How To Handle An Insulin Overdose
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. 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 you’re 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 isn’t affected by your exercise. Symptoms of an Insulin Overdose If you have low blood sugar because of an insulin overdose, you may have: Anxiety Confusion Extreme hunger Fatigue Irritability Sweating or clammy skin Trembling hands If your blood sugar levels continue to fall, you could have seizures or pass out. What to Do If You Have an Insulin Overdose Don’t panic. Most insulin overdoses can be treated at home. Follow these steps if you’re able: Check your blood sugar. You’ll need to know where you’re starting from. *CGM-based treatment requires fingersticks for calibration, if patient is taking acetaminophen, or if symptoms/expectation Continue reading >>
Regulating & Monitoring A Diabetic Cat Using Insulin
Not all cats with diabetes will need to be treated with insulin (some cats with mild diabetes may respond to and dietary change), but a majority of them will. The goal of treatment is to resolve the signs of the disease, maintain proper body weight, eliminate or reduce the likelihood of any complications, and provide the cat with a good quality of life. This can be accomplished by maintaining the blood glucose at an acceptable level (100-290 mg/dL; normal is 55-160 mg/dL). In addition to treating the diabetes, any other concurrent diseases such as pancreatic exocrine insufficiency, hyperthyroidism, Cushing's disease, and infections need to be treated as well. What should an owner know before trying to 'regulate' a cat with diabetes? Before treatment is started, it is important that the owner be well-informed and have the time necessary to make the correct decision since regulating a diabetic cat requires commitment. Owners should know: The cat will need to be hospitalized for a number of days and one or more blood glucose profiles (described below) will need to be performed. The initial regulation of a cat on insulin generally takes 2-8 weeks. The process of getting a cat regulated can be costly. Insulin must usually be given twice a day, every day at specific times, probably for the life of the cat. Insulin must be handled properly (refrigerated, not shaken, etc). There is a proper technique for administering insulin to a cat that must be followed. The type of insulin and insulin syringe that are used should not be changed unless under guidance by the veterinarian. The type and amount of food and when it is fed must be consistent. In most cases, foods high in protein and low in carbohydrates are recommended. These are usually canned foods. The cat will need to be caref Continue reading >>
Death By Insulin: How Sweet It Isn't!!
Case Study S. P. was a nurse who had a long history of depression. She had stopped her medication several months ago since her life had stabilized. However, with the discovery of her husband having an affair, a setback at work, and the terminal illness of her mother, she soon began to have feelings of unworthiness and hopelessness. She was working for a home health agency and was involved in the care of an elderly woman who had a heart condition brought on by her long history of insulin dependent diabetes. Her patient had just received her three month supply of quick-acting insulin. S.P. decided to take one of the bottles and in the privacy of her home she injected herself with the entire contents. Within several minutes she began to feel hungry, nervous, sweaty, shaky, and very weak. This rapidly progressed to her feeling dizzy, disoriented and confused, ultimately resulting in drowsiness, unconsciousness, coma, and finally death. Why did she die? Cause of Death? If your answer to this question is that S.P died from an overdose of insulin, I suppose you are right. After all that’s what I would put on the death certificate. But what I’m really looking for here is the mechanism underlying the cause of death. Only by understanding the pathophysiology of disease, dysfunction, and death, can one begin to appreciate the complexity of life and how easy it is for us to die and fall off the radar screen for the survival of the fittest. The strength of a chain is only as good as its weakest link. In the case here of S.P, most people who are familiar with diabetes and insulin realize that since insulin is a hormone that is needed to keep the blood sugar (glucose) from going too high, then taking too much of it can cause a person’s blood sugar to drop too low. That’s exact Continue reading >>
Insulin Overdose Among Patients With Diabetes: A Readily Available Means Of Suicide
Go to: CASE VIGNETTE Ms A, an 18-year-old woman with insulin-dependent diabetes, was found by her brother while having a generalized tonic-clonic seizure (the direct result of an intentional insulin overdose). He called emergency rescue services, who determined that her fingerstick glucose level was 25 mg/dL and brought her to the emergency department. Her glucose level was stabilized in the emergency department, and she was transferred to the medical service for further observation before transfer to an inpatient psychiatric unit. Although Ms A had not received any psychiatric treatment before this event, she reported infrequent panic attacks and moderate social anxiety, and she used cannabis and clonazepam daily. Ms A had attempted suicide twice in the past several months; both of these attempts involved overdoses of insulin, and neither resulted in her receiving medical attention. For several years, she had been poorly adherent with her insulin regimen (and her hemoglobin A1c level in the past year was 9.2%–10.4%). Ms A, who lived at home with her mother, father, and brother, was failing several classes in her senior year of high school, and she had recently quit the soccer team. Continue reading >>
- Type 2 diabetes breakthrough: Scientists create first pill that not only STOPS the condition in its tracks but also helps patients lose weight - and it could be available on the NHS within 3 years
- Health Insurance Plan for Diabetes Patients: Check out 3 of the best insurance policies available inIndia
- Theresa May's diabetes patch not available to all patients | Daily Mail Online
Insulin
Link to 2.1.7.1.1 Insulin Teaching Resources Link to Problems for Discussion DRUGS INCLUDED Insulin Aspart Protamine, Recombinant/Insulin Aspart, Recombinant Insulin Aspart, Recombinant Insulin Degludec1 Insulin Degludec/Insulin Aspart, Recombinant Insulin Detemir Insulin Glargine, Recombinant Insulin Glulisine Insulin Human Isophane (NPH) Insulin Human Isophane (NPH)/Insulin Human Regular Insulin Human Regular2 Insulin Lispro Protamine, Recombinant/Insulin Lispro, Recombinant Insulin Lispro, Recombinant 1Also available in a 200 Unit/mL concentration (rather than the usual 100 U/mL) 2Also available in a 500 Unit/mL concentration (rather than the usual 100 U/mL) OVERVIEW As expected, the toxicity of insulin in overdose is primarily due to hypoglycaemia, although hypokalaemia may also cause problems. The duration of the hypoglycaemic effect depends on the type of insulin injected (duration of action), the amount and age, diabetes (insulin resistance) and other factors that may increase or decrease the patient`s sensitivity to insulin. Mortality in attempted suicidal overdose with insulin is 25%. Death has occurred after as little as 20 units but doses of 400 to 900 units or more are more common in fatal cases. Irreversible neurological injury occurs when glycogen stores are depleted since the brain is totally dependent on glucose metabolism. It is the duration of hypoglycaemia in the presence of signs or symptoms of neurological compromise that determines post hypoglycaemic encephalopathy, rather than the quantity of insulin injected. The period from injection of an overdose of insulin to irreversible brain damage is frequently about 7 hours (about the time glycogen stores are completely). Treatment is with 50% glucose IV, food (and lots of it) and close observation. MECH Continue reading >>
Ask D'mine: A Killing Dose Of Insulin
Hey, All: if you've got questions about life with diabetes, then you've come to the right place! That would be our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and clinical specialist Wil Dubois. Today, Wil tackles a very serious question that we hope is just one of genuine curiosity. It's about suicide, a sensitive topic to be approached with the utmost caution. Read on to see how Wil responds... {Got your own questions? Email us at [email protected]} Anonymous, type 1 from California, asks: How much insulin would you need to take to kill yourself? [email protected] D’Mine answers: First off, don’t kill yourself. Second off, if you are determined to do it, don’t use insulin. It’s slow and unreliable, with a distinct risk that the attempt will leave you permanently damaged, rather than dead. More on that in a bit. But first, let’s start the day by talking about the different ways to end your day. The Wikipedia entry on suicide methods lists the following ways to usher yourself out of this world: Bleeding, drowning, suffocation, hypothermia, electrocution, jumping from height, using a firearm, hanging, ligature compression, vehicular impact from trains or cars, taking poison, not treating a disease, immolation (including throwing oneself into a volcano), starvation, dehydration, and suicide attack—sometimes called Suicide by Cop. The entry even includes a discussion on the use of homemade guillotines as a way of suicide. But no mention of insulin. That’s odd. Or maybe not, because, as I mentioned, insulin is a crappy tool to try to use to kill yourself. Not surprisingly, studies of insulin suicides are somewhat scarce, but one looked at 160 insulin suicide attempts and found that 94.7% of the PWDs fully recovered, 2.7% Continue reading >>
Nurse Speaks Of Horror After Fatal Insulin Overdose
A NURSE who injected a diabetic patient with ten times too much insulin has spoken of her horror as she realised her fatal mistake. Community nurse, Joanne Evans had visited 85-year-old Margaret Thomas at her home in Pontnewynydd, Pontypool, on Saturday June 2, 2007 to give the pensioner, who was registered blind, her insulin. Two insulin pens jammed and a third was broken.Mrs Evans thought she had an insulin syringe in the car, but she discovered it was a regular syringe which is marked in millilitres instead of insulin units. Mrs Evans converted the amount wrongly in her mind and injected Mrs Thomas four times with the syringe with 3.6ml (approximately 360 units) instead of 36 units. Mrs Thomas died six hours later when she collapsed on her doorstep. Mrs Evans told the Nursing and Midwifery council panel at a disciplinary hearing in Cardiff yesterday, that she had only realised her mistake later that night. She said: “When I was in bed I was going through what had happened in the day. I was going ‘no I couldn’t of done that.’ I have never done that amount of insulin in my life. But I could not believe that I did it. I was thinking and getting more and more irate. I was going round and round the house thinking ‘oh my God, I think I have done this’. “I had nobody to tell because I thought that everybody switched off their mobile phones in the night. I thought ‘look at the time, the patient is dead, oh my God, she’s gone. I cannot ring an ambulance because she’s already gone’. “I can remember thinking my family were so proud of me being a nurse. It’s just horrific. I thought everybody would think I was just evil. If this was my mother I could not forgive myself. “We were short of staff, I was tied, but there was just no excuse.” The panel al Continue reading >>
I Stopped A Nurse Giving My Son Lethal Insulin Dose
When diabetic schoolboy Tony Larner was given insulin in hospital only his mother's protective instinct prevented what could have been a fatal mistake. As a nurse prepared to inject her son, Gillian Larner spotted that the syringe contained ten times the proper dose. Mrs Larner questioned the nurse who said she was giving 11-year-old Tony seven units of the drug. The mother of two said yesterday: 'I told her there was actually 70 units in the syringe. I was shocked she couldn't read the difference between one unit and ten units.' The nurse then reduced the amount of insulin but Mrs Larner says she noticed potentially dangerous air bubbles in the liquid. Mrs Larner, who injects her son with insulin twice a day, said: 'I just said to the nurses, "Get me the insulin and a new syringe and I will do it myself" and I did.' Tony's parents are considering legal action over the incident at Birmingham Children's Hospital. Tony's father Arthur, 54, of King's Norton, Birmingham, said: 'I feel all churned up inside. They nearly gave my son a massive overdose and killed him. We almost lost him.' Tony was in hospital after having a throat cyst removed. But Mrs Larner said she was now too scared to take him back for treatment. A spokesman for the hospital's management trust said an investigation into the incident had been commissioned. He said: 'Although the incorrect dose of insulin was not administered, the Trust is taking this very seriously and would like to assure the family that the investigation will be treated as a matter of urgency.' Dr Roger Gadsby, diabetes expert at Warwick University, said it was possible to reverse the lethal effects of an insulin overdose if treated in time. He said: 'Overdoses of insulin lower the blood sugar and cause hypoglycaemia, which can produce a Continue reading >>
2 Businessmen Kill Selves With Insulin Overdose
PUNE: Two diabetic patients from city killed themselves with an overdose of insulin at a hotel in Chiplun in Ratnagiri district late on Friday night. The suicide note left behind states that they could not cope with the severe financial loss and that no one should be held responsible for their death. The deceased were identified as Mahesh Vijay Kulkarni (42) from Patwardhan Baugh area in Erandawane and Milind Panditrao Pujari (44), who stayed near Deenanath Mangeshkar hospital, also in Erandawane Kulkarni and Pujari together were running a business in commodities for over two decades. They had left for Chiplun, around 230 km from here, on Thursday and checked in a hotel around 8pm. Sachin Ingole, assistant inspector of the Chiplun police station, told TOI over phone that around 12.20 am on Friday, one of the victims sought medical help from the hotel's receptionist. The hotel staff rushed to the room and repeatedly rang the door bell, but no one responded. The staff later managed to open the door with the help of a spare key. They were shocked to see both of them lying unconscious on their respective beds. The hotel manager immediately alerted the police and the duo was rushed to a nearby private hospital. The doctors declared Pujari dead on arrival at the hospital, while Kulkarni, who was in an unconscious state, was immediately taken to another hospital. He died while undergoing treatment at the hospital around 6am on Saturday. Four insulin syringes of 3 ml each and the suicide note were recovered from the room. Ingole said the note was written and signed by the deceased in Marathi said that they had committed suicide because they had suffered a severe financial loss in the commodity business. It further read that no one should be held responsible for their death. "Pr Continue reading >>
Insulin Poisoning With Suicidal Intent
Go to: A 27-year-old paramedical personnel without any comorbidities, working as an assistant in the operation theater, was found to be drowsy and drenched in sweat with bradycardia (34 beats/min) and hypotension (80/50 mm of Hg). She was immediately shifted to ICU. She was pale and there was no cyanosis, icterus, clubbing, lymphadenopathy, or any evidence of external injury. Temperature was 99.0°F, with a respiratory rate of 20/min and cold peripheries. Pupils were bilateral 3 mm, reactive to light, and oculocephalic reflex was preserved. Deep tendon reflexes were brisk and plantars were flexor. Meningeal signs were absent. Her systemic examination was unremarkable. An electrocardiogram showed sinus bradycardia. Atropine was given intravenously and normal saline infusion started. Blood pressure remained low which prompted initiation of norepinephrine drip. Capillary blood glucose (CBG) was 35 mg/dL, hence 50 mL of 50% dextrose bolus was given and 5% dextrose infusion started. Her neurological status started deteriorating and she rapidly lapsed into coma, 90 minutes from her initial presentation. At this stage, pupils were bilateral 2 mm and nonreactive, with loss of occulocephalic reflex and dysconjugate deviation of eye. She continued to have bradycardia and hypotension. Repeat CBG was 32 mg/dL and bolus of 50 mL 50% dextrose was repeated. No history could be gathered regarding the preceding events. At this stage, in addition to malaria, encephalitis, cerebrovascular accident, exogenous insulin administration was considered as another staff detected one empty vial of insulin. Blood samples were drawn for glucose, insulin, and c-peptide. Patient had an episode of generalized tonic clonic seizure which was treated with intravenous lorazepam 4 mg. Again a bolus of 50 mL Continue reading >>
Nurse Gave Lethal Dose Of Insulin, Court Hears
DONALD FAIRBAIRN was only planning to stay at Yagoona Nursing Home for as long as it took to recuperate from one operation and prepare for the next, before returning to live with his daughter. As it happened, the diabetic 81-year-old was there less than three days before he died after receiving a lethal dose of insulin. In September 2006, Mr Fairbairn was admitted to the nursing home from Bankstown Hospital, where he was meant to receive eight units of insulin in the morning and six units at night, a court heard yesterday. But two days later a nurse allegedly administered 10 times his correct dose of insulin after incorrectly reading a medication chart written up by the patient's general practitioner. That chart has become the subject of an inquest into Mr Fairbairn's death. Glebe Coroner's Court was crowded with barristers angling to deflect blame from their clients - and implicitly on to others - yesterday. They represented Mr Fairbairn's family, the nurses who administered his insulin, the nursing home, the GP who wrote out his medication chart, the hospital where he was declared dead and the doctor who finally attended to him. The court heard that Mr Fairbairn's doctor, Ha Tran, wrote out charts for 15 different medications he was to receive while in the nursing home, including insulin. A document tendered to the court indicated Dr Tran had written what looked like "80. mane and 60 nocte", to indicate the morning and evening amounts. The nurse who originally tended to Mr Fairbairn's medication, Kristina Cetin, administered the correct amounts of eight units in the morning and six in the evening, saying she read the zeros as "u's", which she took to mean units. Patients did not usually receive more than 30 units of insulin, she said, and she would have checked with h Continue reading >>
Can Injecting A Huge Dose Of Insulin Kill A Healthy Person?
insulin is a crappy tool to try to use to kill yourself. Not surprisingly, studies of insulin suicides are somewhat scarce, but one looked at 160 insulin suicide attempts and found that 94.7% of the PWDs fully recovered, 2.7% developed “cerebral defects,” and 2.7% were successful in killing themselves. I was blown away by the fact that your odds of being permanently brain damaged from an insulin suicide attempt are exactly equal to your odds of success. Put another way, the overall odds are that nothing will come of your attempt, but if you do have any “luck” you have a 50% chance of dying and a 50% chance of living and being brain damaged. And if you end up brain damaged, you’ll probably want to kill yourself. Of course, if you couldn’t get it right with a full brain, I don’t think much of your odds with half a brain. Oh, and it’s not just insulin. For all the risks of prescription meds, they really aren’t particularly good suicide tools. The average fatality rate for all intentional medication overdoses is estimated at only 1.8%. By comparison, trains are apparently quite effective—with an overall 90% fatality rate—as are volcanoes. Still, I can see the temptation. While estimates vary widely, and can be controversial, we all know that too much insulin can kill you. It’s one of the night terrors we all live with. And I’ll bet there’s not one of us, when filling that syringe of fluid that keeps us alive, who hasn’t had a quick shadow pass over our minds: I wonder how much of this crap it would take to end it all, forever? After all, suicide tools and methods are cultural. For instance, in the USA less than 2% of suicides are jumps from high places, while jumping to one’s death accounts for more than half of suicides in Hong Kong. That be Continue reading >>
Diabetic Patient Unlawfully Killed After Lethal Insulin Injection From Community Nurse
A diabetic patient who was given a lethal dose of insulin by a community nurse was unlawfully killed, a coroner has ruled. Continue reading >>
Massive Levemir (long-acting) Insulin Overdose: Case Report
Case Reports in Medicine Volume 2012 (2012), Article ID 904841, 3 pages 1St Mary's Hospital, Imperial College Healthcare Trust, London W2 1NY, UK 2Cardiology Department, Tahir Heart Institute, Rabwah, Jhang 35460, Pakistan Academic Editor: Linda Gonder-Frederick Copyright © 2012 Mamatha Oduru and Mahmood Ahmad. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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 2.6 mmol/L. The patient was given a 50 ml 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 (GCS) 12 hours after overdose. 1. Case Presentation A 52-year-old man was brought to the Emergency Department after a deliberate huge overdose of long-acting Levemir insulin following an argument with his partner. He reported injecting Continue reading >>
Insulin Overdose
Tweet Taking too much insulin can lead to hypoglycemia. This can become particularly serious if your insulin dose was significantly more than it should have been. If you are worried that you have overdosed on insulin, take ample fast-acting carbohydrate immediately and seek advice from your health team, or the out-of-hours service at your local hospital, if applicable. Symptoms of an insulin overdose The list of symptoms below are symptoms of hypoglycemia which can result from an insulin overdose: Depressed mood Drowsiness Headache Hunger Inability to concentrate Irritability Disorientation Nausea Nervousness Personality changes Rapid heartbeat Restlessness Sleep disturbances Slurred speech Pale skin Sweating Tingling Tremor Unsteady movements Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication. Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 Continue reading >>
- Insulin overdose: Dosage, symptoms, and treatment
- Medtronic Recalls Diabetes Infusion Sets for Overdose Risk
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
