Insulin is a hormone that helps manage blood sugar levels, especially for individuals with diabetes. It moves sugar from the bloodstream into cells for energy. While insulin is a necessary medication, administering too much can lead to hypoglycemia, a state where blood sugar drops to dangerously low levels.
Understanding Hypoglycemia
Taking too much insulin causes cells to absorb excess glucose and signals the liver to release less, leading to low blood sugar. The body needs a steady supply of glucose to function properly, particularly the brain. When glucose levels fall below 70 milligrams per deciliter (mg/dL), symptoms of hypoglycemia can emerge.
The symptoms of hypoglycemia can progress from mild to severe. Mild symptoms include trembling, sweating, intense hunger, a rapid heartbeat, dizziness, and blurred vision. These are the body’s immediate warnings that blood sugar is too low.
As blood sugar continues to drop, moderate symptoms may appear, such as confusion, irritability, difficulty concentrating, slurred speech, and poor coordination. At this stage, cognitive functions are noticeably impaired. If untreated, severe hypoglycemia can lead to seizures, loss of consciousness, coma, or even be fatal.
Common Reasons for Insulin Overdose
Accidental insulin overdose often relates to errors in medication management. Incorrect dose measurement, such as misreading numbers on a syringe or insulin pen, is a common cause. Confusion between different types of insulin, like mistakenly taking rapid-acting instead of long-acting basal insulin, can also lead to an overdose.
Taking insulin without consuming enough carbohydrates or skipping a scheduled meal after injection can result in blood sugar dropping too low. Increased physical activity without adjusting the insulin dose is another factor, as exercise can enhance insulin sensitivity and lower blood sugar. Accidental double dosing also contributes to overdoses. Changes in insulin sensitivity due to illness or weight loss can affect how the body responds to a usual insulin dose.
Immediate Actions and Emergency Care
If mild to moderate hypoglycemia is suspected in a conscious person, prompt action can help restore blood sugar levels. Consume 15-20 grams of fast-acting carbohydrates. Examples include glucose tablets, half a cup of fruit juice or regular soda, or a tablespoon of honey.
After consuming fast-acting carbohydrates, blood sugar should be rechecked after 15 minutes. This is known as the “15-15 rule.” If blood sugar levels are still below 70 mg/dL, consume another 15-gram serving of carbohydrates and recheck blood sugar after 15 minutes. Repeat this process until blood sugar rises above 70 mg/dL.
For severe hypoglycemia, particularly if the person is unconscious or unable to swallow, immediate emergency medical attention is necessary. Call emergency services, such as 911. If available and prescribed, a glucagon injection should be administered by a caregiver; glucagon is a hormone that prompts the liver to release stored glucose. Glucagon can be given as an injection or a nasal powder.
Never give food or drink to an unconscious person, as this poses a choking hazard. After recovery, consuming a small snack containing complex carbohydrates can help stabilize blood sugar levels and prevent another drop.
Preventing Future Incidents
To minimize the risk of future insulin overdoses, careful and consistent management practices are needed. Always double-check insulin doses and measurements before injecting, especially when using a new product or if vision is impaired. Maintain consistent meal timings and carbohydrate intake, eating shortly after injecting insulin.
Regular monitoring of blood sugar levels, particularly before and after physical activity and before driving, is advised. Understanding the different types of insulin and their action times helps prevent errors. Always carry fast-acting carbohydrates, such as glucose tablets, for immediate treatment of unexpected blood sugar drops. Educating family and friends about hypoglycemia signs and emergency response is also helpful. Finally, regular consultations with healthcare providers are important for reviewing insulin doses and receiving ongoing education.