Insulin plays a crucial role as a therapeutic hormone for many individuals managing diabetes, facilitating proper sugar absorption by the body's cells. When administered correctly, insulin is a life-saving treatment. However, an insulin overdose can have fatal consequences.
In this post, we will explore the possible indicators of insulin overdose and the proactive measures individuals can take to prevent such occurrences.
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Insulin Overview - Diabetic Care
The pancreas releases insulin, a crucial hormone necessary for various bodily functions. Even at lower doses, insulin is continually released to support overall bodily functions, particularly in regulating muscle mass and weight. Following a meal, the pancreas releases insulin to facilitate the efficient transport of glucose from food into the body's cells.
Insulin is pivotal in activating a specialized glucose transporter, GLUT4, throughout the body. Without insulin, this activation doesn't occur, making it challenging for most sugars to transition from the bloodstream into the cells. This can lead to elevated blood sugar levels.
In Type 1 diabetes, individuals produce little to no insulin, requiring external insulin administration for survival. On the other hand, Type 2 diabetes involves increased insulin production but reduced responsiveness to its effects, necessitating higher levels of insulin.
Some individuals don't neatly fit into the Type 1 or Type 2 diabetes categories. Issues with insulin secretion or pancreas functionality may require varied insulin doses to manage blood sugar levels effectively.
Establishing the Appropriate Insulin Dosages
Insulin dosing is not a one-size-fits-all scenario, as the requirement for insulin varies among individuals, fluctuating from day to day and meal to meal. Additional factors, such as dietary choices, physical activity, medication intake, and specific health conditions, also contribute to this variability.
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Causes of Insulin Overdose
Unintentional Overdose
Accidental insulin overdose often occurs when an individual combines different types of insulin, such as using both longer-acting basal insulin and rapid-acting insulin during meals, inadvertently switching between insulin types. This practice can result in unintended overdose situations.
Another common cause of insulin overdose stems from a mismatch between the insulin dosage and the content of the meal. For example, if someone consistently administers 10 units of insulin for a meal containing around 60 grams of carbohydrates, consuming a lower-carb meal may result in an excessive insulin dose. Additionally, patients with higher basal insulin doses may unintentionally overdose if their daily intake is lower than usual, or if they experience symptoms like nausea, illness, or continuous vomiting.
Deliberate Overdose
Given that insulin is regarded as a potentially lethal substance, individuals, including family members of those with diabetes, may resort to intentional overdoses. In the event of a suspected deliberate insulin overdose resulting in low blood sugar levels, the individual must undergo a comprehensive psychiatric evaluation as an urgent measure.
Signs of Insulin Overdose
Symptoms of an insulin overdose depend on the extent to which blood sugar levels decrease. Typically, signs begin to manifest when blood sugar falls below 70 mg/dl in individuals with Diabetic Care. However, some individuals may experience symptoms even at higher blood sugar levels.
When blood glucose reaches 70 mg/dl in a person with diabetes, the body initiates defensive mechanisms to prevent further decline. The following symptoms may occur:
Elevated Synthesis of Glucagon
The body's initial response to low blood sugar involves the release of a substance from the pancreas known as glucagon. This hormone counteracts the effects of insulin, prompting the liver to produce more sugar for utilization in the body.
Elevated levels of adrenaline and cortisol
The body's glucagon reserves are typically insufficient to counteract the circulating insulin levels. In addition to mobilizing glucagon, the body also activates defense mechanisms involving steroid hormones like cortisol and adrenaline. This amplifies adrenaline circulation, leading to symptoms associated with insulin overdose, including:
- Trembling hands
- Increased perspiration and warmth
- Feelings of anxiety, palpitations, and nervousness
- Behavioral changes, such as talkativeness and rapid speech
- Heightened hunger and a noticeable search for food
Symptoms are generally mild when blood sugar levels range from above 50 to less than 70. However, if blood sugar levels drop below 50 or fall to less than 40 mg/dl, individuals with diabetes may experience more severe symptoms, including:
- Heightened confusion
- Loss of consciousness or lethargy
- Increased seizures
- Coma
Managing an Insulin Overdose
Addressing emergencies during an insulin overdose is contingent upon the patient's state of consciousness.
When the individual is conscious
If the patient is conscious or able to interact, the recommended initial treatment for this condition involves consuming a quickly absorbed sugary substance, such as orange juice, apple juice, or a soda. Positive changes can be observed within approximately ten to fifteen minutes by consuming as little as 4 ounces every five minutes, and progress can be monitored through fingerstick blood glucose levels. The duration of hypoglycemia depends on the type of insulin responsible for the overdose, as each insulin variant has distinct peak activity times and overall durations within the body.
When an individual is disoriented or unconscious
If the patient is unconscious or confused, consuming juice may prove challenging. In such cases, emergency treatment involves the use of glucagon. As mentioned, glucagon is the hormone produced by the body that counteracts the action of insulin. Currently, glucagon is administered through injection, but an inhaled formulation of glucagon is also available. In instances where the patient is unconscious, the mist of glucagon is sprayed on the nose, allowing them to inhale it for treatment.
Final Reflections
The most effective method to prevent insulin overdose is to exercise caution in administering insulin doses. It is crucial to initiate vigilant monitoring of blood sugar levels while using insulin. If a consistent pattern of low blood sugar emerges, it is important to consult with your doctor to consider reducing the insulin dosage.
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