Terrible hypo due to Lantus or steroids?

[enzina]

I have spent the whole morning trying to get out of a massive hypo after i had injected 18 units of Lantus. Waking levels at 6am were 4.2 and after 30 minutes of being up i took the Lantus. Ten minutes later I was just picking up something from the floor when i noticed i'm feeling dizzy and can hardly see. Libre 2 showed 3.5 but finger pricking showed 1.9. It took me nearly two hours to bring the levels back up to normal although i was taking in incredible amounts of sugar and also ate bread and fruits.
Two weeks ago i got a steroid injection in my elbow. For the next two days afterwards i was running low, then very high and needed more insulin. Only since yesterday i thought everything is back to normal.
At the moment i'm feeling very weak, are walking like drunk and fingers and toes are cramping. Never had a hypo like that before. Could it be the Lantus?

 

[EllieM]

Could it be the Lantus?

From personal experience, it's a possibility. Lantus can act very fast if you inject it into a blood vessel rather than normal tissue. I believe I have had this twice (luckily managed to treat the hypo which happened soon after the lantus injection) and as a consequence now split my lantus dose so as to reduce the quantity being injected at one time. (Also it evens out the dose over the day). I stress that this has only (possibly) happened to me twice in 15 years of lantus use and I haven't had any issues recently.

Should You Watch Out for "Lantus Lows"?

From the official Lantus product monograph: “Hypoglycemia can result from injection directly into a blood vessel.” Have you heard of that before? Have you ever endured a surprising and powerful low blood sugar episode after a Lantus injection? For those wondering, Lantus is a widely prescribed...

www.diabetesdaily.com

Fairly objective treatment of the subject from someone who hasn't experienced a lantus low and whose two doctors hadn't heard of it. (My DN hadn't heard of it either).

https://www.healthcentral.com/article/lantus-lows

From someone who has experienced a lantus low.

and from the product disclosure statement

https://pdf.hres.ca/dpd_pm/00041813.PDF

Intravenous administration of the usual subcutaneous dose could result in severe hypoglycemia.

Of course, there's no way to know for certain whether this happened to you....

I hope you feel better soon. Hypos are horrible.)


Edited to add - any chance you accidentally took fast acting instead of lantus, which might have a similar drastic effect?

 

[enzina]

Thanks very much for your fast reply @EllieM . There's no chance i mixed up Lantus with Novorapid. I also experienced such a Lantus low before and am aware of this thread. Just checked my PJs and there's a blood stain on it, injected in the tigh.
Such a shame, it's a lost day today.

 

[Antje77]

It sounds very much like the Lantus low I had, years ago.
Very happy you managed to stay conscious to keep treating!

 

[Jasmin2000]

I have spent the whole morning trying to get out of a massive hypo after i had injected 18 units of Lantus. Waking levels at 6am were 4.2 and after 30 minutes of being up i took the Lantus. Ten minutes later I was just picking up something from the floor when i noticed i'm feeling dizzy and can hardly see. Libre 2 showed 3.5 but finger pricking showed 1.9. It took me nearly two hours to bring the levels back up to normal although i was taking in incredible amounts of sugar and also ate bread and fruits.

Most likely Lantus and not steroids. I used to get Lantus lows at 3-4 am so I'd snack and go back to bed, but it's a persistent animal and requires mixed snacks of fast and slower acting sugar, so well done for mixing up your recovery bundle. I also found the recovery took ages followed by a massive spike of all the sugars I'd eaten in the emergency!

Thanks for noting the finger prick vs. Libre result - I've given up on Libre for minute-by-minute info, as it doesn't give you the 10 minute warning. If you'd gone with 3.5 you might have lost the urgency and had even more trouble.

 

[Marie 2]

Lantus notoriously can cause lows.

But I also want to say steroids can be an issue. I really really react to them, they work great but even a small amount and my BG level shoots up and requires a lot more insulin. I avoid them as much as possible but sometimes they are needed. Last time I was given a low dose shot for my back I used 16 extra units that day with hardly eating. I had to take pills for a few days and required extra insulin each day. And they stay stubbornly high for a few days plus after. But the worse is all of a sudden I go back to normal and then I will drop, and I don't know when that is going to happen. I know this from experience so I watch for it, but it's all of a sudden with me. I have to wonder since you said you had just returned to normal the day before if that might have happened to you.

 

[enzina]

Lantus notoriously can cause lows.

But I also want to say steroids can be an issue. I really really react to them, they work great but even a small amount and my BG level shoots up and requires a lot more insulin. I avoid them as much as possible but sometimes they are needed. Last time I was given a low dose shot for my back I used 16 extra units that day with hardly eating. I had to take pills for a few days and required extra insulin each day. And they stay stubbornly high for a few days plus after. But the worse is all of a sudden I go back to normal and then I will drop, and I don't know when that is going to happen. I know this from experience so I watch for it, but it's all of a sudden with me. I have to wonder since you said you had just returned to normal the day before if that might have happened to you.

Thanks so much! I believe the steroids have played a big part of it too.