Sleepovers, time changes, travel, weather, falling asleep before a dose, spontaneous snacks or meals, and other interruptions can cause a missed dose. Unfortunately, as human beings, we can also occasionally forget to remind our kids to take insulin.
So, what happens if insulin is not given on time and what are the symptoms of missed insulin?
Missing an insulin dose can lead to increased blood sugar and ketone levels. Give the next dose as soon as you remember, but if the next dose is due the following day or soon after, skip the missed dose and give the next dose as scheduled.
This article will cover what you should do if your child misses a dose of long-acting insulin and how to spot symptoms of raised blood sugar on time. We will also discuss ways to avoid missing another dose so that you don’t have to panic again!
What Are The Symptoms of Missed Insulin?
Missing insulin doses can increase your child’s blood sugar (hyperglycemia) and ketone levels (ketoacidosis).
Check for the following symptoms if your child has missed a dose:
- Frequent urination
- Increased thirst
- Increased heart rate
- Flushed (reddened) or dry skin
- Not willing to eat (loss of appetite)
- Fruity smell on their breath
- Feeling sleepy, lethargic, or drowsy
- Feeling nauseated
- Vomiting
Risks Of Missing a Long-Acting Insulin Dose
A dose of long-acting insulin takes about 2 hours to start working and should last up to 24 hours. However, some long-lasting insulin, such as detemir, may work for only 18 hours. But with children with diabetes, blood sugar levels can go up and down significantly due to meals and activities.
There’s no need to panic if you miss a dose, but you should be aware of the side effects of missing an insulin dose and that things could worsen.
It’s essential to know what your child may experience as a consequence of missed insulin dose.
1. Diabetic ketoacidosis (DKA)
Missing a mealtime insulin dose poses the most significant risk of developing diabetic ketoacidosis (DKA). Without enough insulin, the body starts metabolizing fat, which results in the accumulation of “ketone” acids in the blood.
DKA symptoms include:
- Nausea, vomiting, or stomach discomfort
- Breathing problems or fruit-scented breath
- Confusion.
2. Hypoglycemia
Hypoglycemia is a dangerous condition that develops when the blood glucose level drops below the target level that the doctor has set. “Too low” for many people with diabetes is defined as a blood glucose level of 70 mg/dL or less.
Hypoglycemia can strike suddenly. Although there aren’t always symptoms, here are some typical ones:
- Hunger
- Rapid or erratic heartbeat
- Sweating
- Shakiness
- Headache
- Distorted vision
- Dizziness
- Weakness
- Pale skin
3. Hyperglycemia
When the level of glucose in the blood increases too much, hyperglycemia occurs. For many people with diabetes, a blood glucose level of 200 mg/dL or higher is considered “too high.”
These are typical signs of hyperglycemia:
- Severe thirst
- Blurred vision
- Frequent urge to urinate
- Headache
- Weakness
What To Do If Your Child Has Missed A Dose Of Long-Acting Insulin?
Now, what to do if you miss a dose of insulin? You must act quickly if your kid misses their insulin dose for whatever reason.
First of all, ensure that your child has actually missed a dose because taking an extra dose can dangerously lower their blood sugar levels. If your child has an insulin kit, check the blood glucose and ketone levels with the test strips before giving insulin.
You might need to give short-acting or rapid-acting insulin to lower the blood glucose levels if they are high when you realize your child missed a dose. Ask your medical team for guidance if you need clarification on the dosage to give.
If your child is at school, check with the school nurse if they can get an insulin shot. However, if your child has recently taken a large meal, don’t hesitate to call your child’s doctor. Without insulin, the blood glucose will increase, so it’s important to ask what to do next.
Remember that your kid can still take long-acting insulin throughout the day, even if they forget to take it in the morning. Ensure the subsequent dose is given 8 to 10 hours after the previous one.
What Not to Do If Your Child Forgets an Insulin Dose?
While it’s important to know what to do if your kid misses an insulin dose, there are some things that you should never do in this situation. Do not panic. Missing a single dose of long-acting insulin is not the worst thing in the world.
The bad news is that instead of preventing high blood sugar, you’re now tackling it.
The next important thing not to do is blame yourself. Feeling guilty and blaming yourself does not make things right—moreover, diabetes is not a sprint; it’s a marathon. Long-term glucose control is what you are trying to achieve.
Don’t give your child double the amount of insulin for the high blood sugar and the carbs they have taken. Instead, consider factors like the carbohydrates already digested, the time passed, or their blood sugar correction factor.
A few other things not to do are:
- Call the whole day a wash and let them have high blood sugar for the rest of the day.
- Put them off to sleep immediately.
- Not give a correction dose at all.
- Not telling your partner or family member about the missed dose.
Avoid Missing an Insulin Dose Again
The near-constant need for attention to detail can occasionally impact the mental health of parents with a child who has insulin-dependent diabetes. While no one is perfect, some tricks, tips, and technology can help both you and your kid remember to take insulin.
Insulin pumps are small devices that automatically administer insulin through a fine tube, maintaining a constant flow throughout the day. Since these pumps are designed to continuously deliver a small amount of insulin to maintain stable blood sugar levels, they only use short-acting and rapid-acting insulin; they do not use long-acting insulin.
Another way to avoid missing an insulin dose is to build a schedule of taking insulin at the same time each day. For instance, make it a part of their morning routine; first brush, wash and take insulin.
Set a reminder on your phone to take a dose. Ask your kid to write down once they have taken insulin so that the dose is not repeated. You can also ask them to let you know once they have taken their insulin so that you are in the loop.
Or better yet, you can use Gluroo.
Gluroo is a diabetes logging app that runs on both iPhone and Android smartphones. It is designed to assist you and your loved ones in managing diabetes, making related decisions, sharing information about it, and generally staying informed.
With Gluroo, you can connect with your child and track their meals, exercise, snacks, and insulin in crazy-fast ways. In addition, the app will work with your child’s insulin pump and monitor and alert you about high and low blood sugar levels.
Not just exercise and food, you can track an opening of a new insulin pen or vial or the location of their pod. In addition, Gluroo helps you and your kid remember insulin schedules so that another dose is never missed. With Gluroo, you and your kid can enjoy life more and worry about diabetes less.
Final Thoughts
Missing an insulin dose may cause your child’s blood sugar and ketone levels to rise. Long-acting insulin is flexible and can usually be taken as soon as you remember. However, if there are any signs of DKA or hyperglycemia, or you don’t know what to do, you must seek urgent medical care.
Missing doses frequently can lower blood glucose control in the long run. Set reminders to help you and your kid remember never to skip an insulin dose.
And remember, apps like Gluroo help you track and log things related to diabetes so that you never miss a dose again!
You can download Gluroo today for free.
