I’m carrying this over from what appears to be the beginning of a debate in my group… I have a gentleman who has… mansplained… that I would be fine without insulin for 14 hours. That I’d “probably need some insulin” at the end of it. I, based on hitting a 300 after an hour and a half of no insulin, think this is not right. I’m just curious if any of you have anything to say… because I’d really like to go blast him but can’t do that until I know I’m not completely wrong. 
General statements like that are silly. Our bodies have different insulin needs, and some people seem to go into DKA faster.
When I was on a pump, I think I’d probably be “fine” without insulin for that long as long as I ate nothing and the trial started with a simple disconnect from a pump (meaning I still had basal on board for a while- I just wasn’t giving any anymore).
I’d likely end up around 700-800 though. Not my definition of fine, but I don’t think I’d be dead.
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If I was running in an ultra race, I could be fine for 14 hours without basal insulin (I would still need small boluses for carb intake). But any other time, after 14 hours of no insulin, I would be to the moon. 
But I assume he wasn’t talking about exercise. So please, blast away! 
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Can we assume it’s clear that this is 14 hours without active insulin from bolus or basal ?
I could agree with them, if they meant 14 hours since an INJECTION, and it was NPH or basal insulin.
If 14 hours without any active insulin, I think you would be alive, not feeling well, but not “fine” from a medical perspective.
When I was on single lente injection/day, there were a few times my morning injection was missed, and not realized for 10-12 hours. (College!!) At that point I was usually feeling very tired, and then realized it had been missed, e.g., overslept, late for class, etc. I probably went 14 hours at least once and did not end up in the ER. But wouldn’t do this intentionally.
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When I think of this question, I think about it from the perspective of a non-diabetic persons body. How would their body be after 14 hours if their pancreas and immune system suddenly stopped producing insulin and opening up cells for sugar processing. I would think that, because they have an elevated rate of sugar in the blood, they would at the very least begin feeling hyperglycemic and begin experiencing all the symptoms that go with that. At the very worst, they could end up DKA depending on the persons metabolism?
And this is why I’m glad I asked before blasting. 
(even though I was ready to run with whatever Eric said… sorry everyone else). 
.
I hear what you’re saying and believe, like everything else diabetes, there’s a multitude of outcomes any ONE of us could experience, depending on the circumstances. I’m glad I asked though because I was only thinking about 14 hours for me, and I don’t think I’d still be standing. I think @T1Allison asked whether all highs are equal, and I felt VERY strongly the answer is no. I get really sick without insulin to the point it hurts. It can be like that at 4 or 5 hours…
Now with all of that being said, I see the IVs around here and people using the force and traveling across country to commit what would be “carbicide” for me, and I understand it’s a different caliber diabetic round these parts. I FEEL like I’d be dead at 14 hours but recognize that either you guys don’t follow the same rules of mortality as I do or that fear corrupts my insight. I’m GUESSING it’s the latter, though I’m still not sure.
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I don’t know about “around here.” I think everyone is their own caliber. At the same time I was taking about 12 units of Regular for breakfast, I knew someone who took 1 unit. For juice and cereal and toast, 1 unit!!! And that was only because 1/2-unit syringes weren’t around yet. When I go low, I get sweaty and shaky and can’t speak louder than a whisper. Someone I once knew, when she went low she’d basically have a grand mal seizure, scream and flail and thrash around and bite her tongue, the whole scary show. If I went 14 hours without any active insulin, I’d feel pretty rotten. Others might already be in emerg. But it’s quite possible someone else wouldn’t be bothered by it. A human freak, but possible.
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For my son, definitely would be in DKA. He’s been without insulin overnight for about 8 hours and his ketones were high at the end.
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Absolutely. I agree, but on…
I’d have to agree with myself as well. 
I do get what you’re saying, and you’re right. It was why I came here originally with the question. The actual scenario next door was that I had a member of the group who posted that her daughter’s pump had stopped working. Medtronic was next-daying one, but it wouldn’t be here until this evening. She was nervous about how to handle the long acting insulin and was asking the group for advice, which I answered with how we can’t really GIVE medical advice (nervous at all times, by the way). Anyway, the gentleman responded to her post that basically it was only 14 hours, and it wasn’t a big deal, and the girl would be fine…
He seems like a very nice guy, but all around that makes me uncomfortable… if for NO other reason than what you have said, which is that we’re all very different. And 14 hours is hardly “nothing”… for some of us.
Agreed. [quote=“Katers87, post:2, topic:4165”]
I’d likely end up around 700-800 though. Not my definition of fine, but I don’t think I’d be dead.
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And that is probably more likely than my “dead on arrival” fear… but a 700-800? Yes, not really “fine”.
Not sure if this helps.
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So he is a cyclist… I guess he does about 60-70 mile workout a couple of times a week. He definitely didn’t qualify anything he said as including exercise, but maybe that’s his basis.
I will add though, although I’m NOT doing workouts like him or you, I really use exercise on a regular basis to control my blood sugar, and I have seen that a very intense workout CAN put a dent in my sugar but nothing that’s going to hold. I would have to be in motion at a steady elevated heart rate for more than 50% of that time, probably evenly dispersed, to be able to contend with no insulin. And I’m not even sure then that it would work.
Almost… I’m fine tuning my points.
Cool. I’ll definitely check it out.
That sounds like me…
There is absolutely no reason any diabetic should be without a basal such as lantus, levemir or tresiba, or an alternate pump for a situation like this.
Absolutely asinine to just hold out and wait for the FedEx guy to show up with your replacement pump.
I hope everyone here has an emergency plan, and has practiced it.
Let me say it again, in the strongest terms possible:
waiting for the delivery of a replacement pump instead of injecting a basal insulin = stupid
I don’t throw around stupid much, but this really is stupid.
If he was saying, “It’s only 14 hours, do your best with the basal insulin pen you have, use the guidelines your endo gave you about Levemir or Lantus, and she will be fine, it’s only 14 hours…” that statement is okay in my book.
But if he was saying, “Just don’t worry about giving her any insulin for 14 hours, and she will be fine…”, then that is idiotic.
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This is a good example of how it changes the meaning of how you posted the original question.
Given access to insulin, no one should ever choose to go 14 hours without it. So in your specific case, the suggested wait for 14 hours would not be appropriate. As Eric said, any pump user has to always have a backup plan.
But if no access, then likely to survive 14 hours or more without it, just not the best choice.
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I’m not sure he was saying not to give insulin. I HOPE he wasn’t saying that in such direct terms, at least. But it was a very non-chalant, no worries, kind of message, and when I responded with something along the lines of “14 hours is pretty serious” I got something to the effect of “14 hours is fine. You’d be fine. You’d need a little insulin” There was also a piece about how children all throughout history have gone to school having forgotten their bolus, eaten, played at recess, and returned… fine.
I’m sure that’s true. I’m sure there have been ones who didn’t return “fine” as well.
Now I feel like I’m gossiping. I don’t want to do that. I really want to provide good information and to have a good discussion. And to make sure people in there are hearing practical things in the group.
You guys are doing a great job attempting to answer ALL of the stuff I’ve presented now. The advice, I THINK, was to give her insulin, but just not to worry. The non-chalant part of the message was that “it was only 14 hours after all”. That was the part I was responding to as moderator… I don’t take 14 hours lightly. Thus began the debate. Actually, there’s yet to be a debate. Just the mansplaining… which I’m not fond of.
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I will start that we have emergency plans and practice them at least once per year. We will not be reliant on technology to keep us alive without having backup plans.
With that said, if I had 14 hours until a new pump arrived, I probably would make due with injections of quick acting every 2-3 hours to keep the bg down, so that when the new pump arrived I didn’t have to take the extra basal insulin into account. If that 14 hours was going to be >24 hours, then I would just inject the basal and be done with it.
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I would object to that, in these circumstances.
I think it may also send wrong message to daughter, on what is ok.
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