Perfection is not possible especially in the case of diabetes. Sometimes diabetics miss a dose of insulin and sometimes insulin overdose can occur. Handling these situations needs patience and care.

In this Diabetic & Me article you will learn about:

  • What is insulin and how does it work?
  • What to do when you miss an insulin shot?
  • Can you take an insulin overdose?

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. To maintain these blood glucose levels, one must maintain a healthy lifestyle and insulin.

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 market it can be a bit difficult to make sure you take your insulin injection on time and make sure the insulin dose is correct.

Insulin is a hormone produced by the pancreas. When you eat something, insulin gets the sugar from carbohydrates in your food. This way your body gets the energy it needs or stores energy for later. It regulates your blood sugar levels, makes sure it doesn't go too high (hyperglycemia) or too low (hypoglycemia). Without a working pancreas, your body starts using fat to produce energy but also produces 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 adapt. The most common issue people with diabetes face is to miss an insulin dose. 

The major response of the body 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 to 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 cause damage to your organs and cells. When having a long 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 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 you can set an alarm to warn you when it's for your insulin injection. 

A great option is also to use an insulin pump rather than injections, they’re a bit time-consuming. An insulin pump also works with an alarm to make sure to take insulin on time.

You can also try to carry insulin in your backpack at all times. If you’re considering this then you must take a look at the best insulin travel case for diabetics. Believe me, it is the best option to make sure you can carry all types of insulin safely.

What to do if you forget an insulin shot

The remedy of missing a dose of insulin 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 about you have missed your insulin dose. If you accidentally took insulin twice it can cause complications and severe low blood sugar. If you do forget to take your insulin dose, always test your blood sugar level as soon as possible and take the right dosage according to your sugar levels.

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

If you missed your long-acting insulin then try to 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 ketones levels will be disturbed. Ketones are the chemicals that are 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 via ketone sticks. 

If your blood sugar level is above 250 mg/dL after thirty minutes after your meal then you must consider testing more often and adjusting your insulin. Don't forget to check your blood sugar after every two to three hours. Also, check 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 actually 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 you 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 normally do with insulin), or intramuscular or intravenous, which is a lot faster, you probably will die.

How possible death is, really depends on your insulin sensitivity and weight. I, for example, I'm 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 3 whole bags of white sugar of 1kg.

What are the signs of insulin overdose?

Initially, you can feel sick, 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 your liver will release sugar. 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 if you miss an insulin shoot or take 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 it also includes your sleep schedule, meal schedule, and exercises routines. Be aware of your condition and make sure to take insulin when needed.

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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