Overdose of IV glucose solution

bookworm01 · May 12, 2019

Brief background:
[I don't have diabetes (that I'm aware of) and do not take any medication that would lower my blood glucose]
Two days ago, I was accidentally given 800ml rather than 200ml 10% glucose solution over an hour to resolve hypoglycaemia and dehydration in A&E (ER) secondary to GI dysmotility. This sent my glucose from 2.7mmol/L to an undetectably high value (according to both a meter and the lab machine - so at least 35+mmol/L) in an hour alongside a ketone level of 3.6 (as I hadn't eaten in 7 hours) and a low pH (non-diabetic hyperglycaemic metabolic acidosis?). Over the next 12 hours my glucose levels fluctuated dramatically, tending to plummet to below 3mmol/L when not on a glucose drip (rebound hyperinsulinaemia?) and ketone levels initially dropped to 0.4, then crept back up to 1.5mmol/L.

So my question is now how long might it take for my insulin to return to normal and the risk of hypoglycaemia to reduce? Could the hyper-insulinaemic state I would have been in the other day due to the hyperglycaemia cause me to be more prone to hypoglycaemia until the high insulin resolves, as today I had an episode of symptomatic low blood glucose (3mmol/L, so not dangerously low but enough to feel shaky and tearful suddenly) which was 30mins after eating 80g plain greek yoghurt and 2hours after steak and halloumi, therefore not because I hadn't eaten for some time.

DCUKMod · May 12, 2019

bookworm01 said:
Brief background:
[I don't have diabetes (that I'm aware of) and do not take any medication that would lower my blood glucose]
Two days ago, I was accidentally given 800ml rather than 200ml 10% glucose solution over an hour to resolve hypoglycaemia and dehydration in A&E (ER) secondary to GI dysmotility. This sent my glucose from 2.7mmol/L to an undetectably high value (according to both a meter and the lab machine - so at least 35+mmol/L) in an hour alongside a ketone level of 3.6 (as I hadn't eaten in 7 hours) and a low pH (non-diabetic hyperglycaemic metabolic acidosis?). Over the next 12 hours my glucose levels fluctuated dramatically, tending to plummet to below 3mmol/L when not on a glucose drip (rebound hyperinsulinaemia?) and ketone levels initially dropped to 0.4, then crept back up to 1.5mmol/L.

So my question is now how long might it take for my insulin to return to normal and the risk of hypoglycaemia to reduce? Could the hyper-insulinaemic state I would have been in the other day due to the hyperglycaemia cause me to be more prone to hypoglycaemia until the high insulin resolves, as today I had an episode of symptomatic low blood glucose (3mmol/L, so not dangerously low but enough to feel shaky and tearful suddenly) which was 30mins after eating 80g plain greek yoghurt and 2hours after steak and halloumi, therefore not because I hadn't eaten for some time.

Gosh, bookworm, you've been through the mill. Where are you with the GI dysmobility? Is that now in a managed state?

To be honest, the combination of your condition plus the circumstances you have encountered in recent days probably means all anyone could do would be to speculate, at best.

Your question is really one for the medics looking after you, but in the meantime, don't become dehydrated again, and test, lots.

I'll tag my colleague @Brunneria who has a better understanding of RH than I have.

If you have any doubts whatsoever, call 111 to seek professional advice.

Brunneria · May 12, 2019

Hi @bookworm01
I am very sorry that you have had such a terrible experience, and I very much hope that you are on the mend.

I’m a bit wary of commenting further, purely because you haven’t included much info.
I’ve had a read of your previous posts, and see that you were originally being investigated for type 1/LADA, but since then you have been posting on the reactive hypoglycaemia section of the forum.

So does that mean the T1/LADA tests were negative?
And do you have a proper diagnosis of RH?
Also, if you are/were in hospital on a drip, for gut dysmobilty, what other treatment are you receiving?
Is the hospital familiar with treating RH?

All of these things are very important, and will profoundly affect what answers you get here on the forum.

So without all of the info above, all I feel able to offer is my own personal experiences of RH hypos.
However, please remember that my experiences do not include hospitalisation and being on a glucose drip!
(It is actually a concern of mine that one day I will find myself hospitalised and unable to refuse a glucose drip. It is such a concern that I wear a Medicalert bracelet that says ‘reactive hypoglycaemic DO NOT treat hypos with glucose drip)

So, my hypo experiences:
As an RHer for many years, I have had quite a few hypos, of varying severity, and in various circumstances.
The worst of them have involved shaking/trembling, lost words, rage, a tendency to violence, black depression, a sense of hopeless bitterness, and falling asleep/losing consciousness. Not all at once, I am glad to say.

The 3-4 days following bad hypos include volatile blood glucose fluctuations, physical aches, fatigue, apathy, more depression.
The symptoms gradually ease over time.
Then, one morning, usually the third morning, i wake up feeling normal again.

I can speed up the recovery period by carefully avoiding all carbs, even fruit and veg, and eating meat, preferably fatty meat like belly pork.

If you are being fed on typical hospital food, then I would expect a slower recovery because of the carb content.

I really hope that helps, and please come back and post how things are going.

Overdose of IV glucose solution

bookworm01

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DCUKMod

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Brunneria

Guru

Overdose of IV glucose solution

bookworm01

Member

DCUKMod

Master

Brunneria

Guru

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