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accidental OVERDOSE!!!!!?

Question:
I have been feeling tired for some time and I do have a lot goiing on in my brain right now but with all my double checking I do ....last night I managed to take my novorapid instead of my levemir!!! so that was 22 units of novorapid in one go!!!!...........like almost a whole days worth in one go!!!!!!

i don't understand how it happened...i keep checking things rght in front of me and after the disastrous hypo I had last week.....out of the blue...the worst I've ever had and it scared the living daylights out of me!!!!! ( I couldn't help myself...luckily a very helpful husband did!!) and felt I was on the ball...

so I was testing my blood every 40 minutes through out the night.....I had 4 bottles of lucozade and some biscuits and felt thoroughly sick!!!!

avoided the hypo and stopped taking the sugar when i knew the sugars were rising.

I know the hypo was the main one to avoid....particularly with that much insulin in my system!!!
very very frightening.now at breakfast high high sugars but have had my regular insulin and some correctional..gone for a walk.....and am testing regularly till I know I'm back on track....

I know we were doing all the right things......its just I feel like my brain has lost the plot.....how on earth did I make such a huge mistake, and I could have paid severly for it!!!

frightened.. and just wanted to share it........can't really explain it anywhere else cause it will only cause worry with friends and family.........

did not sleep at all well for last year and now this summer am sleeping like a log.....and could do so any time of the day!!!
feel utterly exhausted at times...had my bloods done and my hba1c has gone from 8.6 to 9. my treatment and care is intensive........not sure what else to do really....oh and I'm quite overweight!!!! I walk or cycle everywhere......no car........what next?! any thoughts
Answers:
<<Hugs>> Megan, I know how scary this type of thing can be. Many years ago, when we used to mix two insulins in the syringe, my then hubby didn't bother putting his glasses on and got the bottles the wrong way round. Fortunately when I went hypo he owned up (and got a thorough telling off!). Doctor advised take Lucozade with each hypo but don't overdo it, as it would stop when the overdose of short-acting wore off.

Even after all these years I sometimes make silly mistakes, usually its because I'm on autopilot and not really concentrating. Once when I was very stressed/depressed I made a note "hypo in sleep?" but failed to act on it. It went on happening for weeks and I ended up in a terrible state, until the consultant spotted what was going on. Could be you're struggling to concentrate properly, despite your best efforts, due to the other things going on in your head.

Also, I presume your thyroid levels are checked routinely? Have you asked for the results? Sometimes if blood results are not too far wrong the medics don't bother to mention it, they just wait to see if it improves next time, but you might be more sensitive to thyroid levels than most.
Answers:
Hi Megan,

What a horrible experience, I hope you're starting to feel better now the anxiety has passed!

Can I recommend you keep your basal and bolus pens seperate in future? Can you keep your Levemir pen in a bathroom cabinate, ideal for a night time dose, and your Novorapid in the kitchen or your bag? Are the pens different colours? That also helps avoid making mistakes. Sorry if that all seems a bit obvious, but those things have helped me avoid goofing up in the past.

Longer term, you need to focus on getting that HbA1c down to a healthier level, aim for the 5's if you can. That may sound daunting right now, but it's do-able if you focus on cutting out the foods that cause your blood sugar to fluctuate in the first place. That will help you reduce your insulin dose and flatten out the peaks and troughs in your blood sugar levels.

Reducing your insulin dose is a vital step in helping you to lose weight as well.

Take care,

fergus
Answers:
I did the exact same thing to my son a while ago. I saw what I had done after I had given him the injection but it was too late. It was lucky he was a bit high that night before dinner so I had a headstart. I then mixed up tablespoons of glucose syrup with fruit puree and then tablespoons of sugar disolved in his bottle to conteract the large dose of Novorapid. I tested him every 1/2 hour and every 10 minutes when he went down to 5. That was as low as he went and ended up having a good night and a normal wake up level. A very close call.

I have since dialed up the wrong dose a few times but because I now always do the Levermir injection first I notice if it a short dose. I also added some stickers of rocket ships to the Novorapid pen.

Like you, I do lots of checks. The time I made a mistake was when all my furniture and belongings arrived after moving house. A big disruption just ruined my thinking and routine. When strange things are going on in the house I am now extra cautious.

We are only human. Jen.
Answers:
Glad you are OK

Strange thing is I did something similiar tonight, BG was running high so took insulin to correct it about an hour before tea. At tea time I not only took my normal amount for some mad reason I took aother big dose to correct the high BG from earlier.

Had tea, then suddenly felt unwell checked BG 3.5, bottle of lucozade, BG 2.7, lucozade tablets, fruit pastels, BG 2.3 this is all within 15 mins. I could feel myself getting lower.

Wife in a mad panic, me trying not to pass out, 4 bottles of lucozade later BG started to rise.

What made it worse for my wife is a few months back and I had a hypo while out walking (not passed out due to hypo for over 7 years and wife of 9 years never seen me have one) Anyway I had not eaten all day but BG was around 6 - 7 which is good for me. I took my evening insulin as normal had a light tea and went for a quick tread, said to her I did not feel well, had a bottle of lucozade and a chocloate bar, passed out !! 4 bags of glucose administered by ambulance and A&E and what ever else they did and sugar level still dropping, managed a touch of hypothermia! coma for 5 hours before BG started to rise. By all accounts I had better days.

The only thing I could think was I got the insulins mixed up, although I still can't explain why it kept dropping for as long as it did. I used to take 30 Glargine and 15 Lispro at the same time. I now keep the glargine and Lispro seperate and never take them together. Just to make sure I don't do it again.

How I make sure I don't do a daft thing like tonight I don't know, maybe I should write it down in a notebook and keep it on the fridge. It scared me a bit and I have to fight the temptation of keeping the BG higher.
Answers:
That must have been very scary to realise your mistake! I'm glad to hear you survived the ordeal. When my daughter was first diagnosed and still in hospital she nearly got overdosed by the nurse who almost gave her 21 units instead of 2 units, all down to misreading the consultant's untidy handwriting. That would have been a huge dose for a 4 year old. If I hadn't been present and questioned her twice about the large dose my daughter might not be with us today. That gave me a big fright and now I won't allow anyone to do her injections apart from myself or my husband. We have a different colour pen for the Novorapid and Levemir but still we double check everything, it's so easy to make that mistake of giving the wrong insulin.
Answers:
Hi Megan

Sorry to hear about your ordeal ¨C a very scary experience but you survived and it will be another story to add to your memoirs in later life!!

Unfortunately or fortunately whichever way you look at it you are not alone.

This has highlighted how dangerous it was for the manufacturers of long acting GM synthetic analogues ¨C namely Levemir & Lantus to make the insulin clear and not cloudy as in the long acting animal insulin & human synthetic insulin¡¯s.

The manufacturers response initially was that it would save diabetics time, as they would not have to shake the cartridge or phial before use! Mmmh but it might just kill off a few more members of the diabetic community through accidental overdose or is that all part of their bigger plan anyway!!!!!

Added to which if a diabetic is using 2 insulin¡¯s from the same manufacturer chances are they could be using same type of pens.

In fairness to Novo-Nordisk who make Novorapid & Levemir there is a choice of pens Novopen Junior, Novopen 3 and Novopen 4 which might reduce error rate except when would having to remember which colour pen contained which insulin!

It's so easy to make that mistake of giving the wrong insulin when both bolus and basal insulin are clear solutions.

Take care

Txx
Answers:
Hi Megan,
Glad you are on the mend,I am grateful you posted what happened to you as I do not feel alone. I did the same thing on Sunday evening I felt such a fool and couldn't believe what I had done as my Novorapid is an orange pen and my Levemir a green one. I have now seperated the two pens I blame myself for having so much going on in my head I sometimes go along on auto pilot. I also stayed up most of the night testing and drinking lucozade to keep the hypos at bay. It was really frightening even the next night when I took my Levemir I still felt aprehensive and although I knew it was the correct green pen checked it over and over again. About a month ago I forgot to take my Levemir and suffered for about a week trying to get myself back in control. I now set my phone alarm to remind me. My levels are still not good quite a few ups and downs but constantly testing so I can give results to diabetic nurses who are monitoring it. I was not going to tell them I had took the wrong insulin but due to reading your post I feel much better in knowing I am not alone.
Wish you well
Senga
Answers:
I think trillions of diabetics must do this. Doesnt help though mind you when you realise the mistake

Short acting only (meant) to last four hours so in theory just battering glucose for four hours should help. I think if it was me I would have had a big gigantic pot of pasta too - shame to waste a good hypo! In all seriousness though, hypos are not funny and its such a HORRIBLE feeling when you take the remedy, test and are still dropping, You cant help but think - should I phone an ambulance now? What if it doesnt come back up etc.

You did the right thing by checkin during the night, though after 4 hours it should have been out of your system, but still, who could sleep after doing that.

Fergus suggestion is good, but maybe use Tippex or Silver pen or something on front of the pouch that says in large letters, NOVO, SHORT ACTING, BOLUS or whatever.
Novo Nordisk pens are the same, and have the same colour pouches. They should write on the side in big letters LEVEMIR or whatever, but they dont, so you might just have to.

L
Answers:
Ha ha. I read this thread on Friday and thought, 'great idea, i'll take my Lantus pen out of my Novorapid pouch and keep it somewhere else so this doesn't happen to me'. And what did I go and do on Saturday? Yes, you guessed it...Shot up 11 units of Novorapid instead of Lantus. How suggestable am I? Luckily, we were about to have dinner so I just about managed. I did go low though but Lucozade worked. I felt so stupid! Such a horrible feeling when you hear the clicks of the pen as you push down and realise what you've done. Eeeek!
Answers:
Blimey megan that's a nasty one, congratulations for being so calm about it, I have to say I would have been considerably less so. Given the circumstances I think that would warrant an ambulance, but you're never going to do that again are you, so no need to worry...?!
Answers:
Hi, I'm panicking slightly as I think I may have accidentally injected double the dosage of my lantus this evening. I'm usually on 12, but I have a new pen and reset it - only then realising that I'd put it up way too high!

What should I do? Lantus is slow release so I'm worried I'll have a hypo in the middle of the night. I live on my own so it's really worrying. Any advice??
Answers:
Hi Becca

Sorry to hear you may have accidentally injected the wrong amount of insulin.

Keep checking your blood glucose (BG) levels frequently i.e start hourly now & if BG's start dropping below 6 mmols then check more frequently - it is highly possibly that BG's will dip - the onset action for Lantus is approximately 2 hours but this can vary in individuals.
You need to check BGs overnight.

Eat some extra carbohydrate food now but avoid fat rich food as it slows the absorption of the carbohydrates.

Have you got some fast acting glucose with you at home i.e. some glucose tablets, lucozade, glucojuice, hypostop etc?

Is there anyone that can come and stay with you tonight?

If you are worried then please go to Accident & Emergency.

Please let us know how you get on.

best wishes

Txx
Answers:
Pheeooo. Thanks for the advice. I checked BG before bed and they were a little low so ate some biscuits and slept after giving a friend a ring so she could check on me in the morning. Quite low in the morning, and generally somewhat lower during today but hypos avoided through just regular eating and keeping an eye on the BGs a little more intensively than usual.

This forum is a total life-saver - honestly, I think it's the best resource for diabetics outside the DN and the Dr's surgery. Thank you!!
Answers:
Hi Becca

Good to hear you're ok and survived the night!!

Just put the episode down to experience and when you write your biography it will be an interesting inclusion!!

best wishes

Txx
Diabetes Mellitus Type
Diabetes Nursing

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