What Happens When You Take Too Much Insulin

Pale Cold And Clammy Skin:

This is another effect of the hormone adrenaline. This hormone causes the blood vessels of the skin to become narrow. So, less blood flows through your skin. Thus, youll be cold to touch. Youll also look paler than usual due to the low blood flow in the skin.

Another thing youll notice is an increase in sweating. This happens for the same reason. Adrenaline has direct effects on your sweat glands. The increased production of sweat will result in clammy skin.

How Do I Take Insulin

Insulin is normally injected under the skin with a very small needle. It can also be taken with an insulin pen. Your doctor will teach you exactly how to inject insulin, but here are the basics:

Wash your hands.

Treating An Overdose Of Long

If you have given too high a dose of long-acting insulin, this could affect you for up to 24 hours.

How you prevent a hypo will depend on how big the overdose was. If the overdose was large, such as a double dose, take carbohydrate to raise your sugar levels and call your health team or out-of-hours service for advice.

If the overdose was smaller, such as up to 5 units too much, take more carbohydrate than usual and aim to keep your sugar levels higher than normal over the next 24 hours to prevent a hypo occurring.

Test regularly through the day and at any time you think you may feel hypo

Take plenty of carbohydrate before sleeping. It is better to wake up with higher sugar levels than risking a hypo overnight. Dont risk going low. If you cannot be certain that hypos will be avoided, call your health team or out-of-hours service.

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What Is Lantus Used For

The Food and Drug Administration approved Lantus to improve blood sugar control in:

• Adults and children with type 1 diabetes
• Adults with type 2 diabetes

Lantus is not used to treat diabetic ketoacidosis . DKA is a life-threatening complication of diabetes in which the body makes high levels of blood acids called ketones. DKA occurs more commonly in people with type 1 diabetes but can also occur in people with type 2 diabetes.

What Are The Symptoms Of Hypoglycemia

Symptoms of hypoglycemia can start quickly, with people experiencing them in different ways. The signs of hypoglycemia are unpleasant. But they provide good warnings that you should take action before blood sugar drops more. The signs include:

• Shaking or trembling.

• Tingling or numbness in the face or mouth.

During a severe hypoglycemic event, a person may:

• Be unable to eat or drink.
• Have a seizure or convulsions .
• Lose consciousness.
• Slip into a coma or die .

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How Do I Treat An Episode Of Hypoglycemia

The American Diabetes Association recommends the 15-15 rule for an episode of hypoglycemia:

• Eat or drink 15 grams of carbs to raise your blood sugar.
• After 15 minutes, check your blood sugar.
• If its still below 70 mg/dL, have another 15 grams of carbs.
• Repeat until your blood sugar is at least 70 mg/dL.

If you have symptoms of hypoglycemia but cant test your blood sugar, use the 15-15 rule until you feel better.

Note: Children need fewer grams of carbs. Check with your healthcare provider.

Do You Have Insulin Resistance

How do you find out if youre insulin resistant? No one test will tell you, but if you have high blood sugar levels, high triglycerides , high LDL cholesterol, and low HDL cholesterol, your health care provider may determine you have insulin resistance.

Important note: Type 1 diabetes is different its thought to be caused by an autoimmune reaction . People with type 1 diabetes dont make enough insulin and need to take it to survive.

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Cold sweats, trembling hands, intense anxiety, a general sense of confusion — these are signs of low blood sugar. Your doctor may call it hypoglycemia. It often happens when you take too much insulin.

Hypoglycemia happens to many people with diabetes. It can be serious. Thankfully, most insulin problems can be avoided if you follow a few simple rules.

Avoiding Injection Bruises And Lumps

Bruising can happen when you catch a tiny blood vessel under the skin where you have injected. It is quite normal for this to happen occasionally when you are injecting regularly and youre not doing anything wrong.

If you are concerned, you could make an appointment with your diabetes specialist nurse who will be able to do a review of your injection technique. In some cases, bleeding and bruising can be reduced by something as simple as using a different sized needle or changing your needle after each injection.

Some people notice hard lumps that can form if you inject in the same place too often. This might be lipohypertrophy , or could be something called cutaneous amyloidosis. These lumps can stop the insulin from working properly, so make sure you rotate where you inject and choose a different spot each time. If you notice any lumps, especially if they’re not going away, speak to your healthcare professional for more advice.

Other side effects from injecting a lot can be itching, rashes and other skin irritations. Changing where you inject helps with this too. You can also get treatments from your local pharmacy that can will help with the irritation.

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Weight Loss Improves Insulin Sensitivity

Scientists arent sure exactly why the cells become less sensitive to insulin. However, being overweight is a major risk factor. Getting your weight down should be your primary focus if youre overweight or obese. Losing weight will not only increase insulin sensitivity, it will lower your risk for other chronic conditions, like high blood pressure and elevated cholesterol.

You dont need to lose a ton of weight to improve glucose balance. Losing just 5 percent of your body weight, if youre obese, significantly improves insulin sensitivity in fat cells, muscle and the liver, reported a study published in Cell Metabolism in February 2016. Thats just 9 pounds if you weigh 180 pounds.

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Massive Levemir Insulin Overdose: Case Report

Mahmood Ahmad

1St Mary’s Hospital, Imperial College Healthcare Trust, London W2 1NY, UK

2Cardiology Department, Tahir Heart Institute, Rabwah, Jhang 35460, Pakistan

Abstract

A 52-year-old insulin-dependant diabetic man presented to the Emergency Department 2 hours after a deliberate massive overdose of 2100 units of long-acting Levemir insulin and a large quantity of whisky. On initial assessment, his GCS was 3/15 and his capillary blood sugar was 2.6mmol/L. The patient was given a 50ml bolus of 50% dextrose, followed by intravenous infusions of both 5% and 10% dextrose. Despite the continuous infusions, he experienced 4 symptomatic hypoglycaemic episodes in the first 12 hours after admission. These were managed with oral glucose, IM glucagon, and further dextrose boluses. Blood electrolytes and pH were monitored throughout. Insulin overdoses are relatively common and often occur with an excess of other drugs or alcohol which can enhance its action. Overdoses can result in persistent hypoglycaemia, liver enzyme derangement, electrolyte abnormalities, and neurological damage. Overall mortality is 2.7% with prognosis poorest in patients who are admitted with decreased Glasgow Coma scale 12 hours after overdose.

1. Case Presentation

He experienced his last hypoglycaemic episode 41 hours after taking the overdose and dextrose infusions were continued for 62 hours in total. Metformin was restarted 10 hours after stopping the dextrose infusion.

2. Discussion

4. Management

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Causes Of An Accidental Insulin Overdose

In life with diabetes, trying to balance your insulin needs with the variables of food, activity, stress, weight management, etc. is a constant challenge. Just one or two units of insulin more than your body needs can easily lead to even the earliest symptoms of an overdose.

Here are the general causes of an accidental insulin overdose:

• Taking a dose of insulin for your meal twice
• Taking your long-acting insulin twice in one day when you normally take it once
• Taking insulin for a planned meal but forgetting to eat
• Overestimating the amount of insulin needed for a meal
• Overestimating the amount of insulin needed to correct a high blood sugar
• Exercising with too much insulin in your bloodstream / not enough glucose
• Taking your rapid-acting insulin instead of your long-acting, or vice versa
• Prescribed an insulin dose that doesnt fit your bodys needs
• Changes in your insulin sensitivity like losing weight, improved diet, decreased stress, exercising more, etc.
• Taking insulin for a high-carb/high-fat meal that digests too slowly to match the peak of your insulin

What Is An Insulin Reaction

If youre going to use rapid-acting insulin, you need to be aware of insulin reactions and how to treat them. Rapid-acting insulin begins to work very quickly. So while you and your doctor are working to find the right dosage of this insulin, you may have some insulin reactions.

Hypoglycemia is the name for a condition in which the level of sugar in your blood is too low. If you use insulin, your blood sugar level can get too low if you exercise more than usual or if you dont eat enough. It also can get too low if you dont eat on time or if you take too much insulin. Most people who take insulin have insulin reactions at some time. Signs of an insulin reaction and hypoglycemia include the following:

• Feeling very tired.
• Being unable to speak or think clearly.
• Losing muscle coordination.
• Suddenly feeling like youre going to pass out.
• Becoming very pale.

• Candy: 5 Lifesavers.
• Glucose tablets: 3 tablets .

If you dont feel better 15 minutes after having a fast-acting carbohydrate, or if monitoring shows that your blood sugar level is still too low, have another 15 grams of a fast-acting carbohydrate.

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How Does Lantus Work

Lantus is a form of long-acting insulin. So, its effects are similar to that of the hormone insulin.

Your pancreas releases this hormone. There is a cluster of cells in your pancreas called islets of Langerhans. These cells secrete the hormone insulin.

Type 1 diabetes occurs when these cells cant synthesize insulin. Type 2 diabetes occurs when your body is resistant to insulin.

So, what does insulin, aka Lantus, do to the body? Its main functions are given below:

How Can I Prevent Hypoglycemic Episodes

The key to preventing hypoglycemic events is managing diabetes:

• Follow your healthcare providers instructions about food and exercise.
• Track your blood sugar regularly, including before and after meals, before and after exercise and before bed.
• Take all your medications exactly as prescribed.
• When you do have a hypoglycemic event, write it down. Include details such as the time, what you ate recently, whether you exercised, the symptoms and your glucose level.

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What Is Insulin And Why Do I Need It

Insulin is a hormone that controls the level of blood sugar in your body. People with diabetes may not have enough insulin or may not be able to use it properly. The sugar builds up in the blood and overflows into the urine, passing out of your body unused. Over time, high blood sugar levels can cause serious health problems.

All people with type 1 diabetes, and some people with type 2 diabetes, need to take insulin to help control their blood sugar levels. The goal in treating diabetes is to keep the blood sugar level within a normal range.

How To Avoid An Insulin Overdose

There are many steps you can take to avoid an accidental insulin overdose. Most of them revolve around avoiding mistakes when you take your insulin and remembering when you took your insulin and how much you took

• Keep an insulin log. If you log every insulin injection, you are much less likely to mistakenly inject the wrong amount of insulin or inject twice. There are many phone apps that will help you calculate your insulin needs and log your injections. Most insulin pumps and smartpens can also do this automatically.
• Always double-check that you are using the right type of insulin. Accidentally using fast-acting insulin when you were supposed to use long-acting insulin can lead to an insulin overdose.
• Dont forget to eat. If you take fast-acting insulin for a meal, you also need to actually eat the meal. Dont take your insulin until you know the meal is on its way and that you have time to eat it.

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A Low Blood Sugar Level Without Diabetes

A low blood sugar level is uncommon in people who do not have diabetes.

Possible causes include:

• a gastric bypass
• other medical conditions, such as problems with your hormone levels, pancreas, liver, kidneys, adrenal glands or heart
• some medicines, including quinine

See a GP if you think you keep getting symptoms of a low blood sugar level. They can arrange some simple tests to check if your blood sugar level is low and try to find out what’s causing it.

What Are The Different Types Of Insulin

The American Diabetes Association characterizes insulin by how fast it works. But everyones body is different. If you have diabetes, you should expect deviations in the amount of time any medication takes to reach your bloodstream. Here are a few useful terms related to how fast and how long insulin acts in your body:

• Onset is defined as the length of time before insulin hits your bloodstream and begins to lower blood glucose.
• Peak is the time during which insulin is at its maximum effectiveness at lowering your blood glucose levels.
• Duration is the length of time insulin continues to lower your blood glucose levels.

These are the five main types of insulin that doctors prescribe:

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Signs Of Insulin Resistance

Most people think about diabetics when they see the word insulin, but problems with insulin can occur in a number of different conditions, in people with normal blood sugar. You have probably heard of insulin resistance it is a significant health problem because its associated with an increased risk of obesity, heart attacks, polycystic ovarian syndrome, cancer and other serious conditions. People with insulin resistance usually have excessively high levels of this hormone, because it doesnt work properly. We are seeing an increasing number of patients who have been diagnosed with insulin resistance by their own doctor, yet they dont fully understand what this term means.

How would you know if your insulin level is too high?

There is a blood test that can measure your fasting insulin, but it isnt always reliable and many doctors are not willing to order this test. This is a shame because elevated insulin is bad for your health and shortens your lifespan.

Insulin has many important roles in your body. People with too much insulin in their bloodstream are said to have insulin resistance, syndrome X, metabolic syndrome or pre-diabetes. They are all interchangeable terms.

Knowing whether or not you have too high insulin is important because it can allow you to make some changes and avoid some serious health problems in the future. Luckily there are several tell tale signs or clues that your body gives you, alerting you to this problem.

The role of insulin in your body

How Do I Detect Spikes In My Sugar Levels

The exact timing of blood sugar spikes can vary from person to person and meal to meal. However, on average, the post-meal peaks tend to be about one hour and 15 minutes after starting a meal.

The best way to measure post-meal patterns is by using a continuous glucose monitor or Flash monitors. These devices can give you a clear view, including graphs, of what happens with the glucose levels after meals without the need for finger pricking . You can ask your diabetes health team if they are available for you as they are not available to everybody.

If you are not using a CGM, then please speak to your healthcare team about the best way to do this for you with finger prick testing.

How do I know it is a spike?

There is no universal answer or specific guidelines on when a sugar level is too high after meals. However, if post-meal readings are consistently above your target range , then you should discuss whether it would be beneficial for you to address these spikes and how to do this, with your healthcare team .

If you are reviewing your post-breakfast sugar levels, you should also be aware of changes in your hormones in the morning, which cause increases in sugar levels . This Digibete video may help.

Some ways to reduce blood sugar spikes after meals

1. Choose low glycaemic index foods

When blood sugar levels are low or hypoglycaemic we need high glycaemic index foods , such as dextrose tablets or juice, that are absorbed quickly to raise our levels and to treat the hypo.

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