This is embarrassing to post, but hope it may help someone else avoid my wee "mishap" (has anyone else ever done this?!?)
For the last week and a half (approx) I have been injecting myself before bed as usual with my once daily basal insulin dose - OR SO I THOUGHT. I have just found out that unknowingly I had loaded my BASAL insulin pen with a vial of fast acting BOLUS insulin.
I was starting to think there was something seriously wrong with me (other than making the said mistake!) as this pattern of overnight lows has continued on for over a week now, including abnormally high blood sugars during the morning through late afternoon, due to having no basal insulin in my system.
I feel blessed to be alive, not taken to hospital, yet incredibly stupid, for both making the mistake of loading a bolus insulin vial into my basal pen and also for being so stuck in routines and daily busyness not to notice this mistake until tonight.
A question that I think needs to be addressed is why is it possible for a BOLUS insulin vial to fit into a BASAL pen? Surely there should be a physical design feature stopping such a mindless/life threatening error such as mine.
Here's hoping to a decent nights sleep tonight with my actual bolus on board again…
Years ago Before pens I used to Carry both Insulins with be in vials.
I used to take the basil @ 3pm since it worked the best being stronger at first and helped control that dinner meal that was the biggest mental of the day. Well, on day I took 15 of the basil @ 3 with no food. Let just say people talking around me sounded like they were from a Charlie. Brown episode (wha, wa wa wa) and it’s then I realized what I did. I didn’t have enough sugar at my desk to cover three meals worth to correct my mistake. So down the stairs to the vending machine for juice and a bunch of other junk.
It is that point I decided to keep the basil in the fridge to be taken before bed and ensure that never happened again. It was the scariest and worst mistake I had ever made.
Since novolog does not need refrigerated after opened and lantis does fine in the fridge it now stays in the fridge. I also started putting one insulin in the vegetable drawer and the other on the door in the butter tray as more separation to prevent anything like that. On a pump threes days as of 2 weeks ago I guess I don’t have to worry about that now.
Glad to hear you caught it before it was to late. You’ll only make that mistake one if your like me.
Glad you are okay—that is definitely VERY lucky!!!
I'm visually impaired, so perhaps I do this when most people don't ... But when I put a vial in the pen, if you touch the back of the vial (the rubber plunger) as you're pushing/sliding it into the end part, the Lantus vial has four little dots on it. The plunger at the end of the Humalog vial has nothing and is smooth. (Or at least this is what it was like when I used them.) So when I was on MDI, I used a combination of touching those ends with my finger every time I loaded up a pen, and also checking the colour. I would often double-check the colour of the vial before doing each shot when I was using the same type of pen for both.
Another strategy that doesn't rely on colour would be to put some sort of tactile marker (like an elastic band) on one pen so that you feel it as you are dialing up or going to take the injection.
I think it's mostly a matter of consciously double-checking each time you do a shot. Whenever we get into a habit of just doing things mindlessly it's easy to make mistakes, whether you're using MDI or a pump or something else.
Or you could switch to NovoRapid for your rapid acting insulin, which is not interchangeable with Lantus pens.
Wow! I'm glad you are okay! Are you able to get the pens that are already loaded? I have those, and I also keep my lantus in the butter drawer. But rest assured, you aren't the only one who has doen this. Back when I had vials, I learned to keep the lantus in the butter drawer and also put red electrical tape around my humalog vials, because the color/size difference just wasn't enough for me to avoid accidental mixups. I only did it twice, and luckily had a nagging feeling that something was wrong. I stayed up and when my blood sugar started plummeting I ate a bunch of crap and took my lantus.
A made a similar mistake 28 years ago, drawing up what I thought was my my bedtime basal from a vial but instead delivered a huge bolus dose. I ended up being transported to the ER in the middle of the night. That's the last time I made that mistake since shortly after that I changed to a pump. It's an easy mistake to make. Our dosing becomes so routine that we go on autopilot when instead we should deliberately focus every time on the matter at hand. It might even be worth getting a separate smaller fridge and locate it in a different room in the house in order to avoid this mistake.
wow, scary mistake, I'm glad you're ok :) I did that too not long ago and came on here- everyone talked me through it. I took 8 units novolog(a large dose for me) instead of levemir. Now I'm super careful and put a rubber band on the levemir too. I don't put vials into the levemir pen so this makes the error that happened to you impossible. I think they just make all the pens and refills the same size and that probably won't change so you have to be super careful and double check each time you inject and refill the pen.
And yes I think you are incredibly lucky that this went on for a few days and nothing super bad happened.
You sound lucky to me! I've yet to make this kinda mistake, but I use a novolog flex pen and a lantus solostar pen where they're drastically different looking. Like the novolog flex pen is navy blue and orange, and the solostar is grey and purple where they're very very different and I feel lucky because I feel like if I used Apidra in a solostar or a levemir flex pen I'd be in trouble. If you can't switch to disposable pens I'd say look into marking them in a way that's obvious without making it hard to put in the pen?
Yes a darwin could have been on the cards, to clarify for about 10 nights I thought I was having my basal shot of lantus, from my basal pen, which was however loaded with a bogus bolus vial of humalog!!
- As mentioned by others my basal/bolus vials are identical in size (just different colour) i.e. fit into both my Autopen 24 and Humapen.
Interestingly on some of the nights I would wake up and have 2-3 dextrose, then proceed to pillage the pantry. Yet on other nights I would just have the dextrose and go back to bed. The worse low that was at the serious end of the scale was a 2.0, I grabbed a whole heap of food and sat on a chair in sweat soaked underwear, to out to it to care that the dog was eating half of my snacks. He is a bullmastiff and looked about the size of a horse that night, I thought it was better he ate the snacks than me. Damn mutt taking advantage of my hypoglycaemia!
I would like to think I won't make the same mistake ever again. But suggestions of getting the disposable lantus pens sound good, although they seem like such a waste of materials etc.
Been there done that. One night after a particularly delicious carb filled meal of lobster risotto and all the accompaniments I was heading home and pulled what I thought was my lantus pen out of my purse - it was dark - and the purse had both lantus and apidra pens in it. I took what I thought was my 12 unit dose of lantus and had a jaw dropping low a few hours later making me wonder wtf ? Maybe I didn't really have as many carbs as I thought.... woke up with a super high blood sugar. It was then dawn broke o'er marble head and I made the connection. The lantus and apidra pens are both "solostar" by sanofi Aventis and are exactly the same shape, size, and texture. Shortly after that I switched to Levemir because the pens are much different. We all make mistakes it's lucky you didn't suffer more than some really bad nights. I now have a pump so no longer use a basal insulin, but I would definitely do something to make each insulin easily distinguishable. But I also agree that the basal vial should not be able to fit in to a bolus pen. But heck as much as they say you can't use them, all the Abbott strips - Freestyle, Freestyle Lite, Insulinx will work in any blood glucose meter by abbott. If it is not supposed to work then it shouldn't work.
I do hope you get some decent sleep with basal on board this time.
