Over injecting insulin

[Jimmy2202]

Hi guys. Hope everyone’s managing well.
A couple of times when I’ve over injected I drop low but don’t feel it like I usually would when dropping low naturally.

This afternoon my wonderful mother made myself and my little family a roast. I injected to much clearly as a Libre check about half hour after was 3.3 followed by a finger prick of 2.2!

I’ve never been that low. But I didn’t feel it which is odd. Is this because the insulin is bringing me down much quicker than usual?

Thank god for apple juice and jelly babies 🙂

 

[rebrascora]

I find roast dinners can be tricky and I often have to split bolus them otherwise I will go low and then high later.

As regards not feeling the hypo, did your Libre show a very dramatic drop or a gentle drift downwards? What was your premeal reading? I usually find that a sudden and dramatic nose dive will trigger hypo awareness earlier but a gentle downward drift can be harder to detect. Also what you are doing at the time can impact how/when you are likely to feel it. So if you are sitting at the table eating or sitting chatting or watching the TV afterwards it might not be so obvious as if you were up washing the dishes or out for a walk. I also wonder if the body, being aware that food is in the system, is less likely to have a severe response. We know that eating shuts down the liver from releasing glucose and I wonder if this might also reduce the adrenaline release caused by a hypo.
Did you get any of the nasty shaking etc after you treated it or was there no hypo effect at all?

 

[Lucyr]

Do you drive? If you are going that low with no symptoms then you need to inform the DVLA and stop driving, as you’ll likely lose your licence. Running higher for a time can help to bring back the symptoms when you drop low.

 

[Jimmy2202]

Do you drive? If you are going that low with no symptoms then you need to inform the DVLA and stop driving, as you’ll likely lose your licence. Running higher for a time can help to bring back the symptoms when you drop low.

If you read the post it clearly says that I do get signals normally, but I’m specifically only referring to a couple of occasions when I’ve injected to much insulin for the amount of carbs.

 

[Lucyr]

If you read the post it clearly says that I do get signals normally, but I’m specifically only referring to a couple of occasions when I’ve injected to much insulin for the amount of carbs.

It doesn’t matter the cause, if you’re getting hypos and especially down to 2.2 whilst awake without symptoms then it shows you’re losing hypo awareness and you must report it and work on regaining symptoms. If it had happened whilst driving you could have caused a fatality.

 

[helli]

@Lucyr I disagree about reporting a couple of cases of hypos without symptoms to DVLA.
We do not crash a car as soon as our levels drop below 4.
As @Jimmy2202 says this is very rare for him and he usually has good hypo awareness.
Running his target range higher for a couple of weeks could be a good idea. As is a bit more roast dinner dosing practice.

 

[rebrascora]

My view is that there are very odd occasions when you don't get hypo signs until you are quite low. As with all things diabetes, there will be a number of things which affect this and I don't think it means you are losing your hypo awareness, it's just an anomaly.
To me, loss of hypo awareness is a more clear pattern and patterns are what we look for with diabetes. What I mean is that sometimes I will detect a hypo coming at 4.2 or even 4.5 but very occasionally I might be down as low as 2.9, but my next hypo might alert me at 4.1 and as long as the majority of my hypos are detected in high 3s or low 4s I consider that I have good hypo awareness but it isn't the same number every time that I get signs. I accept that 2.2 is alarmingly low and I am sure it gave Jimmy quite a shock to see it which is why I am curious about the circumstances and if he felt anything after treating it, as sometimes I feel worse after treating a hypo than I did before. However, unless it starts happening more frequently, then I don't think it signifies a loss of hypo awareness and we have to remember that there is an error level in measuring, so the 2.2 may have been erroneous and not something one should consider potentially losing your licence over. Always a good plan to run levels a little higher after such an event though, so that you are doing your utmost to prevent loss of hypo awareness.

 

[rayray119]

Hi guys. Hope everyone’s managing well.
A couple of times when I’ve over injected I drop low but don’t feel it like I usually would when dropping low naturally.

This afternoon my wonderful mother made myself and my little family a roast. I injected to much clearly as a Libre check about half hour after was 3.3 followed by a finger prick of 2.2!

I’ve never been that low. But I didn’t feel it which is odd. Is this because the insulin is bringing me down much quicker than usual?

Thank god for apple juice and jelly babies 🙂

Is one of your symptoms getting hot and is one of your symptoms getting hot by any chance?

 

[nonethewiser]

As long as you caught it & treated it on your own without third party then its no big deal IMHO, had this happen once whilst eating & treated it with coke & didn't think twice that my hypo symptoms had gone as I know they hadn't, if it were regular occurance than that is different matter & dvla would need to be informed.

 

[Jimmy2202]

My view is that there are very odd occasions when you don't get hypo signs until you are quite low. As with all things diabetes, there will be a number of things which affect this and I don't think it means you are losing your hypo awareness, it's just an anomaly.
To me, loss of hypo awareness is a more clear pattern and patterns are what we look for with diabetes. What I mean is that sometimes I will detect a hypo coming at 4.2 or even 4.5 but very occasionally I might be down as low as 2.9, but my next hypo might alert me at 4.1 and as long as the majority of my hypos are detected in high 3s or low 4s I consider that I have good hypo awareness but it isn't the same number every time that I get signs. I accept that 2.2 is alarmingly low and I am sure it gave Jimmy quite a shock to see it which is why I am curious about the circumstances and if he felt anything after treating it, as sometimes I feel worse after treating a hypo than I did before. However, unless it starts happening more frequently, then I don't think it signifies a loss of hypo awareness and we have to remember that there is an error level in measuring, so the 2.2 may have been erroneous and not something one should consider potentially losing your licence over. Always a good plan to run levels a little higher after such an event though, so that you are doing your utmost to prevent loss of hypo awareness.

I’ve just checked my Libre and at the time of the 3.3 reading the arrow was horizontal.
As for afterwards, once I had treated the hypo I go into panic mode all the time - I get in my head my levels are not going to come back up, which I know is crazy but I tend to think the worst during those 15 minutes waiting. Admittedly I did check after 10 minutes on this occasion due to being so low.
This experience has taught me to stop guessing carb contents of meals (even when at someone else’s house)

That was yesterday and todays a new day, and just enjoyed a lovely fry up at home. Marvellous 🙂

 

[rebrascora]

Is one of your symptoms getting hot and is one of your symptoms getting hot by any chance?

I sometimes find that being too hot causes me to hypo..... at least I think it is that way around and not the hypo causing me to feel hot. Usually it happens when I am working on a manual task with too many clothes on.... Like mucking out the horses with too many layers on or trimming their feet and rather than stopping to take a layer off I crack on trying to get the job finished and then suddenly find I am hypo. It happens a lot at this time of year when I am in between summer and winter wear and one day is cooler and another day warmer.

@rayray119 I was thinking about you with this post and that time you were concerned that you had lost your hypo awareness because you were low 3s when you tested before dinner and didn't feel it. I think it is quite a grey area for people to come to terms with and @Lucyr clearly has a much more "black and white" interpretation of hypo awareness (and loss of it) than others, myself included. I am not sure there is a clear answer and we all have to find a judgement on it that we are personally comfortable with, but be careful that we don't impose that judgement on others. As with everything diabetes, it is about finding a personal balance.

 

[rebrascora]

I’ve just checked my Libre and at the time of the 3.3 reading the arrow was horizontal.
As for afterwards, once I had treated the hypo I go into panic mode all the time - I get in my head my levels are not going to come back up, which I know is crazy but I tend to think the worst during those 15 minutes waiting. Admittedly I did check after 10 minutes on this occasion due to being so low.
This experience has taught me to stop guessing carb contents of meals (even when at someone else’s house)

That was yesterday and todays a new day, and just enjoyed a lovely fry up at home. Marvellous 🙂

It sounds like it might have been a slow drift downwards and it may be that you got a rogue test strip which read low. It is even possible that you weren't hypo at all as Libre often reads lower than you actually are.

There are times when you have to guestimate carbs and carb counting isn't an exact science anyway, so don't let this experience put you off, but I think a strategy of under estimation in that situation and then correcting a couple of hours later may be better than having the full amount that you estimate up front, particularly with a roast dinner which can be slow to release.
I have found that I follow a strategy called "sugar surfing" where I rarely carb count (being low carb makes that easier) but use the data from my Libre to nudge my levels one way or another to keep them in range. I usually give a meal 2-3 units up front and then do minor correction(s) later within the active insulin period (ie 1-4 hours later) to keep levels from going too high..... or have a small carb snack of 3-8g to keep out of the red. I find this technique takes a lot of the mental strain out of my diabetes management and I just concentrate on keeping my levels between 3.9 and 10. It takes a bit of practice but once you get the hang of it, it becomes more like a game than a constant health management issue. I am not sure it is for everyone but if Libre works well for you, then that certainly facilitates this type of management.

 

[Jacen017]

Is one of your symptoms getting hot and is one of your symptoms getting hot by any chance?

Getting hot is definitely one of my warning signs. Usually happens right before the shakes start

 

[rayray119]

Getting hot is definitely one of my warning signs. Usually happens right before the shakes start

Yes that's a warning sign I get(I thinks it's hit and miss sometimes but I definitely caught myslef dropping the other night when I wasn't even hypo it was hot feeling in my face when I wasn't hot before that made me check it) hardly ideal in heat when you're hot anyway. Also heat makes tired and groggy (always has done) hypos make me tired and groggy (so do highs)

 

[rayray119]

Is one of your symptoms getting hot and is one of your symptoms getting hot by any chance?

This was supposed be asking @Jimmy2202 weather it was hot at the time and if getting hot was one of his symptoms

 

[Lucyr]

@rebrascora it isn’t that I have a black and white interpretation of the rules, but that the dvla themselves have a black and white rule. If you’re getting to 2.2 with no symptoms, even after testing, then your awareness is clearly impaired, as per screenshot from government site.

 

[grovesy]

Could it be you had differnt hypo symptoms than is normal for you, and did not recognise them as a hypo symptom?

 

[Jimmy2202]

@rebrascora it isn’t that I have a black and white interpretation of the rules, but that the dvla themselves have a black and white rule. If you’re getting to 2.2 with no symptoms, even after testing, then your awareness is clearly impaired, as per screenshot from government site.

Every single person on this forum, and every single diabetic will at some stage have a hypo without getting symptoms… i know that for a fact. (Even if some do not admit it)
Does that mean everyone must tell the dvla? No it was treated and normal play resumed.

 

[Jimmy2202]

Could it be you had differnt hypo symptoms than is normal for you, and did not recognise them as a hypo symptom?

Potentially… I had just ate a huge roast 🙂 zzzzzz

 

[rebrascora]

@rebrascora it isn’t that I have a black and white interpretation of the rules, but that the dvla themselves have a black and white rule. If you’re getting to 2.2 with no symptoms, even after testing, then your awareness is clearly impaired, as per screenshot from government site.

That of course assumes that on this one occasion Jimmy was in fact hypo and it is perfectly possible that the 2.2 was an erroneous reading. I had a strip gave me a 1.8 once which shocked the life out of me until I double checked it and then triple checked and in fact I wasn't hypo at all and it was clearly a rogue strip. I don't think you can assume anything about your hypo awareness or impairment of it from one incident. Meters are not accurate enough to make sweeping assessments from one reading in my opinion.