Insulin overdose in non-diabetic

[Namztorb]

Just after some advice please, and I know it's very difficult. I've just had a call from my dad's care home. My dad is 84 and has Alzheimer's but is not diabetic. He has been injected with another patient's insulin by mistake. The carer I spoke to knew that it was 17 units but was not clear if fast acting or background insulin.

Paramedics are with him and will be taking him into hospital, which is obviously the right thing to do.

I'm just wondering what the likely outcomes are, if anyone knows? I think I pretty well understand the potential outcome of a novorapid overdose like this, but I'm less sure of how serious it is if it was Lantus. Can anyone help?

My 6 year old son has type 1 diabetes, diagnosed 6 months ago, which is how come I'm a member of DUK forum.

 

[azure]

The hospital will put him on a glucose drip. I would imagine. Insulin can be dangerous for everyone, diabetic or not, but the important thing is that this mistake was spotted and your dad is getting the care he needs. The paramedics may also have been able to give him immediate treatment to counteract the insulin.

That's a positive thing.

Sending you my best wishes and I hope your dad is stabilised very soon. X

 

[Namztorb]

Thank you. Yes, I understand insulin overdose is always dangerous. I feel helpless and I know there's nothing I can do. I'm trying to manage my expectations I think.

 

[azure]

Remember your dad's metabolism will be able to compensate to some extent because he isn't diabetic. He'll have stored glucose that his own hormones will release in response. If it was a slow acting insulin then obviously that will be a slower drop and easier to deal with, but I would imagine the paramedics helped him before he was transferred to,hospital, just like they would if a person with diabetes had taken too much insulin by mistake.

I don't think anyone knows the answer as to how things will progress because it depends on the individual and the insulin given, but getting quick,treatment as it sounds he did must be a big thing in his favour.

 

[Snapsy]

@Namztorb gosh, what a shock, and I'm glad he's getting the care he needs. I'm wishing you and your dad all the very best.

 

[SimonCrox]

Annoying problem to put it mildly.
25% care home residents have diabetes of whom half are known; so there is a 12% chance that your dad has diabetes and it is not known. So if he is a bit tubby, and has undiagnosed T2DM, might not be too much of a problem
But if he is skinny, and not diabetic, then his glucose levels could drop signficantly.
As above, the hospital would but on a glucose drip and watch the glucose levels carefully.
The scope for problems lies in the duration of effect of the lantus; folk would say a 24 hour duration of effect, but it can last for longer eg the 24 hours is the therpeutic effect in standard doses, but a big (much bigger than 17 units) can make folk hypo for days, eg 5 days.
So, if a quick acting insulin, he would need a fair bit of CHO to avoid hypos but should be sorted by 24 hours; but if Lantus, would not need such a rapid rate of CHO ingestion, but it could go on for longer and one would want your dad to be OK off any glucose drip for 24 hours.
If his renal function is poor, and the routine measures of renal function in a frail older person underestimate the proble, then the insulin will hang around for longer.
Safeguarding concerns will be raised (appropriately) and their investigation will probably keep your dad in hospital a few days more.
Best wishes

 

[Namztorb]

Thank you. This makes a lot of sense. x

 

[Brunneria]

have you heard how your dad is doing now, @Namztorb ?

I would imagine that if he has Alzheimers there will be additional factors to allow for (disruption of routine, change of scene, unfamiliar environment, etc), but hopefully he will be back in familiar surroundings in a few days at the longest.

 

[AndBreathe]

Just after some advice please, and I know it's very difficult. I've just had a call from my dad's care home. My dad is 84 and has Alzheimer's but is not diabetic. He has been injected with another patient's insulin by mistake. The carer I spoke to knew that it was 17 units but was not clear if fast acting or background insulin.

Paramedics are with him and will be taking him into hospital, which is obviously the right thing to do.

I'm just wondering what the likely outcomes are, if anyone knows? I think I pretty well understand the potential outcome of a novorapid overdose like this, but I'm less sure of how serious it is if it was Lantus. Can anyone help?

My 6 year old son has type 1 diabetes, diagnosed 6 months ago, which is how come I'm a member of DUK forum.

Gosh. That's all rather shocking.

Do you know how the error was discovered?

Whilst I accept that in any action mistakes can happen, it would seem that something has gone wrong here.

In your shoes, I would be writing to the care home, expressing my shock and disappointment about what has happened, and ask them to investigate it fully. I would also be asking them what steps they are taking, including any changes to procedures to ensure this cannot happen again.

That's not about asking for names or looking for someone to blame, it's about ensuring your father is safe and that you can be confident he is being cared for appropriately.

 

[Namztorb]

I have just spoken to the care home and they have checked with the hospital. My dad is, thankfully, doing well and bg is stable at the moment. They have booked his transport back to the care home for 2pm today. I'm very glad about this, as with his Alzheimer's, big disruptions to routine are massively stressful for him. :'(

I am leaving him alone today to settle back into his room at the care home, as he will be exhausted and very stressed as it is, and I'm going in to see him tomorrow morning.

I have already made it my task for today to get the letter written to the care home and I will hand deliver it tomorrow when I go in. The carers at his home are amazing people who do such a hard, hard job, and I absolutely am not interested in seeing heads roll or anything like that. BUT... this is a safeguarding issue for my dad and all other residents and they must take it seriously. I strongly suspect this has happened because, as usual, they're under staffed and over worked. The managers work their 9-5 and take home their nice salaries and leave the poor carers to deal with everything, and ultimately mistakes happen.

Thank you to all who replied. x

 

[azure]

I'm so glad your dad's ok @Namztorb ! What an awful worry for you!

Yes, definitely write a letter. It's not about apportioning blame, it's about having procedures that will prevent this happening again.

 

[AndBreathe]

@Namztorb - Blame rarely solves a problem, and to be fair the person who did this is likely so shocked you they themselves will be hyper vigilant in future. I imagine they also has a really sleepless night. The people who do these jobs rarely do it for the limelight and the massive salaries (please understand in this sentence I'm being ironic).

As you say it's about your father and the other residents being properly cared for and staying safe at a time in their lives when they are so vulnerable.

I'm so please your Dad is doing well, and can get back to his more familiar surrounding so quickly. It must be such a relief.

 

[SimonCrox]

Totally agree with above on care home staff. They are very stretched due to difficulty recruiting. There are frequent investigations with homes in special measures, sometimes for good reason, sometimes not. And diabetes eduation is difficult; although diabetes specialists can do training, there are not enough staff to allow folk off to do training, and turnover of staff is so high (working in a supermarket pays more and has extra benefits) that trained staff may well soon leave.
I have been highly impressed by staff in homes (I would never be patronising), but just very stretched.
Also the residents are much more dependent than 15 years ago, and the state funding for placements have not rally risen with the costs of care.
Hope dad doing OK
Best wishes