May 9, 2015

Preventing an Insulin Overdose – Part 1

No, this is not just for those of us type 2's and all type 1's that inject insulin, but it certainly applies to us. This also applies the type 2's that take certain oral medications that force the pancreas to produce more insulin and to any person with diabetes that takes oral medications and uses insulin.

Cold sweats, trembling hands, intense anxiety, a general sense of confusion are some of the warning signs. These are signs of low blood glucose (hypoglycemia), and it often happens when you take too much insulin or your pancreas is forced into producing more insulin than the food you consumed required. Hypoglycemia happens to many people with diabetes. And it can sometimes be serious. Thankfully, most episodes related to insulin can be avoided if you follow a few simple rules.

You might have too much insulin in your system and get a drop in your blood glucose for several reasons. It most often happens when you:

Misread the syringes or vials. This is easy to do if you’re unfamiliar with a new product.

Use the wrong type of insulin. Let's say you normally take 30 units of long-acting and 10 units of short-acting insulin. It's easy to get them mixed up.

Take insulin or oral medication, but don't eat. Rapid-acting and short-acting insulin injections should be taken just before or with meals. Blood glucose level rises after meals. Taking rapid-acting or short-acting insulin without eating could lower sugar levels to a potentially dangerous level. Some oral medications force the pancreas to produce insulin that is not needed if you don't eat.

Inject insulin in an arm or leg just before exercise. Physical activity can lower blood glucose levels and also affect how your body absorbs insulin. Inject in an area that isn’t affected by the exercise.

Everyone on insulin needs to talk to the doctor about hypoglycemia. Those on oral medication should talk to the doctor about taking the medication when they are not feeling like eating. The oral medications that can cause hypoglycemia include these classes – Sulfonylureas, DPP-4 Inhibitors, and D-Phenylalanine Derivative are the three classes of oral medications that can cause hypoglycemia.

Low blood glucose can make you feel
  • hungry
  • dizzy
  • nervous
  • shaky
  • sweaty
  • sleepy
  • confused
  • anxious
  • weak

Low blood glucose can also happen while you sleep. You might cry out or have nightmares, sweat a lot, feel tired or confused when you wake up, or have a headache when you wake up. If your blood glucose levels continue to fall, you can have serious complications, like seizures or passing out. Hopefully you will have family or a significant other that can make a 911 call if your have no other remedies available.

Don’t panic. Most insulin overdoses can be treated at home. Follow these steps if you're able to do so:
  • Check your blood glucose.
  • Drink one-half cup of regular soda or sweetened fruit juice, and eat a hard candy or glucose paste, tablets, or gel.
  • If you skipped a meal, eat something now. Something with 15 to 20 grams of carbohydrates should raise your blood glucose.
  • Rest. Get off your feet and take a break.
  • Recheck your blood glucose after 15 or 20 minutes. If it's still low, take another 15 to 20 grams of a quick-acting sugar, and eat something if you can.
  • Pay attention to how you feel for the next few hours. If you still have symptoms, check your glucose again an hour after eating. Keep snacking if your blood glucose is low.
  • If your glucose level stays low after 2 hours, or if your symptoms don’t get better, seek medical help immediately.
Continued on next blog.

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