Warning: Long story.
Came home from work last Thursday and was preparing my evening meal. I remembered that my basal insulin cartridge was empty and put a new one in. It was a big meal, pasta based with a lot of carbohydrate - I injected 16 units to cover it. Before eating I also did my basal injection, 33 units.
As I started to eat my meal an image of the insulin cartridge flashed into my mind. It was brown rather than purple. I grabbed my Lantus pen & it was true I had injected Humalog instead of Lantus. Idiot. A total of 49 units, wow. All I could think was "Eat". I had 3 Dextrose tablets & ate my meal (I can't recommend the combination) I then had a yoghurt.
I tried to think. My BG was 4.9 when I started eating (why couldn't it have been 9.9?) My CGM showed it was about 5. I ate some more glucose tablets washed them down with water. I waited 20 minutes but it went down slightly. I ate a chocolate bar & tried to think.
I didn't have a Glucagon kit - my last one had expired & I had reasoned that as I live alone there was no one to give it me if I was unconscious & if I wasn't, I'd be able to deal with it. Idiot.
Time to phone a friend. I asked him to call into the pharmacy and try to get Glucagon, failing that some Lucozade or similar. Meanwhile I drank some sugar water & wrote down a summary of what had happened.
He came quickly but Glucagon is only available on prescription as I thought. I drank some lucozade. BG 4.9. I was thinking (perhaps not very clearly) I'd keep going & if I did lose consciousness, at least there was someone there to call an ambulance but he talked me into dialling 111.
I tried to explain the situation but had to answer a whole series of questions, at the end of which he said "please wait while I put you through to someone who knows more about this" - or something like that. After a minute or so of music another guy came on the line and asked the same questions, meanwhile my BG had dropped a couple of points.. Eventually he advised me to go to A&E, offering to arrange an ambulance if necessary.
My friend took me down It's about three miles & as we arrived I finally saw my BG had increased. A&E was quiet & after checking in we sat down & waited. I could see my BG was now going up rapidly. After about 15 to 20 minutes (my brain was a really fuzzy by now) I was called in to see a nurse. Very friendly & she asked me more questions & filled out forms. It was very clear that she had little idea of basal and bolus insulins - I had to correct her several times. She did a finger prick test; 11.5. Took my BP & heart rate. I went back to the waiting room & we sat & chatted for 40 minutes or so. I was then called in to see a Doctor & went through the story again. By this time I was quite confident that everything was under control & wanted to get home, it was 9:00 pm. At first he wanted me to stay longer but I showed him my CGM, I don't think he'd ever seen one, & on the basis that I'd be monitoring carefully he allowed me to go home.
In fact there was a slight sting in the tail. After a shower my BG had dropped rapidly down to around 7 and was still falling. I ate a couple of glucose tablets, a packet of crisps & a slice of toast & stayed up for a while keeping an eye on my CGM. Eventually I went to bed, setting my alarm a couple of times to check - I was so tired I wasn't sure the Dexcom alarm would wake me. The next morning my BG was 7.1.
It was rather embarrassing to mess up like that, but everyone was very nice about it. It was the first time I'd ever been to a hospital with a diabetes related problem (in nearly 20 years). As it happened I had dealt with it successfully, not even having a hypo. My worry was that being down in the 4s to start with, there was no lee way if it had dived suddenly. At least if I'd passed out in A&E there was someone to help.
Thoughts:
The people at 111 advised A&E & offered to arrange an ambulance, but all the questions and handing me over to a second person took a lot of time. In that time I could have dropped into a hypo & worse. You'd think the words "I've taken an insulin overdose" would trigger some urgency. The same applied at A&E though the receptionist could see me & perhaps judged that I looked & sounded in control. Or had no idea of the implications of an overdose. As I've found in the past, medical staff's knowledge of diabetes, especially type 1, seems to be rather limited.
I've never eaten so much in such a short time. I'm surprised I wasn't sick. I hate Lucozade. I'm an Idiot.
Came home from work last Thursday and was preparing my evening meal. I remembered that my basal insulin cartridge was empty and put a new one in. It was a big meal, pasta based with a lot of carbohydrate - I injected 16 units to cover it. Before eating I also did my basal injection, 33 units.
As I started to eat my meal an image of the insulin cartridge flashed into my mind. It was brown rather than purple. I grabbed my Lantus pen & it was true I had injected Humalog instead of Lantus. Idiot. A total of 49 units, wow. All I could think was "Eat". I had 3 Dextrose tablets & ate my meal (I can't recommend the combination) I then had a yoghurt.
I tried to think. My BG was 4.9 when I started eating (why couldn't it have been 9.9?) My CGM showed it was about 5. I ate some more glucose tablets washed them down with water. I waited 20 minutes but it went down slightly. I ate a chocolate bar & tried to think.
I didn't have a Glucagon kit - my last one had expired & I had reasoned that as I live alone there was no one to give it me if I was unconscious & if I wasn't, I'd be able to deal with it. Idiot.
Time to phone a friend. I asked him to call into the pharmacy and try to get Glucagon, failing that some Lucozade or similar. Meanwhile I drank some sugar water & wrote down a summary of what had happened.
He came quickly but Glucagon is only available on prescription as I thought. I drank some lucozade. BG 4.9. I was thinking (perhaps not very clearly) I'd keep going & if I did lose consciousness, at least there was someone there to call an ambulance but he talked me into dialling 111.
I tried to explain the situation but had to answer a whole series of questions, at the end of which he said "please wait while I put you through to someone who knows more about this" - or something like that. After a minute or so of music another guy came on the line and asked the same questions, meanwhile my BG had dropped a couple of points.. Eventually he advised me to go to A&E, offering to arrange an ambulance if necessary.
My friend took me down It's about three miles & as we arrived I finally saw my BG had increased. A&E was quiet & after checking in we sat down & waited. I could see my BG was now going up rapidly. After about 15 to 20 minutes (my brain was a really fuzzy by now) I was called in to see a nurse. Very friendly & she asked me more questions & filled out forms. It was very clear that she had little idea of basal and bolus insulins - I had to correct her several times. She did a finger prick test; 11.5. Took my BP & heart rate. I went back to the waiting room & we sat & chatted for 40 minutes or so. I was then called in to see a Doctor & went through the story again. By this time I was quite confident that everything was under control & wanted to get home, it was 9:00 pm. At first he wanted me to stay longer but I showed him my CGM, I don't think he'd ever seen one, & on the basis that I'd be monitoring carefully he allowed me to go home.
In fact there was a slight sting in the tail. After a shower my BG had dropped rapidly down to around 7 and was still falling. I ate a couple of glucose tablets, a packet of crisps & a slice of toast & stayed up for a while keeping an eye on my CGM. Eventually I went to bed, setting my alarm a couple of times to check - I was so tired I wasn't sure the Dexcom alarm would wake me. The next morning my BG was 7.1.
It was rather embarrassing to mess up like that, but everyone was very nice about it. It was the first time I'd ever been to a hospital with a diabetes related problem (in nearly 20 years). As it happened I had dealt with it successfully, not even having a hypo. My worry was that being down in the 4s to start with, there was no lee way if it had dived suddenly. At least if I'd passed out in A&E there was someone to help.
Thoughts:
The people at 111 advised A&E & offered to arrange an ambulance, but all the questions and handing me over to a second person took a lot of time. In that time I could have dropped into a hypo & worse. You'd think the words "I've taken an insulin overdose" would trigger some urgency. The same applied at A&E though the receptionist could see me & perhaps judged that I looked & sounded in control. Or had no idea of the implications of an overdose. As I've found in the past, medical staff's knowledge of diabetes, especially type 1, seems to be rather limited.
I've never eaten so much in such a short time. I'm surprised I wasn't sick. I hate Lucozade. I'm an Idiot.
