're doing ok & please don't restrict insulin for any reason if possible.
My exact thoughts. I hope you’re not struggling OP, you deserve to feel better and it is absolutely possible. Hugs to you!!
I have participated in actual clinically supervised insulin withdrawal studies. They are generally stopped for safety at 5-6 hours, but many participants pull the plug before that because they hit one of the other safety thresholds in the study protocol or feel so awful they are puking.
That's interesting! What are they trying to learn in these studies?
In one, the effects of partially blocking glucagon on how quickly people taking SGLT2is (drugs like Jardiance and Farxiga) go into DKA (or approach DKA). The other was looking for similar effects, but the drug they were testing is a glucokinase activator (triggers the liver to take up more glucose from the blood).
Many participants couldn't last 5-6 hrs without symptoms??? Were they just going crazy with the carbs or sth else going on?
After a pump occlusion in my sleep, I was terribly ill by the 6 hour mark. Wasn’t eating in my sleep.
People had to be on pumps- no MDI, so no basal insulin once the pump was disconnected. They were also already fasted (8+ hours, IIRC) and into ketosis at onset.
As noted by u/drugihparrukava, 5-6 hours is enough to already be in a bad way if you are relying on a continuous infusion of rapid-acting for basal.
Going in fasting and already being in ketosis...makes a lot of sense then! I asked because I'm on the omnipod 5 myself and even with 0 insulin on-board and being on fast-acting I find I can cope fasted for at least a half day (though I avoid it).
Dawn effect will always kick my ass and probs tip me over to a DKA scenario though I haven't tried!
Ketoacidosis is caused by ketones, not blood sugar. Carbs wouldn't really do much to change the situation.
Ketoacidosis can happen in healthy individuals (w/out diabetes). Mainly if they take a keto diet way too far. DKA is what I'm assuming the study was monitoring in which case blood sugar very much plays a role in symptoms (most guidelines across the world factor in blood sugar + ketones in management). If I'm wrong lmk, just a diabetic med student trying to learn.
With zero insulin, DKA is going to kick in in a matter of days or weeks, depending on the person, and would be fatal untreated. Any medical intervention would involve insulin, so I assume that's not part of your question.
Unfortunately, we wouldn't last very long.
To add on to this, keep in mind that experiencing DKA feels absolutely awful and horrendous. Lots of diabetics (including myself) have experienced DKA, and it takes a HUGE toll on your body. When I was hospitalized for DKA, my blood felt thick. I could feel my blood pulsing in almost every part of my body. 😭 I also couldn’t focus, was tired and loopy, miserable and grumpy, and overall just felt awful! OP, I hope you are asking this question just out of curiosity, and I hope OP wouldn’t try to attempt this. It would be the absolute worst way to go to say the least.
Thick feeling blood and trouble breathing, like every cell in your body is gasping for help. About 6+ hours with no insulin pump and I’m there. Most of the time I can’t think about this or I’d never leave the house.
Don’t think it’d take weeks for us to go into dka
I spent about a month untreated before I was diagnosed, and I have never experienced DKA. That being said, I think it’s very likely that I was still in the honeymoon phase at the time.
Two years after being diagnosed T1, I went 24 hours without any insulin whatsoever, then drank an entire case of Mtn Dew and ate an entire cake by myself. My blood sugar was 84 when I went to bed, and 350 when I woke up the next morning.
Oftentimes when the beta cells die, they flood the bloodstream with all of their stored up insulin. It's not like they can hold it in anymore.
With LADA, one characteristic is frequent, severe hypoglycemia. The death of beta cells and insulin flooding the bloodstream makes exercise nearly impossible. Weight gain becomes inevitable, and cognitive function declines during the years-long honeymoon phase. Ratios change constantly. My pancreatic function was one week on, three weeks off. So I was only insulin-dependent 3/4 of the time.
I've talked to a few people in this sub that went through the same hell, but it seems rare even among T1 diabetics.
I have LADA. Are there studies about the cognitive decline?
Probably not. But frequent hypoglycemia has been proven to contribute to cognitive issues.
Like 24 hours with zero insulin on board. Body is going to be starving for any energy quite quickly. Especially after honey moon and everything else. Diabetes were given a year before insulin was invented. This was mostly due to honey mooning
With zero insulin DKA can actually begin in as little as 4 hours (this is 7-9 hours after the last short-acting insulin taken for those on insulin pumps with no long-acting insulin to help cover you - this is why they won't give pumps to people who can't show they take their BG regularly and care about their health). At this point, you likely only have mild symptoms and are likely nauseated and thirsty. This can occur with high BG (symptoms are typically more extreme as DKA is really just dehydration due to excessive ketones and high blood sugar increases dehydration as well) or normal to low BG (called euglycemic diabetic ketoacidosis, eDKA) as DKA is 100% caused by lack of insulin and is not a consequence of high BG. If your BG stays in range (you don't eat, exercise excessively, and have low enough stress hormone levels - not likely but possible with certain illnesses), you probably avoid serious eDKA that will send you to the hospital for 12-48 hours (drinking excessive fluids and peeing a ton to try to flush excessive ketones out of the body). With high BGs, DKA can occur even when taking far more insulin than normal. If your insulin resistance is higher than the amount of insulin you are taking, you can quickly reach DKA by just not having sufficient insulin. With no insulin, I would expect that 4-6 hours is about the maximum you could go before vomiting becomes intense. Once you have started vomiting, DKA can no longer be safely treated at home. From vomiting to death can vary from hours to a few days, depending on your overall health, how much fluid you can get down, if you are taking in electrolytes, how much insulin your body makes (some T1s make a small amount of insulin forever, others make none), how high your BG is, what your cortisol level is (cortisol is a stress hormone that causes insulin resistance), how much glycogen your body is releasing (sugar stored in the liver and muscles - your body releases this hoping to provide energy but it can't be used without insulin so only serves to increase BG even more), etc. It is very important that you seek medical attention as soon as you are unable to keep food or liquid down. You are unlikely to survive DKA without an IV at this point!!
DKA, as I said earlier, is simply dehydration caused by excessive ketone production. You don't usually die from DKA but instead die from electrolyte imbalance, which typically causes cardiac problems, including heart attacks. A diabetic hypoglycemic coma occurs either due to high levels of toxic ketones (an acid) or severe dehydration, which causes the body to start shutting down. A coma is more common when insulin is present but is insufficient to meet the body's needs over a period of weeks or months (such as individuals prior to initial diagnosis while their bodies still make some insulin), but can occur with really high BGs in a short amount of time (a few hours) in some circumstances.
Before insulin was discovered diabetics could be kept alive for months or even as long as 3 years on a strict starvation diet (typically started <1000 calories and was cut as time went on) and exercise program. This was only possible while their bodies were able to keep producing insulin. Most patients under treatment slipped into a diabetic coma and died as their bodies stopped making insulin. I have read first-hand accounts of patients, parents, doctors, and in-home nurses from the Joslin clinic in the years before insulin was discovered (they corresponded through letters after initial treatment plans were put into place). The accounts are heartbreaking! The children who survived the longest were skeletons by the end of their short lives.
An even more detailed response. Agreed.
I’ve only gone into DKA once. I got sick and lost my appetite so I was doing bare minimum of insulin. Got worse and worse before I got into my PCP. She said she can call an ambulance or I can drive myself to the ER. Being in the US I said screw the ambulance (didn’t want that bill) and drove myself to the hospital. They were expecting me because she had called ahead and I had an army of people working on me once I walked through the doors. Didn’t realize how close to dying I had been, and that all took about 5 days to go from getting sick to death’s door.
So it will partially depend on your insulin production and what their current insulin is.
Example: I am t1 for 30+ years with undetectable c peptide. I am on tresiba (which stays in body for over 40 hours)
So I would give myself maximum of 2days before I am in full blown DKA and likely dead.
For someone with same insulin production but on pump, it might be less than 1 day.
I went 7 days without insulin but i don't really remember the last 2. Glucose was unimaginably high. I just remember waking up day 8 with insulin and a needle next to my bed. Not sure how I got to the pharmacy and got it though. Should've died. I wouldn't wish this disease on anyone.
That completely depends on if they’re newly diagnosed and still making some insulin or if they’ve had diabetes longer, as well as what they eat, how hydrated they are, etc. I think the fewer carbs someone eats and the more they stay hydrated the longer it would take them to go into DKA. I think that if a person is not taking any insulin and their body no longer makes any insulin ( they’re not in the honeymoon period) and they are still eating carbs it’s probably 48-96 hours before diabetic ketoacidosis really sets in. It’s absolutely miserable, a person is thirsty nonstop, but can’t keep water down as they vomit it up. So immediate survival would probably depend on them getting IV hydration. I’m not sure how quickly DKA progresses without insulin but it causes hyperosmosis , cerebral edema, and death.
So many factors affect diabetes. I’ve been in DKA twice, once when I was diagnosed and that time I got sick slowly over the course of six months because my body was still making some insulin. The second time I was stressed out because my dad had recently died, I got a little flu-like virus, and I wasn’t eating enough food because I had no appetite. The stress on my body from grief and illness, combined with not eating made me go into DKA even though my blood sugar was under 300. I was only sick for a week I was giving myself insulin the whole time, but I still went into DKA with very high ketones.
type ones don't have specific dietary restrictions. with no insulin at all, a few days max.
I think they meant like going zero carb while not being on any insulin
I was told to stop taking insulin by a new Dr after diagnosis, she was convinced I was type 2. Within 4 days I was incredibly sick, vomiting this nasty black stuff, taken to the ER by my husband. I was in ketoacidosis and fell unconscious in the waiting room. I spent another 3 days in intensive care before being allowed to return home. I don’t think my blood sugar went over 350.
Yep. It’s not about blood sugar. It’s about too much glucagon and a lack of insulin.
Exactly. What I don’t understand is why I didn’t go into ketoacidosis when first diagnosed. I was 43 and understood that my blood sugar was well over 600 for maybe months.
DKA kicks in in a matter of hours. Depends if you had basal recently, or only fast acting (pump).
The DKA is absolutely horrible. One of the worst death possuble for sure. You litteraly can feel your blood as an acid going through your veins and your organs feel like they are going to explode in any second. And the mausea/vomit is constant.
Depends. If you're still honeymooning and you stuck to a low carb diet, you could last a few weeks or maybe even a few months. But if you're out of the honeymoon you're dead in a few days and it doesn't make a difference what you do...
So, my diagnosis was about as late as you can get. At least that's what the doc said in the ER after saying that I was an idiot for waiting so long. A little back story, I was active duty in the US Army, 29 y/o male in 85th percentile physically, and no relevant family history of diabetes. My unaccounted-for weight loss started in January of 2009. Although I didn't really notice until later, a look back at my weigh-in records showed that was the actual start. Frequent urination and ravenous insatiable appetite began late February or early March. Starting mid-April of '09 through the summer (high desert Arizona summer, I might add), I was going through training so going to a doctor wasn't really an option and by late July I was afraid I had some kind of aggressive cancer so I was straight-up avoiding medical personnel. By September, I was back at my home station and basically in a holding pattern, awaiting the process of moving to another base and a new unit. On September 22nd, 2009, I finally gave up and went to the ER. At this point, I was getting too weak to make it up the stairs to my barracks room, so it was really a no choice situation rather than a decision I made. The doctor and nurses were pretty insistent that my labs and observable physical state led them to believe I was days but no more than a week from having died. So I'll go with 9 or 10 months if the subject was healthy before ceasing treatment.
TLDR: I went 9 months from onset of symptoms to diagnosis of T1D and was told I was less than a week from dying. My guess is 6 to 9 months unless they were gorging on cake and cookies 😆
Wow! I cannot imagine how bad you must have felt! I also cannot understand how nobody around you noticed your worsening symptoms and didn’t do anything to get you to a doc (it sounds like you tried to hide that, though).
I would like to echo what many have already said: during the honeymoon phase, your pancreas is still producing insulin. I’m not a doctor, but I’m sure someone such as myself with t1d for 27 years would not last anywhere near 9 months without insulin. But geez dude, you’re tough as bricks for living the military life while dancing with DKA!
It was hell, and although I got away with hiding it from my military counterparts, my family noticed and were very vocal. I saw them right after I finished the training I mentioned in Arizona. My brother, who was also serving at the time, made an idle threat about calling my First Sergeant if I didn't promise to go to medical. I sort of kept that promise just three weeks later. When I saw them in early late August, I was pretty emaciated. I had lost over 70 lbs and was constantly drinking liquids and going to the bathroom every 15 minutes. It was truly a medical marvel that I survived. I believed the doctors and nurses when they said I was literally at deaths door. It felt like death for probably the last two months and close to it that whole summer. Thanks for pumping me up with the tough as bricks statement. Guess I was dumb as bricks too though lol
I also thought the weight loss was some weird cancer lol so glad you’re okay now ❤️❤️
Don’t know why you got downvoted, your story was very interesting and I can seriously relate to “straight-up avoiding medical personnel”😅 I spent a little time in an academy and learned a lot of things about myself, none of them super great, one of them undiagnosed ADHD🤷♀️ and it took a long time before I could admit to myself that no, I really couldn’t do this (not the same I know, but your words did remind me of that sinking moment of realization).
I didn’t get T1 ‘till about five years later. I can’t imagine getting it after years (I’m assuming!) in the military and having to just…be done with the life.
Thank you for both your service and for sharing your experience.
Dang, I didn't know I got down-voted and can't think of a reason why someone would. Well, whomever it was thanks for the thumbs down on a really traumatic year of my life leading up to more years of dealing with military life and learning to live with diabetes.
Yeah, I had been in the military a total of about ten years by the point of my diagnosis and served six more as a T1D. I ended up flying under the radar because my diagnosis occurred at a precarious time since I had orders and did a PCS to a new unit on a different base. My first MEB (Medical Examination Board) only happened because I caught a medical flag trying to deploy. It took a lot of effort, but I won and got to stay in the Army. Then, about two years later, the regulations changed, and I had to do another MEB. That time, I didn't fight and just took the early retirement.
Thanks for letting me know I got down-voted. Guess somebody was in their feels about something lol
Sorry I didn’t realize you hadn’t seen it, or I wouldn’t have said anything! Looks like it got fixed pretty quick tho.
I’m glad you got to stay in a little longer!
It's all good, I appreciate you telling me because I'd have never noticed.
I’ve been T1 for 15 years now, the one time except DX where I went into DKA was due to a pump failure, and I’d say within 18 hours I was vomiting and ill enough to go to the ER
What happened with the pump over 18 hrs?
Somehow I wasn’t receiving my basal, whether that was due to my infusion site or the pump itself I don’t know, but there was no alarm or error on my pump, so I just thought I was regular sick until I got to the ER. I had never had full on DKA before then so I didn’t recognize the symptoms.
3 days
Two days for me.
I had an omnipod fail on me at work, about 1 hour into an 8 hour shift. I went home sick after my blood sugar hit 20 (360ish for Americans) with no sign of going down. I think I lasted about five hours, and I felt like hell the whole evening. At least I had my libre so I could tell how bad it was getting and at what rate.
I learned my damn lesson, and now I keep an insulin pen in the fridge at work!
I figure I would survive somewhere between 12 and 36 hours. I know (because of three sites failing in a row) that by 4 hours without insulin my bg is about 400 mg/dl (36 mmol) and still going up. At that point I am also blowing ketones. Based on how I felt that day, compared to the last time I was in full blown DKA, I don't expect I'd have lived more than another 20 hours.
I have no desire to test this. I know it would be painful. Puking water, or nothing sucks. I just know I'm on a super short countdown clock without insulin.
I went 3 days without insulin before I ended up in the hospital for diabetic ketoacidosis. My doctor didn’t refill my prescription so I had no insulin
I ran out of insulin once, and it was a Sunday morning. About 8 hours later I was in the emergency room in DKA and my blood sugar was in the 800s. They said if I had let it go much longer, I would have slipped into a coma.
The person would be very sick very quickly. There is no insulin free way to live with T1.
Well that person might begin with no insulin and no dietary restrictions, but they would quickly self impose dietary restrictions in that they would not want to, or be able to, eat after too long.
If my insulin delivery were suddenly stopped (and yes, this has happened to me before), I'd be feeling sick within a few hours. In 12 hours, I'd start vomiting and that would continue until I'd start dry heaving. I'd lose the ability to keep water down at all. A few hours after that I would be in terrible pain and be having trouble breathing. It would feel like an elephant were sitting on my chest and someone was stabbing me in the guts. I would be delirious, unable to move and feel like I'd been run over by a truck.
Thankfully anytime I've been in DKA, that's as far as it ever got. I woke up in the ICU getting pumped with insulin and fluids. If it had progressed further, I'd be looking at heart failure and death.
I pray this never happens to you! Take care of yourself and it shouldn't.
I think I’d be unconscious within 48 hours
So I’m going to base my numbers off of insulin wearing off I did a report on it recently and at worst it’s a day to couple days at absolute best a week maybe 2 but it would be absolute hell trying to make it through week 2 you’d probably want to be dead long before that
It did say even a small amount of insulin occasionally can help prolong your life but overall I wouldn’t recommend going without
imagine the life of not having to inject or check our sugars for like a week? Ugh.. what a dream
Back in the day, I would occasionally run out of insulin. Usually a day before payday. (Was too broke even for Walmart insulin). So I would tell myself I’m not eating anything for a day, and I’ll get it once I get paid. Every, single time I ended up awfully sick. I didn’t even test my sugars much back then. I would have my spouse cash my check and bring me insulin, then I’d take 70-100 units, (depending on the size of the syringes I had at the time). Then lay in bed for it yo come down. Often ending up low.
I think one of these incidents is why I had a stroke. I know a few more hours I’d have died. So, for me, about a day.
I’d never do that again; I’d go to the ER first. It’s been over a decade; managing it a lot better. Better living through technology.
Hours before becoming ill.
I start vomiting about twelve hours after missing a dose of Lantus.
There is a lady on tik tok who's been reposted here a few times, her whole shtick is trying to go as long as she can without taking her insulin because she's afraid of big pharma lol. She takes freezing showers, does tons of cardio, drinks acv, takes a million supplements. As far as I could see she could only go without insulin for a few days, maybe four or so before her sugars would be in the three hundreds and she would cave and take the insulin. I think she was on a keto diet but I don't recall. This disease kills.
Happened to me 3 times in my 53 years of living with this disease. My worse one was when I was 10 years old. I was unconscious and vomiting when my twin sister woke up Mom. It was bad enough to stop my heart for several minutes. I experienced a total Near Death Experience. By the grace of love, my heart was jump started and i was in a coma for two days. The others times it happened was due to fighting pneumonia.I was feeling very sick and had bs over 600, but I was still awake when arriving at the hospital.
Probably anywhere between a couple of days to about two weeks (this is a guess). It really depends on how long you’ve had it (how many beta cells you have left). If you’re new onset, like someone said on here, you could go into a coma quickly, or you could stay in the 4-600s for a few days until you get to the hospital. Like most said, it could just take 2 days or a little more. I doubt it would take anywhere near 2 weeks for most people. If it took that long, the T1D would be in a coma, alive but barely. Now, if you’re talking about consciousness, the person would probably vomit for a while and if they didn’t die from the imbalance of electrolytes, dehydration, and/or the very low blood pH they’d probably lose consciousness in no more than a day or two in DKA at absolute most. These are just estimations based on what I’ve experienced myself and heard from others in the T1D and medical care communities over the last 26 years with T1D.
Couple days depending on what they were eating.
I did an 8 day water fast a few years back & still needed to inject a little bit of basal to keep sugars within range on day 8.. so probably not too long (unless you're not too long diagnosed & in your "honeymoon" phase, where your pancreas is still producing a little itself, which might grant you a few more days/maybe weeks.. maybe)
Depends on your current health status, A1C, illness, etc. In as little as 6 hours
Well when I was recently diagnosed I think I was in DKA for about 2 weeks?? I think if I waited any longer to go to the ER it could have been REALLY bad… I was not sticking to any sort of diet of course because I didn’t know I was diabetic yet. I’m still surprised how long I went given my fatigue and not collapsing into coma.
For me, it's probably just less than a day. It only takes 10 minutes for my blood sugar to start rising rapidly. And this is when I take my insulin pump off for a shower.
I somehow made it 10 years with an a1c over 11, over 14 for a good chunk. Had my fair share of DKA episodes when I forgot even the long acting. Closest to death I got was last year, DKA for three days, kidneys started shutting down.
One of my siblings has a father who's been uncontrolled for longer, lost some limbs.
When my pump site kinked it too less than 8 hours
Before 1921, diabetics were treated with a starvation diet with no carbohydrates at all. Lots of lettuce. So kids basically died of hunger. Took weeks to months, or longer, after beginning treatment to kick the bucket. No shit. In the USA. Not sure other countries.
You can die in 7-10 days without insulin. Those that are on pumps go into DKA faster than MDI due to no long acting insulin.
So I (29M) actually tried this. I went no insulin (trypanophobia) and for a while, just didn't really accept that I had T1D. That was a big mistake. The insesant hunger was immediate, I was falling asleep at work randomly due to sugar spikes, pain in my legs kicked in after about a month, I ended up in the hospital multiple times. Family was freaking out. It's not a good idea. I ended up with severe headaches AND diabetic neuropathy. Needless to say, I've stopped doing that. Had to go to a therapist to help with the phobia, and I STILL feel my legs act up at the simplest over indulgence of sugars. Don't do it. Just don't. Take it from me.
Reading the comments makes me wonder if I’m special or something lol I’ve gone more than a day without taking insulin running 400+ for 24hrs+ and although I start to feel discomfort in throat/thyroid area, that’s as much pain or symptoms I experience. How does one even go into DKA?
After years of beautiful numbers I became burnt out around 25 years old and stopped taking my medications and would "sometimes" take my long lasting... ate and drank whateverIfelt like having. That lead to dka every couple months for about a year which led to me developing sepsis, multi system organ failure and went into a coma for about 3 days. You dont last long without meds and hydration. Never again. No matter what levels of burnout I'm experiencing I never want to go down that path again.
2 years max with repeat ICU stays. Otherwise? Maybe 6months no ICU stays
2-3 weeks, but after the 2nd day you will then start to really feel like shit. But you would live for 2-3 more weeks ok. Some could live longer. Just depends on your body and how much carbs you need.
There were many diabetics who survived for a decent amount of time pre insulin.
For instance - https://en.m.wikipedia.org/wiki/Elizabeth_Hughes_Gossett lived for 4 years before she became the first American to receive insulin.
Also Eva saxl made insulin in wwii https://en.m.wikipedia.org/wiki/Eva_Saxl
That person would survive until they die. I'm not a historian, but I think 6 months.
I don’t understand DKA my bloods have often been over 30 (Uk measurements) and I have never burnt ketones from my knowledge…
I think it’s because I have lots of insulin in my system and I just eat too much sugar. (Usually post smoking weed)
Also I have fasted for a few days without taking any insulin and have been fine….
I think it’s different for every individual
I’ll NEVER understand all those who claim DKA will kill you or severely damage you in hours or even a couple days. What the hell do you people think happened when you were finally diagnosed? It was many days before you got diagnosed then treatment. 🤦♂️
Most people are still producing some tiny amount of insulin at diagnosis (which is why honeymoons happen). After many years of T1D, the story is very different. You can hover in mild DKA (the condition is actually defined by the anion gap present in blood, not an absolute ketone level or blood glucose threshold) prior to official diagnosis for quite a long time. It doesn’t take much insulin to restrict ketone production enough to keep you in a state that is survivable.
Generally, the younger you are at Dx, the more rapid the decline in beta cell mass and insulin production capacity. A young child will approach DKA much more quickly after developing autoantibodies than someone with LADA (the other extreme). People with LADA can in many cases go years or even decades without insulin by using “Type 2” meds to boost the effect of the insulin they do still produce.
I don’t think anything you said here is wrong.
I still don’t think those few claiming “DKA is likely to hospitalize you if you miss a shot” are correct. Could it? Sure it’s very possible it could happen to one in a very larger number (a million?).
My point in every comment I’ve made on this subject is that fringe cases do happen and sit sucks. However, don’t turn fringe cases into this WILL happen to you CASES.
Every body is different for sure. But in 30 years I’ve inadvertently gone up to 48 hours without insulin of any kind. Zero issues other than glucose being higher than I wanted. Granted I stayed away from crabs and drank plenty of water the few times it’s happened. I’m older and wiser now so I plan well and it hasn’t happened in many years.
Point is… stop freaking people out! Yes it CAN happen faster in some and every circumstance is different.
Yes it CAN happen faster in some
Point is, you don't want to find out if you are one.
I didn't actually go into DKA at diagnosis. My blood sugar was 624 after 6 months of symptoms. The first time I went into DKA it was almost a year to the day after my diagnosis. It was pre-obamacare and I was rationing insulin. After 2 days of vomiting I went to the ER and was told that I was near death. I was told that by at least 3 of the ER professionals.
I have been in DKA more than a dozen times due to complications of treatment, that was one of two times they told me I was close to death from dehydration. So keep your skepticism if you want to, I've been through it.
“Told me I was close to death from dehydration”… that is not a lack of insulin problem.
And I’m not skeptical about DKA I general…I’m skeptical about going into DKA because you’ve had no insulin for 12-18 hours kind of comments I see all the time here. That’s just fear mongers talking or the worst set of circumstances ever imaginable. Either way it is not something almost anyone should ever have to worry about.
T1 can be hard enough without being constantly fearful of unlikely outcomes.
That happened to me. You can be skeptical, but I won't hesitate to share that it has happened to me. I was supposed to take it at 7 pm, woke up at 7 am vomiting in full DKA needing hospitalization and IV insulin with d20 saline.
You're luky it hasn't happened to you because it's scary AF.
I’m sorry that happened to you.
There’s got to be more to your story than you simply missed one shot of insulin in 12 hours and that is my point. Blood sugar must’ve been super high plus other factors including dehydration.
Oh boy do I wish there was, but there isn't.
You have not heard of euglycemic DKA. DKA without blood sugars over 250.
Again, I do not wish to minimize what happened to you. I just want to openly discuss whether these things are common or outliers and what factors are primary contributors.
Ok, so now you’ve defined that it was EDKA, not just DKA.
EDKA has a few causes and lack of insulin is not in the list. It can happen to T2s as well and they produce insulin. Below is the link to medical information on EDKA. Below that is a snippet from that information so I can be fully transparent here and note that reduced insulin dosages are the LAST item in the list to trigger an episode. In other words, the least common cause.
https://www.ncbi.nlm.nih.gov/books/NBK554570/
“There are many known causes of EDKA in patients with diabetes. The overall mechanism is based on a general state of starvation, resulting in ketosis while maintaining normoglycemia. Therefore, conditions like anorexia, gastroparesis, fasting, use of a ketogenic diet, and alcohol use disorder can lead to states of carbohydrate starvation and subsequent ketosis. Additional triggers for EDKA include pregnancy, pancreatitis, glycogen storage disorders, surgery, infection, cocaine toxicity, cirrhosis, and insulin pump use.[5][6][7] T1DM who underwent bariatric surgery patients experience DKA in over 20% of postoperative cases and may be especially prone to EDKA.[8]
The newer oral antidiabetic medication category of SGLT2 inhibitors, including canagliflozin, dapagliflozin, empagliflozin, or ertugliflozin, can also directly result in EDKA.[2][3][9][10][11][12][13] EDKA may be more common in patients with diabetes on SGLT2 inhibitors with lower body mass index and decreased glycogen stores.[1] Episodes can be triggered by surgery, infection, trauma, a major illness, reduced food intake, persistent vomiting, gastroparesis, dehydration, and reduced insulin dosages.[14]”
No.
As I said in another comment, I have been in DKA over a dozen separate times. Once was after 12 hours without insulin. Once was EDKA caused by starvation ketosis. Once was after a heart attack. One was from rationing insulin so while I was taking insulin every day, it was insufficient.
So you do not have a full picture of all the different factors that cause DKA.
Do you feel like you’re a “typical” T1 with your different DKA instances? (Yes I know we’re all so different that typical is very relative)
Because my point has never been that these things can’t or don’t happen. My point has been and is that these are not normal everyday occurrences. I personally know nearly 20 T1s of varying ages. Most have been T1 for 10+ years and not a single one of us has ever been diagnosed with DKA. I know of/communicate with many others (people I know their real names and such) and the cases of DKA in that expanded group are rare (not unheard of though).
Bottom line is that no amount of anonymous redditors telling the world how missing one shot/dose will lead all these T1s to near death is anything but INCREDIBLY EXTREME.
NOTE: I didn’t say it can’t / doesn’t happen ever.
It's not incredibly extreme to be asked a specific question about survival without insulin to answer about survival without insulin. These comments weren't issued unprompted.
Yes, it is typical to be in DKA without insulin.
Is it typical to miss so much insulin? For many, yes. For some, no. Rationing kills people yearly.
If you're asking me what my medical team would say if you asked them if I was "typical" the answer would be "yes" because I have issues other type 1s do not, so for me, yes it is typical.
There's multiple people here telling their actual experiences and you're "skeptical" that they happened??
“Told me I was close to death from dehydration”… that is not a lack of insulin problem.
Lack of insulin causes DKA, which causes vomiting, which causes dehydration. The dehydration is a direct result of lack of insulin.
I never said I was skeptical of any individual’s event. I’m skeptical that we’re not getting FULL details.
You don’t puke once and immediately become dehydrated. You puke and puke and puke to become dehydrated from that. If you read up on DKA from reputable sources (real medical sources) you’ll find that while it CAN happen quicker in some outside cases, this is FAR from the norm.
Again, my point here is that the majority of DKA cases do not mysteriously appear because you simply miss one shot. They “normally” happen from longer times of no insulin and higher glucose.
There’s nothing wrong with saying “what happened to you” but maybe people could just admit that many of these sudden/one shot missed cases are fringe events not what happens every day to most people.
It’s kinda like saying walking to the mailbox will cause a broken leg just because it happened to you. It doesn’t negate that it DID happen to you but the vast majority of people do not break their leg walking to the mailbox.
Have you heard of catamenial DKA?
I forgot basal once and I was in DKA less than 12 hours after the missed dose. DKA without medical intervention is a painful death as you vomit until you die of dehydration, maybe 3 days?