Accidental Overdose

Anyone ever accidently overdose with rapid acting? I am not suicidal- see my blog for the whole story http://www.three2treat.com Oops.
If you have done this what happened? How did you manage the OD?
Cheers!

I use to be on MDI and mistakenly grabbed my Humolog Pen instead of my Ultralente. The pens were the same color and I was chatting with my sister and was distracted. I took 28 units of Humolog then realized my mistake and used a Glucagon kit, went on a sugar binge while testing every 30 mintues for the next 6 hours. Worse part is a few years later I did the same thing with my Novolog and Levemir Pen while again talking to the same sister (the pens weren’t eve the same anymore). I’m now on the pump and always have a Glucagon kit.

I did the same thing 6 months ago. Took 28u of Humalog instead of Lantus just before bed and immediately knew what I did. I drank the largest glass of OJ that I’ve had in 15 years :), took 75% of my long-acting, then I woke up and tested every 2 hours all night. It was a long night…

I think that the accidental dosing of insulin is probably something to be prepared for. I think the most common serioous accidents would be double dosing (heck I’m old, it is easy to forget) and using rapid mistakenly as your basal. One of our members double dosed lantus a few months ago and I related the story of a woman who injected 2700 units and lived. Another man attempted to kill himself with 10,000 units of R and 6,000 units of N and he was not successful and survived without effect. Now granted, these cases were overseen in the hospital, but insulin overdosing is not the immediate death that is often portrayed.



I’ve only been using insulin for about a month, but everything my doctors told me indicated that I would probably die if I made the slightest mistake. It turns out, it is not true. There are actually things that your body does to counteract the biggest mistakes, you actually become insulin resistant to high doses of insulin. That being said, you should know by heart what to do with an insulin overdose. And first, you should not panic.



I don’t mean to criticize what Nancy did, but you should not immediately use a Glucagon kit. That kit can only be used once and is there as an absolute last resort. If you still went hypo and passed out, further attempts to use glucagon would have failed, leaving you vulnerable. Even if you are insulin sensitive, you should work to treat the overdose. Let’s say you injected 28 units of Humalog and had an I:C of 20. That would normally cover 560 grams of carbs. Using insulin suggests that 20% of Humalog is activated each hour, so you need to treat with 100-120 g of carbs every hour. That is 3 12 oz cans of coke/hr. You can do that. And Nancy did the right thing checking every thirty minutes or so. Chances are that you would actually not need all 120g/hour after the peak, and that actually the insulin would have a longer duration that typical, perhaps as long as 10 hours. And obviously, the first thing you do in such a situation is not be alone, even if that involves a call to 911.



But my point is that there appears to be two common serious dosing insulin mistakes, double dosing and mistaking basal and bolus. You should have memorized by heart the required action to deal with both of them. If you have a double dose of rapid, you just double the counted carbs. If you double dose basal, figure out the equivalent carbs/hour and just have a little snack every hour or couple hours. If you mistake basal for your bolus, treat like a double basal dose. And if you mistake bolus for basal, get ready to have a nice 6 hr ride. But with cool and calm, you can ride through this sort of thing without ill effect.



ps. Jeez, that man was Crazy. That is 10 vials of R and 6 vials of N. He must have spent an hour injecting.

oh yes…a few times.

i used to take 1 shot of lantus that was 12 units. 12 units of novolog is a kicker…lol

That sucks, don’t mess with my sleep I say! We all somehow survive though.
Cheers!
www.three2treat.com

I’m pretty sure if that happens you can mix the glucagon solution in the glucagon kit and then extract and inject yourself with a regular syringe- not that huge one that comes with the kit. That’s how they treat kids who bolus and get sick and can’t eat, so i don’t see how the situation is any different. Here’s a link
http://www.childrenwithdiabetes.com/d_0j_20w.htm

http://care.diabetesjournals.org/content/24/4/643.full another link.

Yup! This is very helpful if you ever get sick and can’t keep food/fluids in your system. You can actually mini-dose your Glucagon to keep yourself out of the hospital. I beleive Lorraine had to do this with Caleb recently if I recall.



My support team told me about this when I was first diagnosed a couple of years ago - just to keep a glucagon kit handy in case it was needed for a sick day.

Actually, my endo, who is also a T1 diabetic, is the one who told me to use the Glucagon kit and a secondary dose of Glucagon is used in hospitals if the first one didn’t work. Those kits are a must for diabetics.

Great Research paper, thanks, I will consider this for my house full of type 1’s
Cheers!
www.three2treat.com