Insulin Mix-Up

I’m Type 1 and on MDI. I cover my meals with Humalog (one unit per 15g of carb works for me), and inject 28 units of Lantus each night at 9pm.

This past Friday, my reading was 244mg/dl at 9pm. I was comfortable with this, as Lantus tends to lower me gradually in the night. I injected my 28 units as usual and forwent the Humalog. Or so I thought. Approximately 90 minutes later, I began feeling very ill. I grabbed my glucose monitor to test and was horrified when the meter read 27! The only explanation I could come up with was that I had accidentally injected Humalog at 9pm instead of Lantus!

Needless to say, I was terrified. My boyfriend and I remained calm and I hit the juice immediately. My mind was racing with calculations: Okay… so if one unit of insulin works against 15g of carbs, I now need to consume… 420g??? The prospect of having to ingest so much was overwhelming, but I kept at it and thankfully, my levels rose ever so slowly over the course of the night.

I feel sheepish admitting that I have never had appropriate means to deal with an emergency situation like this, but I never in my life imagined that I would make such a serious goof. What is the best approach in this type of situation? Should I have called an ambulance? And goodness gracious, has this ever happened to anyone else? 28 units of Humalog is a BIG chunk to inject all at once.

Oh, and since that night, my sugars have been on the high side. Could this possibly be a defense mechanism of sort? Perhaps my body is in a survival mode of some type and is clinging to its glucose…

What a nightmare! I’m glad that your OK! That is one of my biggest fears, especially when I was using sample insulin pens. They were so much alike that only the tip of the end was a different color. Now I keep my insulin pens in completely different places, just to make sure I don’t do that. My meal insulin stays in my purse no matter what!

I have never done this, but I was terrified of doing this when my 18 month old was first dx’d. He was getting humalog diluted 1:10 and NPH (undiluted), so if I gave the NPH instead of the humalog for a correction in the middle of the night he would have been in serious trouble! Being sleep deprived in general at that time (and now ;)), I was in constant fear of making such a mistake. We ended up marking the diluted insulin with red tape. I think that the different types of insulin should be color-coded to avoid this problem, especially for newbies.

If you go too low your liver will dump glucose, so that probably caused your later highs.

I’m glad that you’re OK.

Ah, thank you for the tip about the liver dumping glucose. I bet you’re right on about that…

I’ve never done that before, but I’m glad you are ok now. My blood sugar was 21 the other day and I blacked out, so I can only imagine how terrified you were seeing your levels that low.

My biggest problem, is that I had a very bad habit of not testing at night at all and if I didn’t test, I couldn’t always remember if I had taken my Lantus the night before. At least, not until I woke up and my levels were in the 300s and 400s.

So obviously - I test every night now and my machine has an area where I can input the amount of insulin I take each time I test, so I make sure I key in the amount of Lantus I take so I never question myself.

What a NIGHTMARE! Glad you are okay.

You may have mixed up the insulins, but you may also have run into a strange phenomenon I have heard about from a few Type 2s who don’t use bolus insulin at all. They report that they have occasionally injected Lantus and had it all hit at once. The mechanism isn’t clear, but it may have to do with injecting into a blood vessel. If Lantus goes into a blood vessel it isn’t delayed in its action but acts just like fast acting.

I’d suggest doing what the oldtimers tell us they were instructed to do: pull back on your syringe before you inject and if you see blood, pull it out and find another spot.

I did not do this yesterday with my R, but noticed blood in my syringe after the shot. Sure enough I ended up at 66 really fast, and I think it was because I hit a vessel.

I also had a period of infrequent testing, but thankfully I outgrew it. My monitor records insulin intake too, but my use of that function is very irregular!

The lowest B.S. reading I ever had was 20, and that was after blacking out while driving. I never had a single symptom until just before passing out. Needless to say, I went off the road and rolled twice down an embankment. I was alone in the car, thank God, because it landed passenger-side down in a bog. My only injury was from the airbag deploying - I looked like I had been punched in the face! I was very lucky…

I am on a pump so my big oops did not come with mixing up my insulins. It came when I took and easy bolus usingthe pumps remote control and then like the fool i was, took the easy bolus by remote again about a half hour later. I think the only thing that saved me is that I realized it about a half hour later, i tested, was normal and I had about 10 units floting around in me. I immediately disconnected and called my husband who drove like a maniac home from a friends and swore that if his phone got disconnected and he couldnt get me back on the line he was calling 911. I drank so much Dr Pepper and chomped on so many glucose tabs and yet every 15 minutes when I tested i was still dropping. I dont think I ever went below 85 but man i was scared. It was a real eye opener. If I hadnt realizedwhay i had done, i dont know what would have happened.
I also felt very sheepish. I swore my husband to secrecy after it happened. I got pretty down on myself and kept saying i was too stupid for this disease. But i got over it and I am a LOT more careful now. I try to use the bolus wizard as much as I can because it will tell me if I still have active insulin in me.

I hate when that happens. Before I had diabetes, my body did this stuff by itself without help from me. Since diagnosis, I have to get involved with the process. I make mistakes sometimes…

A few minutes ago, I started to microwave a Stouffer frozen food. I input the number of carbs named on the box into the microwave timer. Oh well.

oh my goodness how scary. glad you’re ok. I once accidentally took 5 units of lantus with dinner instead of my 5 units of humalog. I had already taken my 13 units of lantus that morning. I freaked out but nothing happened. I was worried that maybe in the middle of the night I’d go low since its the slow acting insulin. I think its really more dangerous if you take too much of the last acting instead of the slow acting.

I did that once, taking Humalog instead of NPH at night. I stayed up for hours testing & eating as needed. I realized it before my BG came crashing down, so it wasn’t too bad.

Another time on my pump I mixed up my BG and my carbs when I entered them to figure my bolus, and bolused for my BG number.

Nasty. I’m glad you got through it okay.

I’ve only come close… I almost injected myself with 25u of Novolog instead of Lantus. Ever since, I’ve refused to use Novolog vials, relying on the pen exclusively, since I know I can’t mix that up…


My doctor didn’t prescribe a glucagon kit. I did get an informational sheet on how to use it though. Do all of you have one?

My son never goes anywhere without it!

If you use insulin pens, the pen for Lantus here in Canada is either bright green or bright blue, plastic, and has a side slider to inject rather than pressing down on the top. This is very different from either the Humalog or NovoRapid insulin pens. The vial of Lantus is also tall and skinny.

Of course, I’m not sure about Levemir. It probably uses the same pens as NovoRapid.

Once when I was younger my mom accidentally gave me 15 units of Humalog (or it might have been Regular back then, not sure) before bed instead of 15 units of NPH. She realized what she’d done immediately after doing it and had me drink a ton of juice boxes, eat ice cream, and have a huge bedtime snack, and I ended up being fine. It’s still scary, though!

Thank you very much for the info on glucagon. I can’t believe you’ve had to use it - more than once! I wonder if this is something my physician can prescribe…

I wonder if Lantus comes in pen form (I’d imagine most insulins do). Using a pen exclusively for either kind of insulin (and a syringe for the other) is a great idea!

A-ha! So you know exactly what I went through… It seems as though a glucagon kit is one of the best ways to deal with such an event.

Wow. And here I was, thinking that this sort of thing never would have happened to me if I was on the pump! It’s a terribly panicky thing, isn’t it?