HELP!! I mistakenly injected twice my usual dose of Lantus during a moment of distraction. Would love some input: What can I expect over the next 24 or more hours? Any tips/suggestions for what to do, especially overnight?
Sorry to hear that…I guess all I can say is get some regular soda nearby and plan to eat more over the next day. Check often and maybe skip the short acting insulin, if you take it?
Do you think your endo’s office would be helpful if you called them?
I think JohnBen did this once… I wonder if he’s around to help.
Drink alot of water and enjoy eating today. I would not bolus before a meal. Eat and THEN check your bg about an hour after to determine if you need bolus (you may not). Definitely call your endo – it sure cant hurt. But before I was on the pump i made a few stupid mistakes out of tiredness or distraction. Monitoring is the key.
A couple questions: How much Lantus do you take (4 instead of 2 is different than 40 instead of 20). Second is, you take it once a day? I wouldn’t panic, but as others said, test quite frequently to make sure you aren’t low and also lower your bolus amounts a bit as well to compensate for the extra basal. I recommend using Glucose Tabs rather than soda because it raises your blood sugar more rapidly. Do you know how many grams of glucose raise your blood sugar by how many points? Just hang in there, keep testing, and it should be ok.
First off are you positive you gave it twice? I’ve thought that when I was MDI and I also thought I skipped it while I was already at the office. I gave it a lot of thought and mentally retraced my steps that morning. Luckily I did not do either. I agree with Hope. Keep a close eye on it.
i’ve done this a couple times before too. keep close watch on your blood sugars. dont take any naps, stay awake. when i accidently did this i ended up not having to take any fast acting insulin all day and at each meal i had either 3 or 4 carbs. have lots of protein too to help keep your blood sugar from dropping. and dont have anything too sugary because it will spike your blood sugar and then youll drop quickly even without fast acting insulin… before bed tonight have an extra snack. mayb have your blood sugar a bit higher than usual too. be sure to set an alarm or two in the middle of the night. i hope this will help!
What is your usual Lantus dose? What is your usual rapid acting before meal dose? I think the biggest risk will be overnight. I would set your alarm for every hour to two tonight depending on what you notice happens during the day today. You probably won’t need to take much rapid acting today. I would try small frequent meals but would not eat way more than usual especially if you decide to skip your rapid acting insulin. As Donna said monitoring will be the key.
When this has happened to me I have to snack a little extra throughout the day and go to bed with blood sugar a little bit high and set an alarm to test several times in the middle of the night. (I’ve done this like 10 times) Good luck!
Don’t skip short acting insulin, you need it to cover your meals!
Definitely: test a lot more often (if you test 6-7 times per day, test 10-12 times), try not to exercise (it will make you go lower more easily), and eat a bit more than you would (carbs, specially).
Let us know how you are doing throughout the day, if you can please! Perhaps you can post your BG readings here?
For the overnight, you might want to snack extra before bed and maybe wake up every 2 hours or so to test (or every hour, if that would make you feel more comfortable). You may not get a good nights sleep regardless so no harm in waking up a few times to test. That should be the worst of it, unless you are very sensitive to highs. If you’re setting you’re target higher to be safe then it may not be the best day you’ve ever had. I hope it all washes out!
Let me make a suggestion. Rub the area of injection or use a hand massager. Alternate this with the application of a heating pad. This will increase the circulation and accelerate the absorbtion. This may very well shorten the duration of the lantus and avoid overnight problems. Of course, that could be weird walk around all day with a hand massager and heating pad. With a face like mine would I kid you?
Ok, I was thinking about you again. So just so that you don’t panic too much, here is a case report of a woman who took 2700 units of Lantus and survived, although the did make her go through psyciatric evaluation(http://www.ncbi.nlm.nih.gov/pubmed/20493654).
Let me suggest that you plan on feeding your overdose. Since you took an extra 5 units, that is 0.21U/hr. If you work that out with your I:C ratio, for example 30, then you would need to eat 6.3 g/hr of carbs. You could set your alarm for every two hours and have a glucose tab and you should be able to match the extra basal with carbs.
You are going to be fine.
ps. How do you take 2700 units of lantus? A whole vial has 10ml which is 1000 units. 2700 units is like three vials. Jeeez.
I had a fairly large peak on Lantus. It might be worthwhile to pay special attention to the time you would get the effects of a peak; could be that at that time you would go low.
This is a great thought, Trudy. Not sure I would’ve come up with it!
I love reading your input, bsc – I always learn something!
Thanks for the input! I just got off the phone with my dr’s office and I am not convinced the nursing staff knows diddley about Lantus, type 1, or even understand the concept of “insulin sensitive”. Still, I did call them to ask what I should do.
The nurse told me I should continue to take my Humalog as directed, to stay well-hydrated, and to monitor my bgs. If they fall below 60, I should call them immediately. When I asked about changing my I:C ratio to something that would cover more carbs with less insulin (1:30, 1:40, etc), I was told NO, just eat normally and take the prescribed amount of insulin. I asked how I should handle the overnight, and she was pretty dismissive about my concerns for overnight lows. She felt that checking every 2 hours was “excessive” and unnecessary. She also said that drinking lots of water would help keep me from going low. HUH? Has anyone heard this one before, that if you stay well-hydrated, your lows can be moderated?? That makes very little sense to me. It’s as if she were confusing the treatment of a low with a treatment of a high, unless there’s something I’m missing!
Anyhow, I checked my bgs at 1:30 PM EST, and they were 145 after eating a ham sandwich, potato chips, and drinking a sugared soda. NO Humalog. My thinking was the same as yours: I would rather be a bit high before the Lantus kicks in than fighting low after low after low for the rest of the day. I’ve checked them again, and they were up to 235. Not ideal, but I took 1 unit of humalog to correct for that number.
FWIW, My TDD (when I don’t screw up like this) is approximately 15.5 units – 1/3 Lantus, 2/3 Humalog. So, today, if I take the amount of insulin that I should, I will have taken 20.5 units – 10 units Lantus, 10.5 units Humalog.
I’m headed to see Harry Potter and the Deathly Hallows in a few minutes. I’ll keep everyone updated, and THANKS!!!
Manny,
Thanks for the support! I tested before lunch (~12:45 PM EST) and was at 72, but was having low symptoms. As you read above, I had some lunch, no Humalog, tested about 45 minutes later and was at 145. Tested at 2:30, and had hit 235, which, with my 1:100 CF, meant I could take 1 unit to bring it down. I’m headed to the movies, so I will be eating more carbs, and will be watching the bgs carefully, as that should be about the time the Lantus should start to peak. We’ll see how things go over the next few hours!
If that ever happen to me, I would go to the hospital in a heartbeat. Lantus makes me awful lows. very difficult to control even eating pure sugar. But that’s me. I had Lantus before I have the pump and I gave about 30 units before sleep.
I would eat extra carbs and try to stay been 100 and 150. I would treat 80s as lows already. Better to coast a little higher for 24 hours.
BSC had a good suggestion about consuming a small number of carbs each hour.