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Is It Possible To Overdose On Insulin?

Intentional Insulin Overdose Associated With Minimal Hypoglycemic Symptoms In A Non-diabetic Patient

Intentional Insulin Overdose Associated With Minimal Hypoglycemic Symptoms In A Non-diabetic Patient

Go to: CASE REPORT A young medical professional is brought to the emergency department (ED) by ambulance, following insulin overdose 3.5 hours previously. There was a history of chronic alcohol abuse, physical self-harm and substance misuse (paracetamol/codeine); no regular medications or allergies. After drinking approx. 300 mls of vodka, the person impulsively decides to commit suicide by injecting in the abdomen (4 times over 90 minutes) a total of 10 mls (1000 units) of Actrapid® insulin (100 units/ml) from a vial procured for this purpose 3 months before. On the onset of the hypoglycaemic symptoms, the person became scared, however, and informed family members. The family called the emergency services who attended the patient approx. 2.75 hours after the overdose. On initial assessment, the GCS was 15/15 and the capillary glucose 1.4 mmol/L. Oral glucose gel (20 g) was administered; after 15 minutes the capillary glucose was still 1.4 mmol/L. After 1 mg of glucagon, the capillary glucose rose to 2.9 mmol/L. An 18 G IV access was established and a bolus of 250 mls of dextrose 10% was given. This increased the capillary glucose to 13.3 mmol/L; the remaining 250 mls was given over 90 minutes. On arrival, the patient was alert and oriented; GCS 15/15, capillary glucose 9.3, blood pressure 127/79 mmHg, pulse 109 bpm, temperature 35.1°C, respiratory rate 16, SaO2 100% on room air. Clinical examination was unremarkable. A second 18 G IV access was established and blood drawn for a full blood count, urea and electrolytes, liver function tests, plasma glucose, creatinekinase, amylase, CRP, salicylates/paracetamol levels. Initial ECG: sinus tachycardia with a normal axis and a QTc of 492 msec. The ECG was repeated after 5 minutes and the QTc was 477 msec. Also multiple ven Continue reading >>

Diabetes Prescription Insulin Medications (cont.)

Diabetes Prescription Insulin Medications (cont.)

font size A A A Previous 1 2 3 4 5 Next What are the side effects of the diabetes drug insulin? The main side effects of insulin have to do with taking too little or too much of the drug. The former can result in high blood sugar, or hyperglycemia. A person with diabetes who has hyperglycemia frequently or for long periods of time may suffer damage to the blood vessels, nerves, and organs. In a worst-case scenario, hyperglycemia can lead to diabetic ketoacidosis, a potentially life-threatening condition. Loss of appetite, thirst, flushing, drowsiness, and a fruity odor on the breath are the first signs of diabetic ketoacidosis. Low blood sugar, or hypoglycemia can result from taking too much insulin, although missing meals and exercising excessively can also bring it on. This, too, can be a life-threatening. Initial signs of hypoglycemia include dizziness, sweating, tremor, confusion, and hunger. It's important to intervene before symptoms progress. High doses of insulin can lower levels of potassium. If potassium gets too low, it can cause muscle aches or weakness, abnormal heart rhythms and even death. Other side effects of insulin include break down of fat at the injection site, the injection site might be depressed or raised, and allergic reactions, which can be local or involve the entire body. The latter may be life-threatening. lower your blood sugar Amputations. INVOKANA® may increase your risk of lower-limb amputations. Amputations mainly involve removal of the toe or part of the foot; however, amputations involving the leg, below and above the knee, have also occurred. Some people had more than one amputation, some on both sides of the body. You may be at a higher risk of lower-limb amputation if you: have a history of amputation, have heart disease or are at Continue reading >>

Diabetes Warning: What Is Insulin Overdose That May Have Killed Actor Iain Rogerson?

Diabetes Warning: What Is Insulin Overdose That May Have Killed Actor Iain Rogerson?

Former Coronation Street actor Iain Rogerson, who played Henry Flagg in the ITV show, died from a suspected insulin overdose on October 13, according to reports. Insulin is used to normalise blood sugar levels in diabetes patients. Too much insulin causes an overdose, and leads to hypoglycaemia. The condition’s symptoms include double vision, confusion and shakiness. In most extreme cases, it can causes patients to lose consciousness, and even die. Having too little glucose in the bloodstream means the body can’t operate properly. Every patient reacts differently to low levels of glucose. Common symptoms of mild hypoglycaemia include shakiness, a rapid heartbeat, irritability and tingling in the lips or around the mouth. Patients with low blood sugar levels should eat about 15g of a high-sugar food, including honey, raisins or chocolate. The amount of insulin diabetics need varies from person to person. It depends on the type of insulin taken and the body’s sensitivity o the hormone. The strength of insulin also varies. The most common strength is the equivalent of 100 units of insulin per ml of fluid. But, some people require a higher dosage, so it’s available up to 500 units of insulin per ml of fluid. Overdosing on insulin isn’t difficult, according to Healthline.com. You can overdose from the hormone if you forget to take an injection, and then take another before necessary. Overdoses can also be caused by accidentally injecting too much, exercising vigioursly without changing the dosage of insulin taken, or even forgetting to eat. If you realise you may have overdosed on insulin, you should seek medical attention immediately. Continue reading >>

Ask D'mine: A Killing Dose Of Insulin

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 >>

Death By Insulin: How Sweet It Isn't!!

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 >>

Teenage Girl Died Of Insulin Overdose After Injecting Herself With Diabetic Boyfriend's Pen 'in Cry For Attention'

Teenage Girl Died Of Insulin Overdose After Injecting Herself With Diabetic Boyfriend's Pen 'in Cry For Attention'

A teenage girl who died after injecting herself with insulin may have taken it to try to lose weight. Charlie Dunne, 19, used an insulin pen belonging to her diabetic boyfriend while he was out at a hospital appointment. An inquest heard the trainee hairdresser may have taken the hormone previously after hearing that it could help slimmers. But the teenager, who was fit and healthy, would have been unaware of the ‘catastrophic’ danger the drug posed to non-diabetics, a coroner said. Miss Dunne was discovered collapsed at the home in Atherton, Greater Manchester, she shared with boyfriend Terence Rhoden, 28, when he returned hours later. She suffered brain damage caused by a dramatic drop in blood sugar and died in hospital six days later. Police later investigated claims by Miss Dunne’s family that Mr Rhoden had confessed to injecting her with insulin in the past to help her lose weight. But he denied doing so and officers found no evidence that he was involved in his girlfriend’s death. Bolton Coroner’s Court was told that ‘bubbly’ Miss Dunne was a regular at her local Methodist church, where she was given the community title of ‘rose queen’ for her charity fundraising. However, the inquest was told she suffered mood swings and had tried to overdose on tablets during a previous relationship. She also claimed to have suffered a miscarriage and was worried she could not have children, despite a lack of medical evidence to support her fears. The court heard that Mr Rhoden was woken when Miss Dunne returned from her local pub in an ‘agitated’ state on December 17 last year and threatened to take painkillers. She told him to leave, saying he was ‘too good for her’. After talking, she calmed down and fell asleep on the sofa. Mr Rhoden left for his a Continue reading >>

Is An Overdose Of Insulin Untraceable?

Is An Overdose Of Insulin Untraceable?

No, an injected overdose of insulin is quite simple to trace. Endogenous insulin is co-secreted with an equivalent amount of C-peptide which is easily measurable. If you detect a high level of insulin with very little or no C-peptide the insulin is sure to be exogenous. It also depends of the insulin itself. It is possible to tell apart porcine and bovine insulin from human insulin, but they are very rarely used now. Nowadays most diabetic people in developed countries use analogues of insulin, which can also be told apart. But the so-called human insulin (although its origin is biosynthetic) is still widely used and cannot be told apart from endogenous insulin. Finally, it is theoretically possible to get some C-peptide and inject it along with human insulin, which would make the deed virtually untraceable. C-peptide is of course a lot less readily available than human insulin (it has no therapeutic use) but I guess you can order it from somewhere. Now don’t get any ideas…. Continue reading >>

How To Deal With An Insulin Overdose And Other Insulin Complications

How To Deal With An Insulin Overdose And Other Insulin Complications

Administering too high a dose of insulin for diabetes can cause cold sweats, trembling hands, intense anxiety and a general sense of confusion because of low blood sugar or hypoglycaemia. Learn more about avoiding hypoglycaemia from an insulin overdose. When insulin works too well Insulin stimulates the cells of the body to absorb sugar (glucose) out of the blood. It also inhibits the production of glucose by the liver. In type 1 diabetes no insulin is present. In type 2 diabetes, the body is resistant to the insulin that's there. All people with type 1 diabetes need insulin injections. Many people with type 2 diabetes - those whose blood sugar can't be controlled with oral medicines, diet and exercise - need insulin injections. There are several ways you can get too much insulin in your system: You inject too much insulin because you have difficulty reading the syringes or vials or are unfamiliar with a new product. You inject the right amount of insulin but the wrong type. For instance, you normally take 30 units of long-acting and 10 units of short-acting insulin. Injecting 30 units of short-acting insulin is an easy mistake to make. You inject insulin, but then don't eat. Insulin injections should be timed with meals. Blood sugar rises after meals, but without eating, insulin lowers blood sugar to a potentially dangerous level. Symptoms of an insulin overdose It doesn't matter how it happens. An insulin overdose always has the same effect - low blood sugar levels, or hypoglycaemia. Symptoms of hypoglycaemia include: Anxiety Confusion Extreme hunger Fatigue Irritability Sweating or clammy skin Trembling hands. If sugar levels continue to fall during an insulin overdose, serious complications - seizures and unconsciousness - can occur. Low blood sugar, or hypoglycaemi Continue reading >>

Side Effects Of Taking Insulin When You Don't Need It

Side Effects Of Taking Insulin When You Don't Need It

Insulin-dependent diabetics take insulin injections because their pancreas no longer produces insulin. Insulin helps cells absorb glucose, the body’s main energy source, from the blood. All Type 1 diabetics, formerly called juvenile diabetics, and some Type 2 diabetics, formerly called adult-onset diabetics, need insulin because their bodies no longer produce enough of the hormone. Without insulin to remove glucose from the blood, blood glucose levels rise, a condition called hyperglycemia. Taking too much insulin or taking insulin when your body already makes enough removes too much glucose from the blood, a condition called hypoglycemia, or low blood sugar. Video of the Day All cells require glucose to function. When you eat, carbohydrates in the food break down in the intestines into glucose. The blood absorbs the glucose. When this happens, your blood glucose levels rise. In response to the increase in blood sugar, the pancreas releases insulin. Insulin facilitates a cell’s ability to remove glucose from the blood and utilize it for energy. If your body has already released enough insulin and you take more, too much glucose is removed from your blood and you become hypoglycemic. Taking an overdose of short-acting or intermediate-acting insulin is more dangerous than taking too much long-acting insulin, eMedTV explains. Taking insulin when you don’t need it causes symptoms such as sweating, shaking, headache, irritability, nervousness, anxiety, weakness, dizziness, hunger, tremors, nausea, and difficulty concentrating or thinking. For diabetics, the treatment for hypoglycemia is to eat something containing quickly absorbed glucose, such as candy or special glucose tablets. If you have a hypoglycemic reaction and take glucose, follow up with a snack containing b Continue reading >>

An Accidental Over Dial Leads To An Overdose

An Accidental Over Dial Leads To An Overdose

With millions of Americans suffering from diabetes, there has been tremendous growth in the use of insulin. For convenience, many insulin dependent diabetics carry their insulin in a prefilled syringe available from drug manufacturers. The device is called an insulin pen because it looks similar to a writing pen and can be carried in your pocket. An insulin pen is designed to give multiple injections of insulin after changing the single use attachable needle. Occasionally a patient may use the pen incorrectly resulting in serious side effects. Patients who are new to using an insulin pen are at most risk for making a mistake.Recently, we received an interesting report from a Certified Diabetes Educator (CDE)/RN about a first time user of an insulin pen who suffered an insulin overdose by misreading the amount dialed on an insulin pen device. The patient, who was admitted to the hospital with a dangerously low blood sugar, had been instructed by her doctor to give herself 6 units of NovoLog insulin using the pen device. As with other insulin pens, this device works by turning a dose selector dial to set the pen to deliver the prescribed amount (Figure 1a). The dose then appears in a little built-in window on the pen (Figure 1b). Once you set the dose, you inject the pen’s needle (1c) into your skin and push a button to release the dose of insulin (Figure 1d). After talking to the patient, it was determined how the overdose occurred. The patient misunderstood where to read her insulin dose! Instead of reading her dose within the little built in window, she read the dose to the right of the window (Figure 2). When the woman began to turn the dose selector dial, she looked to the right of the window, not within the window. When she saw the number six she thought that was Continue reading >>

Insulin Injection

Insulin Injection

Insulin injection is used to control blood sugar in people who have type 1 diabetes (condition in which the body does not make insulin and therefore cannot control the amount of sugar in the blood) or in people who have type 2 diabetes (condition in which the blood sugar is too high because the body does not produce or use insulin normally) that cannot be controlled with oral medications alone. Insulin injection is in a class of medications called hormones. Insulin injection is used to take the place of insulin that is normally produced by the body. It works by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Insulin comes as a solution (liquid) and a suspension (liquid with particles that will settle on standing) to be injected subcutaneousl Continue reading >>

Insulin Overdose Among Patients With Diabetes: A Readily Available Means Of Suicide

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 >>

Lantus

Lantus

Lantus is a prescription medication used to treat type 1 and type 2 diabetes. Lantus is a long-acting form of insulin and works by replacing the insulin that is normally produced by the body and by helping the body to use sugar for energy. It also stops the liver from producing more sugar. This medication comes in an injectable form and is usually used once daily. Common side effects include low blood sugar, redness and skin thickening at the injection site, and weight gain. Lantus is a prescription medication used to treat people with type 1 and type 2 diabetes for the control of high blood sugar. Lantus may be used along with fast-acting insulin or oral medications to control blood sugar. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. Lantus can cause hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), allergy, and skin reactions. Hypoglycemia (low blood sugar): Early warning signs of hypoglycemia may be different, less noticeable or not noticeable at all in some people. That is why it is important to check your blood sugar as you have been advised by your doctor. Symptoms of hypoglycemia may include: anxiety, irritability, restlessness, trouble concentrating, personality changes, mood changes, or other abnormal behavior tingling in your hands, feet, lips, or tongue dizziness, light-headedness, or drowsiness nightmares or trouble sleeping headache blurred vision slurred speech palpitations (fast heart beat) sweating tremor (shaking) unsteady gait (walking). If you have hypoglycemia often or it is hard for you to know if you have the symptoms of hypoglycemia, talk to your doctor. Mild to moderate hypoglycemia is treated by eating or drinking carbohydrates, such as fruit juice, raisins, sugar candies, Continue reading >>

Insulin Overdose

Insulin Overdose

Tweet Save If you take too much insulin, symptoms of an overdose may include blurry vision, shakiness, and extreme hunger. These are the early symptoms of low blood sugar levels. More severe (and potentially life-threatening) problems may include seizures, difficulty speaking, and loss of consciousness. Treatment for an overdose of insulin involves supportive care, which consists of treating the symptoms that occur as a result of the overdose. Can You Overdose on Insulin? An insulin overdose can be extremely dangerous. Insulin can be a difficult medication to properly dose, and it is actually fairly easy to accidentally overdose on this medication. It is very important to recognize the symptoms of an overdose and to know exactly how to respond. If you or someone else may have overdosed on insulin, seek immediate medical attention. General Information on an Insulin Overdose An overdose with a short- or rapid-acting insulin is typically more dangerous than an overdose with an intermediate- or long-acting insulin (although an overdose with any type of insulin can be lethal). An overdose of insulin can be caused by several factors, such as misjudging how much insulin is needed. Also, not eating after taking a dose of a rapid- or short-acting insulin may result in an overdose. Eating less or exercising more than usual could also lead to an insulin overdose. Symptoms of an Overdose An insulin overdose can cause low blood sugar levels (hypoglycemia), which can be quite dangerous. Some of the early symptoms of low blood sugar include: Sweating Extreme hunger Dizziness Cold sweats Shakiness Blurry vision. More severe symptoms include: Loss of consciousness Changes in behavior, such as irritability Loss of coordination Difficulty speaking Confusion Coma Loss of life. You may find Continue reading >>

Massive Levemir (long-acting) Insulin Overdose: Case Report

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 >>

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