Insulin, a hormone produced by the pancreas, regulates blood sugar levels by allowing glucose to enter cells for energy. For individuals with diabetes, especially those whose bodies produce little to no insulin, external insulin administration is crucial for survival and blood glucose management. Abruptly stopping insulin can have severe, life-threatening consequences, leading to a rapid and dangerous rise in blood sugar. Understanding these risks is essential for anyone relying on insulin therapy.
The Body’s Immediate Response
When insulin is suddenly withdrawn, the body’s cells are starved of glucose, their primary energy source, because insulin acts as a “key” to unlock these cells. Blood glucose levels rise quickly and significantly, a condition known as hyperglycemia. To find an alternative fuel, the body shifts to burning fat for energy. This process produces acidic byproducts called ketones, which accumulate in the bloodstream.
The body tries to eliminate excess glucose through urine, leading to increased thirst and frequent urination. This fluid loss can rapidly cause dehydration. Individuals may also experience fatigue, unexplained weight loss, and weakness as their cells cannot properly utilize glucose for energy. These immediate physiological changes set the stage for more severe medical emergencies if insulin is not restored.
Life-Threatening Complications
The sustained lack of insulin can quickly lead to life-threatening medical emergencies. One is Diabetic Ketoacidosis (DKA), occurring when excessive ketone buildup makes the blood dangerously acidic. DKA symptoms often appear rapidly, within 24 hours, and include nausea, vomiting, abdominal pain, and a characteristic fruity-smelling breath due to acetone.
Rapid, deep breathing, confusion, and decreased alertness are also common signs. DKA is common and dangerous for individuals with Type 1 diabetes. Without prompt medical intervention, DKA can lead to diabetic coma and death.
Another severe complication is Hyperosmolar Hyperglycemic State (HHS), which typically develops more gradually over days or weeks. HHS is characterized by extremely high blood sugar levels, often exceeding 600 mg/dL, and severe dehydration without significant ketone accumulation. This condition is more common in individuals with Type 2 diabetes and results from the body’s attempt to excrete large amounts of glucose through urine, leading to severe fluid loss. Symptoms include extreme thirst, high fever, confusion, and can progress to seizures and coma. Both DKA and HHS require immediate emergency medical attention, as they can be fatal if left untreated.
Gradual Damage to Organ Systems
Beyond immediate life-threatening events, prolonged periods of uncontrolled high blood sugar due to insulin deprivation cause gradual damage throughout the body. This chronic hyperglycemia harms both large blood vessels (macrovascular complications) and small blood vessels (microvascular complications). Damage to small blood vessels in the eyes can lead to diabetic retinopathy, potentially causing vision loss and even blindness over time. Similarly, the kidneys can be affected, leading to diabetic nephropathy, which may progress to kidney failure and necessitate dialysis or a kidney transplant.
Nerve damage, known as diabetic neuropathy, is another common long-term complication, causing pain, numbness, or loss of sensation, particularly in the extremities. This can increase the risk of undetected injuries and infections. Large blood vessels can also be damaged, significantly increasing the risk of cardiovascular events such as heart attacks and strokes. Additionally, sustained high blood sugar weakens the immune system, making individuals more susceptible to infections and impairing wound healing.
Understanding the Necessity and Seeking Support
For many individuals with diabetes, insulin is a life-sustaining medication, particularly for those whose bodies produce no insulin. Stopping insulin without medical guidance is extremely dangerous. While reasons for considering cessation can vary, including financial concerns, fear of injections, or misunderstandings about its role, these should always be addressed with healthcare professionals.
It is important to never discontinue insulin therapy on your own. If symptoms of DKA or HHS begin to appear after stopping insulin, immediate medical help is essential. Open communication with doctors, diabetes educators, or support groups can provide solutions for challenges with insulin adherence, ensuring proper management and avoiding severe health consequences.