18 Responses

  1. Mike Barry
    Mike Barry March 9, 2013 at 4:35 am | | Reply

    Elizabeth Hughes was dx’ed in 1919 and survived until 1922, when she started taking insulin when it became available. 400 calories/ day is less than the diet recommended for inmates in Nazi concentration camps although obviously in those sort of horrible conditions, the availability of food may have been restricted for sinister purposes by those evil people..

  2. Riva
    Riva March 9, 2013 at 4:50 am | | Reply

    I seem to always read about DKA (BS over 300) with the potential for quick death. Yet weren’t we type 1s walking around with blood sugars in the high hundreds or over 1,000 for days, weeks or months before diagnosis? Mine was 750 when I was diagnosed, yet it must have been high for months as I had symptoms for a few months before diagnosed.

    1. Kari
      Kari March 9, 2013 at 6:50 am | | Reply

      But you were likely honeymooning and still had some insulin being produced by your own beta cells. This, as pointed out above, would offset the likelihood of going into DKA right away.

  3. Scott E
    Scott E March 9, 2013 at 6:05 am | | Reply

    I’m not quite sure I agree that insulin production is certain to drop to absolute-zero by year 18. Some recent research by Dr. Faustman suggests that minute amounts of insulin production can last in some patients 30 years after diagnosis. A recent blog post by a Joslin 50-year-medalist (for what blog posts are worth, also suggests that production can continue.

    In my almost-32 years since diagnosis, I’ve never been in DKA and my BG seems to max-out in the 400s, no matter what (not that I’ve really tried to push the limits that far, but I’ve made some counting and bolusing mistakes in my time, none pushed me to the 500s). Unscientific, yes, but I think I’ve got a tiny bit of natural insulin production left. The beta-cell destroyers are half a step behind the beta-cell creators.

    Is this a reason to think I’m immune to DKA? Absolutely not. And I’m scared at the thought of disconnecting my pump for over an hour for that very reason. But PWD’s bodies vary a lot, and this is just another example of YDMV.

  4. riva
    riva March 9, 2013 at 7:21 am | | Reply

    Yes, thanks Kari, my best guess too but wasn’t sure how even if you still have some insulin production, if your blood sugar is that high how you wouldn’t DKA

  5. Vicki Baker
    Vicki Baker March 9, 2013 at 8:55 am | | Reply

    When the blood sugar is very high it knocks out the ability of beta cells to produce insulin. There’s why T2DMs also come down with DKA. Also why there is thinking for T2DM to get BG down and keep them down to perserve the functioning of the beta cells.

  6. Denise
    Denise March 9, 2013 at 9:24 am | | Reply

    So does that mean, given your type of insulin and what you’ve had to drink or eat, you’d be sick in less than a day, in a coma by 2 days at the most, and could linger for up to a couple of weeks? I mean does being in DKA mean you are in a coma? How long in DKA before you are unconcious or incapacitated?

  7. Terry Keelan
    Terry Keelan March 9, 2013 at 9:57 am | | Reply

    Both informative and scary. At least I’ll have an answer when this question comes up again. I thought I’d have months, assuming I ate carefully and kept as active as possible.

  8. Steve
    Steve March 10, 2013 at 1:30 pm | | Reply

    I would not try to see how long you could last.

  9. Puddin
    Puddin March 11, 2013 at 10:38 am | | Reply

    This is why I have given my spouse permission to eat me when I during in case of a zombie (or any other sort) apocalypse. He will survive with the skills, health and fortitude he has. Me – not so much; I’d be DKA DOA.

  10. Ginger Vieira
    Ginger Vieira March 11, 2013 at 2:20 pm | | Reply

    This is fascinating, Will! I have always wondered this and people often ask me, and my guess has been a few days….but boy, either way, those are going to be a very rough few days! Yuck!

    Thanks for digging into this and sharing it with humor!

    (Cinnamon whiskey, sounds good!) ;)

  11. Stacey
    Stacey March 11, 2013 at 5:48 pm | | Reply

    Interesting…. With all the talk about apocalypse, (zombie, 2012, etc.) I told my son to just leave me as I wouldn’t last long anyway after my supply of insulin dried up. Of course he was horrified but understood. Of course I wasn’t 100% sure how long I would last, but why should food be wasted on me if I was going to die for sure anyway.
    Just something of the strange things that go through my mind…

  12. mike C
    mike C March 11, 2013 at 6:26 pm | | Reply

    With the physiological change that occurs to the system when one contracts the Z-virus, how would that affect the timing of the onset of DKA and the expected lifespan of said Z-PWD.

  13. Tiffany
    Tiffany March 12, 2013 at 1:56 am | | Reply

    This is a great article – not only because it goes out to answer the question none of us want to ask – but because it has introduced me to cinnamon whiskey! Thank you Wil!

  14. Sooz
    Sooz March 12, 2013 at 9:51 am | | Reply

    Two weeks is the time quoted by those who work with developing countries where insulin is unaffordable for many, and where donations of insulin and diabetes supplies go. And they are horrible weeks, especially in remote parts where there is barely any medical care and little diabetes education. Of course, cheap carb loads are often higher in those places, but once in advanced DKA, you’re often too sick to be eating much anyway. There is data around to substantiate.

  15. Kathy
    Kathy March 13, 2013 at 9:47 am | | Reply

    There’s a book called “One Second After” I read a couple years ago about what happens after an electromagnetic pulse attack. The main character’s daughter is a type 1 and survives but eventually her insulin goes bad – took months in the book. I was always told when I was dx’d that I was in DKA for 2 weeks. So I guess it was close…

  16. Gary Wald
    Gary Wald March 19, 2013 at 6:17 pm | | Reply

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  17. Type 1/Type 2 Conversations:  Diabetes in the Great Outdoors | Test Guess and Go

    [...] asks how long a person with Type 1 can survive without insulin.  Will Dubois at Diabetes Mine has a good post on the subject and concludes with the answer of a few days to 1 or 2 weeks.  How quickly would I feel so sick [...]

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