If A Person Is Unconscious
If a person loses consciousness because of severe hypoglycaemia, they need to be put into the recovery position and given an injection of the hormone glucagon . The injection will raise their blood glucose level.
The injection should be carried out by a friend or family member who knows what they’re doing, or by a trained healthcare professional.
You should dial 999 to request an ambulance if:
- a glucagon injection kit isn’t available
- there’s nobody available who’s trained to give the injection
- the injection is ineffective after 10 minutes
Never try to put food or drink into the mouth of someone who’s unconscious as they could choke.
If you’re able to give a glucagon injection and the person regains consciousness, they should eat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich.
You should continue to monitor the person for signs of recurring symptoms in case they need to be treated again.
Lets Look At An Example
Lets say that you check your blood sugar before a meal and its 170. Youll need 1 unit to adjust to your target of 120.
If you plan to eat a meal that has 60 grams of carbohydrates, youll need to give yourself 6 units of insulin to adjust for your meal.
This means youll need 7 units total.
If your child needs help learning to calculate their insulin needs, Childrens Healthcare of Atlanta has created a helpful worksheet just for this.
Remember, there are two components to insulin correction:
- your blood sugar levels before your meal
- corrections for the carbohydrates you eat
Combine both of these when considering how much insulin to inject.
Descriptive Analysis And Study Of Prognostic Factors
Over a 6-year period, 25 patients were admitted in our ICU because of intentional insulin poisoning. A past psychiatric history was noted in 20 of the 25 patients and diabetes mellitus in 13 of the 25 patients . The five nondiabetic patients were nurses. Rapid-acting insulin was involved in 14 out of 25 patients, while intermediate-acting or slow-acting insulin was used by 13 out of 25 patients. Two patients self-injected both insulin types. Drug ingestion, mainly benzodiazepines, was also identified in 68% of patients. The interval between insulin self-injection and pre-hospital glucose administration was 2.7 hours. At presentation, Glasgow Coma Scale score was 9 , systolic blood pressure was 120 mmHg, pulse rate was 95 beats/minute and respiratory rate was 20 breaths/minute. The temperature was 36.0°C . At the scene, the capillary glucose concentration was 1.4 mmol/l. Six patients were mechanically ventilated for persistent coma despite correction of hypoglycaemia. On ICU admission, the blood glucose was 5.3 mmol/l, plasma potassium was 3.3 mmol/l, plasma lactate 2.0 mmol/l, and the maximal observed plasma insulin concentration was 197 IU/ml.
Table 1 Comparison of patient clinical parameters according to the outcome
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Cautions With Other Medicines
There are some medicines that may increase the effects of empagliflozin.
This can make you more likely to get side effects.
Tell your doctor if you are taking any of these medicines:
- medicines that make you pee more , like furosemide â these can increase your risk of dehydration and lower your blood pressure
- high blood pressure medicines
- other medicines that can lower your blood pressure â including some antidepressants, nitrates , baclofen , tamsulosin , or co-careldopa or levodopa
- medicines that cause low blood sugar, such as insulin or gliclazide â your doctor may lower your dose of these other medicines to prevent hypos
Factors That Speed Insulin Absorption
Variation in insulin absorption can cause changes in blood glucose levels. Insulin absorption is increased by:
- injecting into an exercised area such as the thighs or arms
- high temperatures due to a hot shower, bath, hot water bottle, spa or sauna
- massaging the area around the injection site
- injecting into muscle this causes the insulin to be absorbed more quickly and could cause blood glucose levels to drop too low.
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How To Prevent Insulin Overdoses
- Take care when calculating meal time insulin. Taking an extra couple of minutes to be sure of your dose will save the time and hassle of an overdose.
- Never be tempted to delay your meal or snack if you have injected.
- Dont inject whilst doing other tasks, such as watching the TV, holding a conversation or performing another task as this raises the chance that you may forget your injection has been done. Concentrate solely on giving the injection
- Be careful of injecting insulin when you are hypo as mistakes are more likely to be made. Ideally, ensure your blood glucose has risen to safe levels and then put in your scheduled insulin dose.
- Ask for help if you have difficulty seeing the numbers or gradations on your insulin pen or syringe. See also our page on diabetes and visual impairment which lists a number of injection aids for people that have visual impairments
Signs And Symptoms Of Low Blood Glucose
Each person’s reaction to low blood glucose is different. Learn your own signs and symptoms of when your blood glucose is low. Taking time to write these symptoms down may help you learn your own symptoms of when your blood glucose is low. From milder, more common indicators to most severe, signs and symptoms of low blood glucose include:
- Color draining from the skin
- Feeling weak or having no energy
- Blurred/impaired vision
- Tingling or numbness in the lips, tongue, or cheeks
- Nightmares or crying out during sleep
The only sure way to know whether you are experiencing low blood glucose is to check your blood glucose levels, if possible. If you are experiencing symptoms and you are unable to check your blood glucose for any reason, treat the hypoglycemia.
A low blood glucose level triggers the release of epinephrine , the fight-or-flight hormone. Epinephrine is what can cause the symptoms of hypoglycemia such as thumping heart, sweating, tingling, and anxiety.
If the blood sugar glucose continues to drop, the brain does not get enough glucose and stops functioning as it should. This can lead to blurred vision, difficulty concentrating, confused thinking, slurred speech, numbness, and drowsiness. If blood glucose stays low for too long, starving the brain of glucose, it may lead to seizures, coma, and very rarely death.
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How Is Hypoglycemia Treated
The treatment of hypoglycemia depends upon its cause. If youre otherwise healthy and you notice occasional hypoglycemia-like symptoms, try eating a diet thats lower in simple sugars and/or try cutting down on your caffeine intake. If this doesnt make the symptoms go away, be sure to talk with your doctor.
Do Count Your Carbs Before Using Mealtime Insulin
The amount of mealtime insulin you need to inject is based on the number of servings of carbohydrates you plan on eating during a meal. Over time, youll get better at figuring out your carb intake. In the meantime, a dietitian can help you come up with a meal plan that works for you.
There are also several smartphone applications and internet-based calculators available to help you figure out your carb intake and your corresponding insulin dosage.
Hypoglycemia can happen when you take the wrong insulin dose, dont eat enough carbs right after taking your insulin, exercise more than usual, or when youre stressed.
You should take the time to learn the signs and symptoms of hypoglycemia, including:
- loss of consciousness
You should also learn how to manage hypoglycemia if it happens to you. For example, you can eat or drink glucose tablets, juice, soda, or hard candies. You should also be extra cautious after vigorous exercise, as it can lower blood sugar for hours after the workout.
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Effects Of Taking Too Much Insulin
Insulin has a variety of effects on your body. However, youll notice that most of these effects are aimed at one thing. And that is decreasing the blood glucose concentration.
So, the main danger of taking Lantus twice is hypoglycemia. Hypoglycemia is a condition where blood glucose levels are lower than normal. This can have harmful effects on your body. That is what you have to watch out for.
You can see the same outcomes if the insulin is taken directly into the vein.
Glucose is one of the primary sources of energy. The maximum of the carbs is broken down into glucose in your small intestines. It is the universal fuel for the cells of your body. So, lower glucose levels can be fatal.
Some of the prominent harmful effects of hypoglycemia are:
How To Avoid Mistakes
Several things can put too much insulin in your system. It most often happens when you:
Misread the syringes or vials: This is easy to do if youâre unfamiliar with a new product.
Use the wrong type of insulin: Let’s say you usually take 30 units of long-acting and 10 units of short-acting insulin. It’s easy to get them mixed up.
Take insulin, but don’t eat: Rapid-acting and short-acting insulin injections should be taken just before or with meals. Your blood sugar rises after meals. Taking rapid-acting or short-acting insulin without eating could lower your sugar to a dangerous level.
Inject insulin in an arm or leg just before exercise . Physical activity can lower your blood sugar levels and change how your body absorbs insulin. Inject in an area that isnât affected by your exercise.
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Causes Of Low Blood Glucose
Low blood glucose is common for people with type 1 diabetes and can occur in people with type 2 diabetes taking insulin or certain medications. The average person with type 1 diabetes may experience up to two episodes of mild low blood glucose each week, and thats only counting episodes with symptoms. If you add in lows without symptoms and the ones that happen overnight, the number would likely be higher.
Treating An Episode Of Hypoglycaemia
The immediate treatment for hypoglycaemia is to have some sugary food or drink to end the attack.
For example, this could be:
- a glass of fruit juice or non-diet soft drink
- between three and five dextrose tablets
- a handful of sweets
At first you should avoid fatty foods and drinks, such as chocolate and milk, because they don’t usually contain as much sugar and the sugar they do contain may be absorbed more slowly.
After having something sugary, you should have a longer-acting carbohydrate food, such as a few biscuits, a cereal bar, a piece of fruit or a sandwich.
It will usually take around 15 minutes to recover from a mild episode of hypoglycaemia. If you have a blood glucose meter, measure your blood sugar again after 15 to 20 minutes. If it’s still too low , you should have some more sugary food or a drink before testing your levels again in another 15 to 20 minutes.
When treating someone else with hypoglycaemia, if the above treatment isn’t effective, you may be able to help them by applying glucose gel to the inside of their cheeks, and gently massaging the outside of their cheeks.
It may take 10 to 15 minutes before they feel better. This shouldn’t be done if the person is drowsy or unconscious because of the risk of choking.
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What Should I Do If I Take Too Much Novolog
Question posted by 19Dianne48 on 19 July 2012
I also take Levimire 70 units. If I pick up the wrong one and take 70 of the Novolog, what may happen and what should I do?
How much novolog do you take? An overdose can drop your blood sugar fast, putting you into insulin shock. This is a reason to call 911. You can try to avert this by eating lots and lots of sugar and protein. I’m just curious, how would you mix them up? Could you explain better? I will try to help you prevent this.
My husband has ALZ. And took it when I went to bathroom
My husband has ALZ and took 32 units of Novalog raither then his 32 units of Lantus. I was in the bathroom. He doesn’t take novalog at bedtime. He is on a sliding scale during the day for that
Insulin Overdose Safety And Suicide
Insulin is a medication. People should keep it out of the reach of children and only use it according to a doctors instructions. If a person takes too much insulin or takes it when they do not need it, it can be fatal.
Occasionally, a person will use insulin in an their life. If a person shows signs of severe depression or suicidal thoughts, they or a loved one should seek medical help or contact the National Suicide Helpline.
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Relationship Of Participant Characteristics And Skills To Glycemic Control
Four patient characteristics were significantly related to A1C . These included education level , race , insurance , and diabetes type . In addition, participants who reported that they sometimes or never administered insulin at correct times and those who reported having little confidence in their ability to determine correct doses had significantly higher A1C levels. There was a trend for those with the poorest diabetes numeracy to have higher A1C levels . BIAS scores were not associated with A1C level.
Two participant characteristics were significantly related to mean blood glucose level. These included education level and race . Participants who reported that they had little confidence in their ability to determine correct insulin doses , who reported less often administering insulin at correct times , and who reported sometimes or never rotating injection sites had higher mean blood glucose levels. BIAS scores were not associated with mean blood glucose levels.
For Moderate To Severe Insulin Overdoses: Blood Sugars Below 50 Mg/dl
There are two things you can and should do if you feel youve taken a significant overdose of insulin or youre suffering from severe hypoglycemia:
Use a glucagon kit
Aglucagon kit can save your life and is prescribed by your doctor. Be sure to keep it in an easy-to-reach location that others in your household or office know about. A glucagon kit works by giving you an injection of glucagon which is a hormone that tells your liver to release stored glucose .
This large dump of glucose from your liver can save your life, or at least prevent seizures in someone who is already unconscious.
or get someone to drive you to the ER immediately
If youve taken a serious overdose of insulin or your blood sugar is crashing and you do not have a glucagon kit, call 911 immediately.
If youre caring for someone else who has taken an overdose of insulin and they are unresponsive and unable to chew or swallow, you absolutely need to call 911. The emergency medics will give dextrose intravenous to hopefully revive the person suffering from a severe insulin overdose.
If you take insulin, you are at risk of experiencing an insulin overdose nearly every day of the week because juggling insulin doses with the many other variables that affect blood sugar levels is a complicated game. The more you observe how much insulin you need with certain meals and with meals that occur right before exercise, the more you can prevent overdosing.
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What Causes Hyperglycemia In People With Diabetes
- The dose of insulin or oral diabetes medication that you are taking is not the most helpful dose for your needs.
- Your body isnt using your natural insulin effectively .
- The amount of carbohydrates you are eating or drinking is not balanced with the amount of insulin your body is able to make or the amount of insulin you inject.
- You are less active than usual.
- Physical stress is affecting you.
- Emotional stress is affecting you.
- You are taking steroids for another condition.
- The dawn phenomenon is affecting you.
Other possible causes
- Pancreatic diseases such as pancreatitis, pancreatic cancer and cystic fibrosis.
- Certain medications .
- Gestational diabetes, which happens in 4% of pregnancies, and is due to decreased insulin sensitivity.
- Surgery or trauma.
Insulin Toxicokinetic/toxicodynamic Relationships In Acute Intoxications
TK/TD relationships allow descriptive and quantitative characterization of the time course of in vivo drug effect in relation to its corresponding drug concentration within an individual . To our knowledge, there is no case of human insulin poisoning with a TK/TD analysis addressing the effects of insulin on glycaemia. We used the glucose infusion rate as a surrogate marker of the severity of hypoglycaemia. In the six patients the maximal glucose infusion rate was associated with a wide range of insulin concentrations, suggesting a saturable toxic mechanism at these high concentrations. Consistent with this, insulin-stimulated glucose flux is a saturable, receptor-mediated process with a nonlinear dose-effect curve . The range of insulin concentrations accompanied by a decrease in glucose infusion rate was highly variable, enhancing the weak prognostic value of circulating insulin concentration. In contrast, the rate of glucose infusion decreased only when plasma insulin concentrations dropped dramatically. Our findings clearly demonstrate that prompt recognition and adequate treatment of the hypoglycaemic events is the key to achieving a successful outcome.
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Use Insulin If You Need It
Depending on the type and severity of your diabetes, you may take insulin to help manage it. After eating excess sugar and experiencing hyperglycemia, you may require insulin to help your blood sugar stabilize. However, this is unique to every individual. The type of insulin, dosage, and time of dosage is different for everyone. You must consult with your doctor or endocrinologist about your specific insulin needs, and follow the recommendation they provide you. If dosed and used correctly, insulin helps to stabilize the blood sugar after eating too much sugar.