Changing Insulins

[Mal272]

Hi all, this is my fist post but I have lurked for a while, I’m just after opinions or advice.
A couple of weeks ago my chemist told me they could no longer get my regular Lantus and would have to change to solostar, I was asked to let my GP know and ask for a new prescription, my own Gp was away on hols but another member of the practise was asked to look into it, this was supposed to take just half a day to sort out but in fact after a lot of phone calls from myself took 4 days.
Still she sorted it out eventually, for the next two weeks my sugars were all over the place, I just couldn’t control them, I couldn’t sleep I was shaking, sweeting I’d never felt as bad, my wife suggested it might be the new insulin so I went to the surgery and told another doctor what we thought, she checked the insulin and said they had prescribed Apidra Solostar and it should have been Lantus Solostar, which means I was taking 60ml Apidra thinking it was slow release which it wasn’t plus 20ml Humalog with my evening meal =80ml fast release. No wonder I couldn’t sleep, I’m amazed I woke up! I got the proper insulin and had a great sleep last night.
My worry is does anyone know what harm, if any, two weeks like this can cause and would you recommend seeing someone about it.
Kind regards
Mal272

 

[smidge]

Hi Mal272!

:shock: I nearly fell off my chair in shock when I just read your post! You are extremely lucky this 'mistake' didn't kill you! All your GP needed to do was swap you from the Lantus cartridges to the Lantus pre-filled pens - this would have made no difference whatsoever to your health. By giving you Apidra, you have effectively been severely over-dosing on insulin. Apidra works immediately before or after your meal to control the post meal rise in blood glucose. You take it in direct ratio to the carbs yoou have eaten e.g. 1 unit Apidra to 10g carb. Lantus is your background, long-lasting insulin which you take once a day. The good new is that if it hasn't killed you, it probably won't have done any lasting damage. You will have had high blood sugars between meals because you weren't taking any Lantus, but you will have been seriously overdosing on Apidra which should only be taken with meals. So I guess you were injecting before bed and then having hypos during the night - hence the sweating etc. Apidra is a very aggressive insulin, but is used up by the body within a few hours, so you should have no lasting problems from it. However, you must report this in writing to your Practice Manager. This type of mistake could easily have killed you. Personally, I would be reporting it to the primary care trust as gross negligence on the part of the doctor who did this. I think you've had a very close shave.

I hope you're feeling better now.

Smidge

 

[phoenix]

Ditto to the above response. I know that people are more likely to write when they have problems but in the last few day there seem to have been some horrendous accounts of bad practice .
Fortunately you are alive to tell the tale.
The awful thing is that there have been several deaths because of errors with insulin and the NHS was concerned enough to investigate it. They produced a document in 2010 which catalogued the possible errors . It also stated:

A training programme should be put in place for all healthcare staff (including medical staff) expected to prescribe, prepare and administer insulin. An e-learning programme is available

http://www.diabetes.nhs.uk/safe_use_of_insulin/

They have also started to issue an insulin passport which should contain full details of the insulin you take.
http://www.doncaster.nhs.uk/your-health ... -passport/

As well as complaining locally, I would also fill in this report.
http://www.nrls.npsa.nhs.uk/report-a-pa ... -incident/

 

[noblehead]

Mal,

60 units of Apidra is a massive dose of fast-acting insulin and I'm surprised you weren't hospitalised, assuming you used the same pharmacy that told you about the change in lantus.....I'm amazed that they didn't pick-up on the fact that you'd been prescribed a QA insulin as opposed to a BI :?

Do complain as this mistake could have had a more serious outcome, good luck!

 

[iHs]

I was also going to comment on the pharmacy issuing the prescription too. Big difference, and as you had not used Apidra before they should have picked up on this.

Really glad that Apidra was not used in the morning as the basal and you had also used your usual bolus Humalog. You would definately gone very hypo and would have found yourself coming round in hospital with a glucose drip in you.

This thread really backs up the need though for everyone to read the patient info sheet inside the packaging. It does state that Apidra is a fast acting insulin.

 

[chhabra]

mate sue them express solicetors google them i was no lantus 10 years 95 units twice daily 240 units humulog 5 times a day byetta avandia metmorphine reductil slimnoa all private medical cover just changed to ispphane half all insulin blood sugar half average 5-7 on lantus 12-18 had shoulder pain severe last 10 years 3 operations different private doctors pain gone since change of insulin from a running machine now disabled with a stick all private consultants any comments