What Happens if You Miss a Dose of Long-Acting Insulin?

Missing a dose of long-acting insulin can lead to elevated blood sugar levels, potentially resulting in hyperglycemia. This can cause symptoms like increased thirst, frequent urination, and fatigue. Repeated missed doses may increase the risk of diabetic ketoacidosis (DKA), a severe condition characterized by high blood sugar, dehydration, and ketone buildup. It can also lead to unpredictable blood sugar swings, long-term complications like neuropathy and retinopathy, and increased insulin resistance, necessitating higher doses in the future. In this content, we will discuss what happens if you miss a dose of long-acting insulin with many more details about long-acting insulin that should know for you!

Understanding Long-Acting Insulin

Before we explore the consequences of missing a dose of long-acting insulin, it’s crucial to comprehend how this type of insulin functions within the body. Long-acting insulin is specifically formulated to mimic the body’s natural insulin release, which occurs continuously in small, background quantities to regulate blood glucose levels, even when you’re not eating. It serves as the foundation of insulin therapy, offering a steady baseline of insulin action that ensures your body can efficiently utilize glucose for energy while keeping blood sugar levels within a healthy range. Several common types of long-acting insulin include:

  1. Lantus (Glargine): This insulin provides a relatively constant level of insulin action for approximately 24 hours.
  2. Levemir (Detemir): Known for its slightly shorter duration of action, Levemir typically lasts between 12 to 24 hours.
  3. Tresiba (Degludec): Tresiba is distinguished by its extended duration of action, with effects lasting up to 42 hours, offering greater flexibility in dosing times.
  4. Basaglar: Similar to Lantus, Basaglar offers a comparable duration of action.
  5. Toujeo: This insulin is characterized by its high concentration of Glargine and provides an extended duration of action compared to Lantus.

What Happens When You Miss a Dose?

Missing a dose of long-acting insulin can significantly disrupt the carefully managed balance of insulin in your body, leading to a cascade of potential consequences that can impact your overall health and well-being. Here’s a more detailed exploration of the potential outcomes:

Blood Sugar Levels Rise

Long-acting insulin plays a pivotal role in maintaining stable blood sugar levels. Missing a dose can result in a gradual increase in blood sugar levels, leading to hyperglycemia. This, in turn, can cause symptoms like increased thirst, frequent urination, fatigue, and blurred vision.

Risk of Diabetic Ketoacidosis (DKA)

Suppose you miss multiple doses of long-acting insulin or neglect to take your rapid-acting insulin. In that case, you may be at risk of developing a severe and potentially life-threatening condition known as diabetic ketoacidosis (DKA). High blood sugar levels, dehydration, and the accumulation of ketones in the blood characterize DKA. Symptoms of DKA can include nausea, vomiting, abdominal pain, fruity breath odour, and confusion.

Unpredictable Blood Sugar Swings

Missing a dose of long-acting insulin can lead to erratic blood sugar fluctuations, making it challenging to predict how your body will respond to factors such as food, exercise, and stress that influence blood glucose levels. This unpredictability can be frustrating and may require frequent monitoring and adjustments to insulin doses.

Long-Term Complications

Consistently missing doses of long-acting insulin can contribute to the development of long-term complications associated with diabetes. These complications may include neuropathy, retinopathy, kidney disease, and cardiovascular issues. Maintaining stable blood sugar levels is vital in preventing these debilitating complications.

Increased Insulin Resistance

Prolonged elevation of blood sugar levels due to missed doses can lead to increased insulin resistance. Insulin resistance means that your body’s cells are less responsive to the effects of insulin, requiring higher insulin doses in the future, making diabetes management more challenging.

Strategies to Manage a Missed Dose

If accidentally missing a dose of long-acting insulin, it is vital to take proactive measures to mitigate the potential negative effects. Here’s a more comprehensive look at the strategies you can consider:

Take the Missed Dose as Soon as You Remember

If you realize you missed a dose of long-acting insulin, it’s advisable to take it as soon as you remember. However, it’s important to note that this may not fully compensate for the missed insulin, so be prepared to adjust your subsequent doses to maintain balance.

Consult Your Healthcare Provider

Contact your healthcare provider or diabetes educator for guidance and expert advice. They can offer personalized recommendations on managing the situation effectively and may suggest specific adjustments to your insulin regimen.

Monitor Your Blood Sugar Levels

Regular monitoring of your blood glucose levels is essential after missing a dose. This helps you assess how your body responds and enables you to make informed decisions regarding insulin doses and other aspects of your diabetes management.

Adjust Your Meal Plan

Modify your meal plan to accommodate temporarily higher blood sugar levels. Focus on consuming foods with a lower glycemic index and consider reducing your carbohydrate intake until your blood sugar stabilizes.

Stay Hydrated

Staying well-hydrated is crucial. Drinking plenty of water can help your body flush out excess glucose and prevent dehydration, especially if your blood sugar is elevated.

Consider Extra Monitoring and Rapid-Acting Insulin

Depending on your circumstances, your healthcare provider may recommend additional monitoring and doses of rapid-acting insulin to help control high blood sugar levels until your long-acting insulin regimen is back on track.

Develop a Plan for Avoiding Future Missed Doses

To reduce the risk of missing doses in the future, it’s imperative to establish a robust routine or employ alarms and reminders to ensure you take your insulin as prescribed. Consider using insulin pens or pumps, which can simplify the administration process and enhance adherence to your treatment plan.

Best Time to Take Long-Acting Insulin

The best time to take long-acting insulin, also known as basal insulin, can vary depending on your individual needs and your healthcare provider’s recommendations. Long-acting insulin is typically taken once a day and provides a steady release of insulin over an extended period to help control blood sugar levels between meals and overnight. Here are some general guidelines, but it’s essential to consult with your healthcare provider for personalized advice:

Evening (Bedtime)

Many people take long-acting insulin at bedtime. This can help stabilize blood sugar levels overnight when your body’s insulin requirements are lower. It may also help reduce the risk of morning hyperglycemia.


Some individuals may take long-acting insulin in the morning, which can provide basal insulin coverage during the day. Your healthcare provider will consider your specific needs and lifestyle when determining the best time.

Split Dosing

In some cases, a split dose of long-acting insulin may be recommended, with one injection in the morning and another in the evening. This approach can help cover insulin needs more evenly throughout the day.

Individualized Timing

Your healthcare provider will consider your blood sugar patterns, mealtime insulin (if applicable), physical activity, and other factors when deciding the best time for you to take long-acting insulin.

Experiment and Monitor

Your healthcare provider may recommend adjusting the timing of your long-acting insulin based on your blood sugar readings. Regular monitoring is essential to determine if your current regimen is working effectively.

Final Words

Effectively managing diabetes is a continuous commitment that necessitates a thorough understanding of various factors and a dedicated approach. Long-acting insulin is pivotal in helping individuals with diabetes maintain stable blood sugar levels. However, missing a dose of long-acting insulin can disrupt the delicate balance of insulin within the body, potentially leading to a range of adverse consequences, including elevated blood sugar levels, an increased risk of diabetic ketoacidosis, unpredictable blood sugar swings, long-term complications, and insulin resistance.

In the event of missing a dose of long-acting insulin, it’s imperative to take swift and informed action by consulting your healthcare provider, adjusting your meal plan, and closely monitoring your blood sugar levels. With the right strategies and proactive communication with your healthcare team, you can effectively mitigate the impact of a missed dose and continue to manage your diabetes optimally. Remember that personalized care and guidance are essential in achieving the best outcomes in your diabetes management journey.

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