Might Have Accidentally Taken Double Lantus Dose?

J. Wilson said:

Hello!

I'm a type 1 diabetic and just wanted to ask if there was any way for me to check if I've accidentally taken my long-acting insulin (Lantus) twice? Or what symptoms I should be on the lookout for in regards to that (the only one I can think of is hypoglycemia after taking a usualy amount of insulin for a meal) I usually take my Lantus at around 10PM, but tonight my blood sugar was 3.2 so I was somewhat distracted with treating that and as a result I can't remember if I took my Lantus during that period as well as later on (around 10:55PM) when I definitely did take a dose of it. I can't check the amount in the pen either since I don't remember what it was the day before yesterday.

The only thing I can think of is doing a blood test every hour to see if it falls noticeably or as a trend - so far it's actually gone up (I waited a couple of hours before checking, which I think is the amount of time Lantus takes to start kicking in?), so I'm hopeful that I've not accidentally taken a double dose, but wanted to know other people's opinions too.

Thanks in advance!

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Hi,

Welcome to the forum.

Ooooh…

You could have raised BGs from treating the hypo you had & also what’s left of the meal if there was a mistiming of bolus dose for it?
The Lantus. If you know you dosed at least “once” for it. Keeping a close eye on your BGs is what I’d do. Treating any lows regarding a wrong Lantus dose. Fast acting carb for a quick pick up. But also some longer acting carbs or you may find the lows recurring.

I do Lantus myself, & even when a single dose for me is wrong, that tends to be my course of action..

Edit to add; long acting carbs in a basal hypo crisis for me, milk, any sort of pastry like on a sausage roll or pork pie. Maybe bread, digestive biscuit. or you may find a recurrence if your Lantus dose is too high? For me in about an hour if I just hit it with sweets..

Hope this helps.

J. Wilson said:

I think what happened with my meal is that I sized it up incorrectly and just took too much fast acting insulin with it.

Definitely agree on the raised blood sugars from hypo treatment.

My concern primarily is whether I should be treating this as an emergency or not, I'm not entirely clear on how harmful a double dose can be (I'd have thought that if I'm monitoring, etc, it would just mean taking less fast-acting insulin with meals and being vigilant during and after exercise). And as I said before, I'm not really sure if I've even taken one or not. I've lived with Diabetes for a long time (somehow never made this mistake before) and as a result I think I have a tendency to underestimate it and I can't decide how concerned I should be about this.

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OK.. I’ve been T1 for 46 years. Started on porcine as a kid then on MDI in the late 1980s as a student. (Doc felt it more flexible.)
I’m also still fully hypo aware.
Now to be fair injection wise. I have doubted my actions in the past. It’s just soo “routine.”
Even asked a room mate in a hotel once if he saw me using something like (holding up Lantus pen.) last night. My BGs were actually great that morning but had no recollection rolling in from a gig what happened. I’m pretty laid back. The anxiety of my childhood behind me on this. I took it on myself at the time that I’m the only one who can deal with the lows? Everyone else is slow to respond as I babble like a sweaty fool.. “if you feel funny? Tell mummy.” (It said in the handbook given at the time..)

It’s late night & I just rolled in from doing another gig.

If you have a sensor? You should be alarmed if approaching a low.? Which helps. Though for me a Lantus low is a slow creeper.
If I were you..? If in any doubt. Set your alarm & test every hour if you are just using a BG tester?
If you have any work scheduled for the Sunday? Be wary.. if you plan extraneous exercise, for fitness & leisure you have the choice to give it a miss.

Other members may have differing views, which I respect.
With the best will in the world, don’t panic. You know your diabetes better than I do.
Lantus for me is an odd flakey insulin. You may find all will be apparent if the dose is wrong, the latter half of the following day? Sunday.

A sensor is a game changer. But not a total replacement for the meter..(Just yet.) I had to fight dirty for mine on prescription with an endo.
At the time bloodletting & “food prep” as a job was not appropriate..I was collecting free rage eggs outside during covid.
I’m back in engineering.. still dodgy on the infection from wound front. (Pretty much hands on.)

Sorry if I may have sounded terse in the earlier posts. I’m confident you can handle this “one..”

Please let us know how you got on.

Best wishes.

To prevent this you could use a pen cap with timer on it. I have been using a timesulin cap on both my levermir and short acting Fiasp. Tells you how long since you last removed the cap.

Hi, I’d blood test every couple of hours, after 6 or 7 hours you should see your sugars going very low if you double dosed. You’ll need to eat low G I foods to balance out the low release Lantus. Little bit of porridge, half a banana, wholemeal buscuit etc
I recently rang my outpatients Diabetes clinic nurse and she’s changed my insulins to Novorapid from Humalog and Tresiba from Lantus, the pen injectors are Novopen 5’s and have a screen on the end to tell you when the last dose was given, brilliant.
The Tresiba is better than the Lantus, my average blood sugars have come down a touch and it seems to last longer then the Lantus did. I take 8 units Tresiba to 10 units Lantus.
I would try and get a Libre freestyle sensor, make up a story about stress and hypos and cry and wail to get one, it has really made a difference to my control and understanding of food effects and insulin action.
I’m a type 1 for nearly 60 years, very fit, been a pro athlete and travelled round the world a few times.
Good luck !

I know from experience how frightening it is when you can't remember if you've done an injection or not or whether you think you've done it twice and it's the same with tablets. When you've been on insulin a long time,(for me it's 27 yrs in total and 19 years on insulin) it gets so second nature that you can do it without thinking, especially if you're doing something else at the time. Several years ago I would just get a needle out of the box and inject but to make it much safer now I have a routine whereby with the Novorapid my pen is in a case with places for three needles. This way I can tell straight away if I haven't done an injection, if a needle's not in its place then I've done it. With my Tresiba, I inject at 10.00am every morning when I take my tablets for MDS (blood cancer). I keep my Tresiba pen in a case and one needle with it, (separate from the Novorapid case) so again I can tell straight away if I have done the injection or not, and an alarm on my phone sounds to remind me it's time to medicate. I also made a sheet with boxes to fill in for sugar levels before and after meals and I write the doses of Novorapid I've given each time which also helps keep track.

When I was first diagnosed at age 49 I was told I was Type 2 like my father (who was on insulin) but neither of us were overweight, me particularly and a few years ago my twin sister was diagnosed with Type 2 (not on insulin) and she's even thinner than me but my son was diagnosed and he is the only one who is overweight (he's not on insulin). It was only this year, after I had a fall and broke six ribs and my collar bone just by fainting after I got out of bed, that my diabetes was reviewed in the hospital by a specialist nurse and that started the ball rolling with my surgery when I was taken off Lantus put onto Tresiba and told that because of the patterns of my fluctuating sugar levels I was probably not Type 2 but was late onset Type 1 and was eligible for the Freestyle Libre sensor on prescription. I had been buying one for myself a few years ago, when i was first being investigated for the blood cancer but was advised not to use one again because of the risk of infection. Now my blood levels are all back to normal, (still got the bood cancer) I may be able to use them again. I have to say that they are very good at showing you how food affects your sugar levels and I was surprised when i discovered that I was going very low during the night but had good levels on waking which I would never have known without the Libre. People shouldn't beat themselves up about not remembering if they've done an injection or have done too many as it's probably happened to most of us at one time or another but when it does it doesnt half give us a fright!

I’ve made the same mistake and treated with lift tablets as eating to correct makes me sick. I’m allergic to all latex’s and can’t wear a CGM. Had a brain haemorrhage at 40 so I write my Lantus injection in the note section on contour app.

J. Wilson said:

I'm not sure a case-needle system would work for me as I'm certain I'd forget to set it up at some point, but it does seem like a very good idea for someone with better organisational skills than me!

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Something like this works very well for basal insulin, just put a needle in for every day.