Should You Withhold Insulin From a Diabetic?

NO!  Are you nuts?  Are you trying to kill them?

I was looking at the stats for my blog and saw someone searched for “latest research – should you withhold insulin for a diabetic.”  I have seen several similar searches the past month or so and since I was trying to think about something to write about, decided this would be my new topic.  I actually wrote about this happening to me and several other people in Hospitals Are Dangerous Places for Diabetics Part 1 and Part II.  I can assure you, if anyone ever tries to do that to me again, unless I am unconscious, I will be going to different hospital.

I know that I do not have to explain this to anyone that is diabetic, but there are obviously people that “think” it is OK to withhold insulin.  There are basically two insulins.  One is basal insulin – Levemir, Lantus and NPH.  The other is bolus – Apidra, Novolog, Humalog and Regular.  There are also mixed insulins that combine the two.

Basal insulin is your background insulin and you take that regardless of whether you eat or not.  When I do basal testing to make sure my levels are set correctly, I take my Levemir and do not eat – I do my test for 24 hours.  If my levels are set correctly, my blood sugar should stay within 30 points of my starting blood sugar.  Your bolus is taken with your meals and should be based on what you eat.  Bolus insulin is also taken as a correction to get your blood sugar back in range.

For you people doing these searches, do you even understand the difference between Type 1 and Type 2?  Type 1s are generally producing little to no insulin on their own.  What do you think is going to happen if you withhold their insulin?  I had a c-peptide done last year before getting a pump and that came back as <0.1 with a range of 0.9 – 4.3. Guess what that means – I am NOT producing insulin.  What do you think will happen to me if you withhold my insulin?  A Type 2 is producing some insulin but they are not producing enough insulin on their own. They need that insulin also – they are taking it for a reason.

How would you like it if we took your pancreas away from you for 24 hours or more? Think about that the next time you think about taking away someone’s insulin.  I believe in karma and hope that what you do to others happens to you so you learn your lesson.  So, just DON’T DO IT!
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  1. There are only a few reasons to withhold insulin. 1) Desire death of the patient 2) Patient wants to drop weight 3) Patient desires to play mental games with friends and family
    Silly reasons and no one would ever think any one of them is valid. In fact if a patient told their doctor one of those reasons that doctor rightfully would be addressing the mental stability of said patient!!!

    • You are right Kathy! The sad part is, some of these searches are medical people doing it. I have had miy insulin withheld in the hospital – I did not know my rights then but I do now and it will never happen again.

  2. I have read stories of others having issues when admitted to the hospital – and I know you have too. When your system is stressed the last thing you need done is to have your regiment changed more than it has to be. Only makes sense, huh? HA

    • Yup, makes sense to me! Your BS usually goes up when you are sick, so why not add a little more fun to that. Scott Johnson wrote a post about hospitals but I was too lazy to go look for the link – he had some good responses to his.

      • I wonder if most of it is liability issue? Sad if true, hurt the patient so you don’t have legal actions.
        The place that did my MRI last year wanted to screen me every 6 months but the BC specialist felt yearly with his review would be fine. Based upon my conversation with him, it was apparent this was more of a liability issue. At least hoping!…..

      • Hopefully this falls in the right spot – I ran out of replies!

        I know that they worry about lows but you would think they would just cut back your insulin. Part of it probably is liability (a big part!) but I think they are taking it too far. Guess no one would question your dying if you are sick and in the hospital.

  3. Larry Jones says:

    My daughter was on dyallisis and developed an infection the doctors said it went to her heart and fro there her brain and caused a stroke she never regained alertness they waited six days then took everything away except oxygen the thing that bothers me is they also quit insulin all she had for life support was oxygen they then put her on morphene and gave her insulin no more with out the insulin i knew she would die how can this be legal if the insulin may have keep her alive long enough for antibiotics to have a chance to fight.

    • Larry, I am really sorry to hear about your daughter. I am not an attorney, but unless she had a living will or you (or someone else in her family) agreed there would be no life support, I don’t see how that would be legal either. Withholding her insulin would definitely kill her. A type 1 diabetic will die if their insulin is withheld.

  4. well – maybe I am one of the people who looked that up … I wanted to see what info was out there for the general public –

    I was at work yesterday (psych ward) and a patient (type 2 diabetic) had a blood sugar level of 2.3mmols (41.4 in American measurements) at 1700 hrs and the other nurses had given him his Humalog insulin on that. I was taught to get blood sugar up to 4.0 (72 American) before giving insulin and had to take measures to make sure he got his blood sugars up immediately. Who wants their patient to go into a diabetic coma? Not me. Have requested staff education – shouldn’t happen even in a psychiatric hospital.

    • Suzanne, I am glad that you are taking the time to look this up! I agree that it is wrong to give someone Humalog when they are 41. As I explained in the article, there are 2 kinds of insulin, basal and bolus. Humalog is a bolus insulin and is considered fast acting. Basal has nothing to do with what someone’s blood sugar is and we need that insulin as background insulin. Basal insulin doesn’t kick in immediately so giving that to someone when their BS is below 70 is not going to hurt them. If someone withheld my Levemir, the only thing they would do is put me into DKA. As I stated above, when I do basal testing, I do mine for 24 hours – that means I take my Levemir and do not eat anything for 24 hours.

      There is also a difference between Type 1 and Type 2. A Type 1 general produces little to no insulin. A Type 2 produces more insulin, but their bodies are not able to handle it effectively. Some long term Type 2s also lose insulin production over the years. You need a c-peptide test to know how much insulin someone is producing.

      Unfortunatley, most people in hospitals do not understand the difference between basal and bolus and I stand by my remarks. I had my basal withheld twice and I can assure you, unless I am unconscious, that will never happen to me again!

  5. I agree hospitals are dangerous places for diabetics – in fact they are dangerous places for all people due to potential for medication and other human errors as well as picking up infections. I have to agree that people with diabetes usually are experts at their own management. I don’t disagree with you, just wanted to let you know why someone like me might be looking that up. 🙂

    • I have been there with the infection also. I can understand why you are looking it up and I am really glad that you are actually taking the time to figure out between what is right and what is wrong. That obivously says you are a good nurse and we need more like you!

  6. Bruce Peden says:

    Is it a criminal act to withhold basil insulin from a type 1 insulin dependent diabetic?
    The reason I asked is because my 19 yr old son who was on a pump had his pump removed while in a psychotic state. This happened in a mental hospital. I immediately asked what basil insulin they were going to give him. They did not give me an answer. I asked them to check for keytones and give him a basil insulin-for four days. I visited him on the third day and recognized he was going into DKA. They still ignored my concern.
    On the fourth day the hospital called me and said they were sending him to the ER where he was admitted to the ICU in DKA.
    I want to criminally prosecute them for withholding his basil insulin.
    Any info at all is appreciated.

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