Perfection is not possible, especially with diabetes. Sometimes, people with diabetes miss a dose of insulin, and sometimes, insulin overdose can occur. Handling these situations needs patience and care. Missing a dose of insulin can lead to high blood sugar levels (hyperglycemia), and an overdose of insulin can cause dangerously low blood sugar levels. Immediate action and medical attention are necessary in both scenarios to prevent serious health consequences. 

Key Facts

  • Missing or overdosing on insulin is common and requires careful handling.
  • Insulin regulates blood sugar by enabling glucose absorption, which is crucial for type 1 diabetics to avoid hyperglycemia and diabetic ketoacidosis (DKA).
  • Missing a dose leads to high blood sugar, potential DKA, and attacks on beta cells; monitor blood sugar immediately and take a dose if necessary.
  • Common reasons for missing doses include being in a hurry, confusion, time zone changes, or unexpected events. Use alarms, involve loved ones, or consider an insulin pump to prevent missed doses; always carry insulin.
  • Establish and maintain routines for insulin administration, sleep, meals, and exercise to manage diabetes effectively.

How Does Insulin Work?

Receiving the diagnosis of diabetes in the life of any person is a life-changing moment. Suddenly, life revolves only around your blood sugar levels. One must maintain a healthy lifestyle and insulin to maintain these blood glucose levels.

If you have type 1 diabetes, you're insulin-dependent. Most of the time, you use long-acting insulin and rapid-acting insulin. You must be very careful with your dosages. Although there are different insulin pumps and pens available on the market, it can be a bit difficult to make sure you take your insulin injection on time and that the insulin dose is correct.

Insulin is a hormone produced by the pancreas. When you eat something, insulin gets the sugar from carbohydrates. This way, your body gets the energy it needs or stores energy for later. It regulates your blood sugar levels, making sure they don't go too high (hyperglycemia) or too low (hypoglycemia). Without a working pancreas, your body uses fat to produce energy and keto acids. When these keto acid levels are too high, you can get into diabetic ketoacidosis. 

What Happens If You Miss a Dose of Insulin?

The human body takes time to adapt to changes. And when we talk about the diabetic lifestyle, it's a bit difficult to adjust. The most common issue people with diabetes face is to miss an insulin dose. 

The body's major response to insulin deficiency is its antibody reaction. These antibodies start attacking beta cells, which resist the movement of glucose from the blood to cells.

Insulin is a hormone that helps your body maintain blood glucose levels. So, when your body faces its deficiency, your blood sugar levels start getting higher. High blood sugar is not less dangerous than low blood sugar. It can damage your organs and cells. When having high blood sugar for too long, your body can reach a diabetic ketoacidosis state.

To control your blood sugar levels, you have to consume fewer carbs and take an insulin injection according to your current blood sugar level and acting insulin. In addition to this, your doctor and nutritionist can give you medical advice and help you with your insulin dosage.

1. Possible causes

Any cause is possible, but most of the time, it happens when you're in a hurry, a bit sleepy, or confused, you are traveling through a change of time zone, or some unexpected events or meetings occur.

2. Precautionary measures

Two minds can perform better than one, so always be connected with your loved ones. You can also ask someone to remind you or set an alarm to warn you when your insulin injection is due. 

A great option is also to use an insulin pump rather than injections, which are a bit time-consuming. An insulin pump also works with an alarm to ensure insulin is taken on time.

You can also carry insulin in your backpack at all times. If you're considering this, you must look at the best insulin travel case for diabetics. Believe me, it is the best option to ensure you can carry all types of insulin safely.

What to Do if You Forget an Insulin Shot?

The remedy for missing an insulin dose is simple: measure your blood sugar. If the amount of mg/dL is in the range, don't act. But if your levels are peaking, take your insulin dose instantly. But do it only when you're 100% sure you have missed your insulin dose. If you accidentally take insulin twice, it can cause complications and severe low blood sugar. If you need to remember to take your insulin dose, always test your blood sugar level as soon as possible and take the correct dosage according to your sugar levels.

Don't be overwhelmed or panicked in such a situation; it happens to every person with diabetes. Sometimes, you have the urge to take as much insulin as you can to have a low blood sugar fast. But remember that your insulin has a potential working time between 3 and 5 hours, and some of it, like Lantus, long-acting insulin, works for 24 hours.

If you missed your long-acting insulin, consult your endocrinologist after taking a dose. You may feel a headache, but it's normal. Try to consume more water than your usual routine. Remember, I am not talking about excessive drinking of water; six to eight glasses will be enough.

The worst thing that could happen is that your ketone levels will be disturbed. Ketones are the chemicals responsible for fat burning. The best way to check your ketone levels is to check your blood sugar levels via a 2-way blood glucose meter or ketone sticks. 

If your blood sugar level is above 250 mg/dL thirty minutes after your meal, you must consider testing more often and adjusting your insulin. Remember to check your blood sugar every two to three hours and again after 24 hours.

What happens if u overdose on insulin?

It's important to know that any insulin overdose can have fatal consequences. If you are aware of taking too much insulin, do not wait for any physical or health changes. Immediately contact your doctor. What happens is that when you overdose on insulin, your body starts dropping your blood glucose levels dramatically. 

Insulin overdose comes in many graduations. People with diabetes might accidentally take too much insulin when overcompensating a high blood sugar. Always check the type of insulin and measure your blood glucose regularly.

There are cases where patients have severe issues and type 1 diabetics overdose on 200 units of insulin. If you are a loved one and notice something is wrong with your friend or relative. Please make sure you take action. Insulin overdose is potentially lethal. Unless you get medical attention pretty fast by calling the emergency department immediately. Either within an hour or so or within 5–10 minutes, depending on whether you inject it subcutaneously (as you'd typically do with insulin) or intramuscular or intravenous, which is a lot faster, you probably will die.

How possible death depends on your insulin sensitivity and weight. I, for example, am pretty skinny and have high insulin sensitivity. One unit of insulin corresponds to 12 g of carbohydrates, meaning that 200 units would require around 3000 g of fast-acting carbs. That would mean eating three whole bags of white sugar for 1kg.

What Are the Signs of Insulin Overdose?

Initially, you can feel sic, dizzy, get a headache, and become confused. This specific situation is called hypoglycemia. Even worse, a coma can also occur, and your brain could potentially be affected.

The more insulin you take, the less sugar your liver releases. In women, the majority of cases show an excessive weight gain when having an insulin overdose.


No one is perfect, so don't blame yourself for missing an insulin shot or taking too much insulin. But definitely do not make this a habit, and try to make a to-do list to avoid this unhealthy routine. When I say unhealthy, I also include your sleep schedule, meal schedule, and exercise routines. Be aware of your condition, and take insulin when needed.

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About the Author

Ely Fornoville

Hi, I'm Ely Fornoville, and I am the founder of Diabetic Me. Being a type 1 diabetic since 1996, I developed a passion to help people learn more about diabetes. I write about diabetes and share stories from other diabetics around the world. I currently use a Medtronic Guardian 4 CGM and a MiniMed 780G insulin pump with Humalog insulin.

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