Last night I was exhausted from another busy, crazy day and I was slightly low for a number of reasons. After I laid down with one of my daughters trying to get them to go to sleep, I went to get ready for bed and wondered did I already give my Lantus injection. I knew I hadn't, but I still second guessed myself to the point that I thought I might have. When I am low I get a little spacey. I checked my supplies while eating a half an apple, taking inventory of where I usually put my things after I get ready for bed and I was sure I hadn't. So I gave myself my injection, and thanked God for my CGM and went to sleep. What would you do If you double dosed yourself? Has anyone ever done this? I was pretty freaked out. My Lantus dose is 11 units so I would have had 22 on board. Yikes.
Molly
Sorry this happened, Molly. I assume by now you are seeing what is happening and monitoring your lows. I don't have a CGM but know they aren't always reliable so I would test frequently, up your carb intake and lower your boluses to keep yourself from going hypo throughout the day.
Thanks Zoe, I didn't end up double dosing (whew!), but really wasn't sure for a few minutes. I was kicking myself for not having a better system and for not correcting my oncoming low beforehand. I also have gotten a little lazy just injecting my Lantus before I go to bed, instead of at 9pm. I knew my cgm should catch the lows so I did fall asleep, but it could've been a long night. I'm thinking about switching my Lantus to the morning as sometimes I tend to go low at 3 am, but have been putting that off for awhile as I really don't need one more variable to figure out lately.
M
Glad to hear it. I've come close a couple times to using my Apidra instead of my Levemir, but caught myself. Yep, it's definitely best not to do things like that when you're low. (or to try and figure out what you just did when the mind is on slow motion!). I don't know if it would matter if you took your Lantus at 9PM or bedtime, because the peak, such as it is, happens about five hours in. Some of us found splitting the dose worked better.
By the way I see you're in San Jose. I don't know if you'd be willing to drive to Berkeley once a month, but I started a wonderful Type 1 women's group there that I'm sure you'd love! Let me know if you want the contact info (I moved to the mountains, so I no longer run the group but still have contact).
I think anyone that uses an MDI should be prepared for the most common errors. Double dosing (both basal and bolus) and mistaking basal for bolus (and vice versa). Frankly, a double basal error is minor. It is the dreaded double bolus error and even worse the taking the bolus instead of basal error that are really bad. I take 30 units of basal at night and normally take 5-10 units of bolus. If I take my 30 units of Humalog at night by mistake that is "epic."
I think it always good to have thought through the actions one needs to take under these circumstances. In the case of a double basal, it is pretty straightforward. Lantus has an onset of about 5 hours, so starting about then you will need to monitor your blood sugar every couple of hours (2-3 should be fine) and eat an amount of carbs that is sufficient to offset your extra Lantus. So you injected an extra 11 units which will result in about 0.5 units/hr extra. If your I:C ration is 10, then you would need to eat about 5 gms of carbs/hr. So basically you set the alarm every 2-3 hours, test, eat enough glucose tabs to "correct" plus another tab or two (from the above calculation) and then go back to sleep. Contine monitoring throughout the next 24 hours.
A pain in the but, but actually not very dangerous.
If you mistake you bolus for basal you may need to consume "large" amounts of carbs to compensate and you would be best not to sleep and test every 15 minutes or half hour until you have assurances that it will be ok.
I would love that. Thanks! This communication helps me so much, not just the extra knowledge, but the support and encouragement here are lifesaving. I think I'd be going to see a shrink at this point if I didn't find you all at tuD!
Thanks! This is what I needed to know, especially the units/hr breakdown, no one had ever explained that to me. Appreciate it!
I will look for Extend bars and thanks for making me laugh. I will be sure not to screw up with the HL,
I ran into a simular situtation in that I thought I might have taken my Novolog instead of Levemir. My remedy was to enlist the help of my son. It was his job to keep me awake long enough for the Novolog to clear my system. I experienced no lows so I must have gotten it right.
I guess if it had been a double injection it would have been a long night. Good thing my son is a night owl.
I have been faced with that decision when your standing there with a pen in hand and not be sure that you had not already taken it. My decision was to skip it. That's a hard one to make when you know that if your wrong you will wake up high. I was high the next morning but I feel that was better than staying up all night and testing.
Gary S
This is one of those hypotheticals that scares the crap out of me as a new Dx. I've been told to keep my fast acting insulin at room temp since I'll have it on me at all times and keep my Levemir in the fridge, so that helps out a lot in terms of keeping them separate. Also, being new I'm checking and double checking everything but am just worried that I'll get too comfortable in my routine which is what could trip me up.
It's honestly one of the biggest attractions I have to the idea of the pump where a quick double-check could potentially show me if I had bolused or not.
I chose the CGM over the pump as I wasn’t ready for two sites. I do think the pump has it’s huge advantages of smaller dosing and the ability to suspend your basal while exercising,etc.
Keeping your Lev in the fridge is not a bad idea… Gonna try it 
There is a product available in Europe (not in the US yet, this summer maybe) that may help us out with this. It has a timer on it. Take the cap off it stops timing. Put the cap back on and it starts counting. One look will tell you when you last injected (or at least the last time you took the cap off).
I was just thinking of that, as well - someone had posted about it a little while ago - sounds like a really, really cool, simple device that can help limit some mistakes.
Here's the link to Riva's blog: http://www.tudiabetes.org/profiles/blogs/timesulin. I have taken Apidra instead of Levemir, or lost track of when I last took Levemir. This device should really help.
this is why i LOVE the pump. it has a memory for every bolus. i ALWAYS forgot if i took a shot. which is easy to do when your super busy and you take 5+ shots each day. i find it intersting that you have a CGM. do you also have a pump for rapid insulin? when i accidently double dosed it was with novolog so the "drama" would be over in a few hours. if i couldnt remember if i had taken Levemir (long acting) i would not dose and try to figure out the mystery through my numbers. besides you can sorta make up for the missing long acting insulin with small amounts of rapid acting.
someone needs to invent something that helps busy people keep track of their injections. in the same way a pill box helps the elderly keep track of their medications.
good to know you pulled through:)
"in the same way a pill box helps the elderly keep track of their medications"
This made me smile, jeffri kay, because when I started using a pill organizer a few years back for my meds, my daughter told me that I was officially an old lady. I actually started using it to save time in the mornings not having to search for the right bottles and open them. This way, I dump it in my hand and go.
Of course now that I'm in my 50s, I use not one but two pill organizers - one for morning meds and one for evening... Daughter just rolls her eyes now. :)
I just wrote about this in a different thread recently...
I've taken in excess of 44,000 injections over the course of my time as a diabetic. That's a lot of injections. I've been way overtired at times, certainly groggy in the mornings, even a bit liquored up now and then (well, sure!!), but it was not until last year (on Mother's Day of all days!) that I made the BIG MISTAKE: I shot up my Lantus (I'm a morning Lantus shooter, which is good considering what came next...), and then my Novolog, as I usually do. It was only after injecting my Novo, that I realized I'd just shot up from the same vial twice: I did 30+ units of Novolog! I usually do 4-7 or thereabouts. Oops. Big oops.
The next several hours were a whirlwind, that's for sure. My wife was actually out on a business trip, and my boys were watching some TV on the couch (it was a Sunday after all). I just started eating, then eating again, and when I was done with that, I ate some more. This went on for hours and my sugars just kept plummeting, and I was exhausted by it. I got really, really out there a couple of times, but somehow I kept my wits about me throughout the process. By the end of the day when things had finally settled in, I thought I never wanted to see a carb again. Ever.
/\/\
Even pill boxes can be mixed up. I took the night set in the morning one time. After that I started using two different types of pill boxes to prevent another mix-up.
I bolused twice whithout noticing it. There was no cgm back then . I passed out, and my college roommate called the paramedics. On a pump there is no guessing I can always look back to see when I bolused last. Even on my cgm display there is a little mark showing when I bolused.
Once I took a double dose of Humalog, and fortunately, immediately realized it. I stuffed myself with jellybeans. I live near a hospital, but they charge a huge copay if you're seen at the ER but not admitted. So, I went to the ER and just sat in the waiting room, monitoring myself. I figured if I started trending down really badly, then I'd go up to the desk and tell them I needed an iv. That did not happen and I went home.
Yes, I have glucagon but in two attempts have never been able to inject it - the needle is just too whooping big.