- With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Living with diabetes blog
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Feb. 11, 2011
Insulin safety
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
My husband and I recently went on a road trip to Arizona for our son's wedding, and our van broke down. Fortunately, there was a motel and repairman nearby. We settled in at the motel and went through the routine of getting ready for bed. My husband — who takes two types of insulin — suddenly said, "I feel like I'm going to pass out." I immediately went into "nurse mode" and checked his pulse.
Next, I glanced at the bedside table and saw a bottle of NovoLog insulin and a used syringe. I picked up the vial and asked if he'd just given himself that insulin, and he said he had. I realized he'd accidentally given himself NovoLog — his rapid-acting insulin — instead of Lantus — the slowly released insulin. We tested his blood sugar and it was 40 mg/dl (2.2 mmol/L). We spent the next 4 hours giving him simple carbohydrates and testing his blood sugar every 10 to 15 minutes.
For many people with diabetes, injecting two types of insulin is a daily requirement. As diabetes educators, we suspect that taking the wrong insulin happens more often than is reported. Giving yourself your injections can become so much a part of your routine that you can do it without thinking — which can lead to errors. My husband learned this lesson about insulin safety the hard way. He was distracted, thinking about the van repairs we needed to get back on the road.
To increase insulin safety and avoid taking the wrong insulin:
- Pause, and double-check that you're taking the correct insulin.
- Use a syringe for your long-acting insulin and an insulin pen for your short-acting insulin.
- Label insulin vials or pens with different-colored tape, so that you can differentiate between them. For example, use red tape for short-acting insulin and yellow tape for long-acting insulin.
If you accidentally give yourself the wrong insulin:
- Call 911 or your local emergency number.
- Test your blood sugar frequently until help arrives. Eat or drink a fast-acting carbohydrate to maintain a blood sugar within your goal range.
In preparation for such issues, it's a good idea to:
- Always carry a simple sugar source with you, such as glucose tablets, juice, regular soda or hard candy.
- Wear a diabetes medical I.D. bracelet.
- Carry a glucagon kit.
We'd love to hear from readers who've had similar insulin safety experiences.
Peggy
9 comments posted
November 8, 2012 2:55 p.m.
To Yvonne, I'd like to mention that not everyone can afford the insulin pens.....and not all insurance covers them.....and not everybody has insurance......and not everybody that HAS insurance has GOOD insurance. It's a big expensive diabetes world out there! The pens are available everywhere -- but extremely costly!
- Linda
November 8, 2012 2:48 p.m.
I just did that very thing this week, making supper afte a 13-hr work day.....got distracte.....grabbed my Novolog pen & dialed up 45 units and injected! When my symptoms told me what I'd done, I called my Dr. She gave me the same instrux that you give in your article. What a scary episode! The Dr said it happens a lot...is easy to do...and not to feel stupid about it. She said it was right to call for help instead of being too embarrassed. My Lantus pen is gray & my Novolog pen is orange -- but I'm now keeping them on opposite sides of the fridge. Take good care of yourselves, everybody!
- Linda
March 9, 2011 3:43 a.m.
You still use insulin in vials in America ? We in "the old world" are more progressive with insulin pens who are color coded : )
- Yvonne
March 6, 2011 10:58 a.m.
I am a type one diabetic who has been on 70/30 humalog novolog latus asprits and regular. Insulin pumps shots pills. we have tried everything and one way or the other i over bolos. Trial and error is everything.
- beth
February 20, 2011 11:15 a.m.
This is interesting. I take Humalog before meals + prn. It comes in a gray pen. I take Lantus Solostar, 22 units at night, which comes in a darker gray pen. I slipped up once and took the Humalog at night. I did panic a tad and called my pharmacy and TWO ERs. They all told me it was no big deal, have some fruit or juice and go to bed. What's up w/ that?
- Joyce
February 17, 2011 8:26 a.m.
Taking the wrong insulin is a scary situation. I take 6 units of Novalog before every meal and 22 units of Lantus at bedtime. Just once I took the wrong insulin at bedtime. That is a lot of Novalog. I woke up in the night sweating and shaky. I knew at once what had happened. I live alone. I keep a bottle of regular soda in my refrigerator and got to the fridge and took a good drink of that, then I took my blood sugar and 50 is really low for me. I knew it would go on down so again took my blood sugars at regular intervals. Now I keep my day time insulin in one part of my fridge and my night time insulin in another. I check every time before I pull the insulin out to be sure I have the correct one. I try to relax before every injection to be sure I am not distracted. Pat from Iowa
- No name given
February 16, 2011 10:37 p.m.
Hi there from the land downunder Australia. I too take both types of insulin, however we can purchase different coloured pens, the Lantus being Grey, my rapid is in a red pen, so no problems getting them mixed up and taking one instead of the other. however i find that sometimes I can't remember if I've already had the night time Lantus or not, so I take it at the same time every night, and keep,it in a certain place before injecting , then once done I store it back where it is usually kept when not needed! hope this kin of routine may be of some assistance to your husband in preventing the occurence of Hypos. All the very best to you and yours
- Monica
February 15, 2011 8:09 p.m.
I have done the same thing - taking the NovoRapid instead of Levemir. It is a dilemma that takes some quick thinking. I have also done it more than once. I never did come up with a solution other than my husband hovering while I do my insulin. He is my 'nurse', my second monitor, and my life line so often. Thqank you for being a caregiver to your husband.
- Kay
February 15, 2011 12:27 p.m.
I've been on the pump for 8 years now - it's been awhile since I was taking Lantas and Humalog. When I was using syringes, I was taking 11 units of Lantas 2x per day. I think I only injected the Humalog by mistake once, and it was scary. 11 units of Humalog is ALOT. Fortunately, I realized right away what I had done, and spent the next two hours eating and testing. No trip to the ER that time. I do sometimes over-bolus with my pump, but it is much less extreme.
- Carl
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