When you take too much insulin...

[viranth]

so lately I've had a bad habit of taking too much insulin. Mostly because I take less throughout the day. I think it's the exercise and weightlifting.

Anyway, what do you do when you take too much?

This happened today:

I took 40g of carbs in a shake after gym, set 4IE of novorapid as I drank the shake.

I get home and eat sammon and potatoes. Set 3 IE novorapid for that one. Normally I would be stable, but now I drop.

So I check BG 30 minutes or so later, and it's dropped down to 4.8.

Do I take something to drink to get it back up? Do I have to take another novorapid for what I drink then? Or is that covered by the fact that I took too much insulin?

It's hard these days, since it changed every day. Some days I take a little more, some days I take very little (19 IE is my all time low).

[thomasb]

Remember that you will probably have active insulin onboard after that shake as well, might mess up the lunch dose if you don't count it in...

i go low sometimes after the gym and lunch. I found that taking insulin after the workout was tricky, so now i am basically eating just enough carbs to recover after workout, but not enough to take insulin. i am still honeymooning though. If i'm at 4.8 after lunch and gym, i'll just eat something to get me back up, and not bolus for that. I just risk stacking otherwise.

[morrisma]

Viranth,
Given a choice of going low or going high, I almost always prefer high because the risk of a bad low is so severe. I would start by cutting the insulin you use on workout days by enough to insure that you wont go low and slowly, by repeating the same carb intake and workout regimen, add more insulin until you can be more confident in the amounts required to keep you normal.
High bgs will hurt you in the long run but lows can hurt you right away.
Mike

[UpNorth]

If you have taken too much insulin and go low, then just eat or drink something sweet to get your bloodsugar up to a more comfortable level. You don't need to take insulin when you fix a low, unless you overcompensate the low bloodsugar and go too high. But just test and see, and don't take insulin to cover carbs you take to treat a low bloodsugar :) If injecting to cover those carbs, you might aswell skip them since you'll want your bloodsugar to go UP and not be at the same low level.

[Alice]

I really like glucose tabs for these adjustments...you can eat just a couple...or a handful for severe emergencies...in that case, I chase them with a Coke. But, they are fast and good for corrections.

I avoided glucose tabs for years...they really are easy. I buy the big bottles but keep refilling the small "tubes" for carrying around with me.

I used to buy the foil wrapped tabs, but they are more expensive and the foil always tore in my purse.

[viranth]

I have the glucose tabs, but I figured they will destroy my teeth if I use them often.

I correcte my "low" insulin (4.8) with a glass of apple juice (natural, no sugar added) and a glass of milk.

Been feeling off all day, so that might have made it worse. A few hours later I ate a meal and felt somewhat fine.

I'm either about to get sick, or just because I've been working out hard this week.

[UpNorth]

It's not needed to chew the glucose tabs :) I normally just suck on them for a while before chewing them, then they're softer. And if you worry about it being so sweet for the teeth, just take a chewing gum which is good for your teeth :)

[TenderVittleS]

I always carry a 1 or 2 juice boxes with me wherever I go, they work really well for me and they are fairly cheap. Juice is good!:)

[JJM335]

Viranth:

In addition to the immediate exercise-induced drop in BG you will probably experience a longer term effect. I assume that you are using either Levemir or Lantus as a long acting insulin. It may be that if you are exercising on a regular basis you need less basal.

My experience (and everyone is different), is that if I stick to a regular exercise programme, I need at least 20% less Lantus. The effect on my I:C ratio is much less signficant.

Joel

[thomasb]

oh and another note, the pump(and no, not the one arnold get's) is really good for working out, it made a huge difference for me. Just a thought.

[Eddy]

So I check BG 30 minutes or so later, and it's dropped down to 4.8.


Is that comfortable for you? Everyone is different... but I don't worry too much about 4.8. Sometimes I'll leave that be.

You might try this:

Make notes of how you feel _before_ testing BG. Jot down _why_ you're checking BG. You should start to find a pattern about what works best.

For example:

5.0 = I feel my best
4.5 = usually correct upward
4.0 = always correct upward
3.5 = use fast-acting stuff (soda with high-fructose corn syrup)
3.0 = feel really crummy
2.5 = have to lie down
2.0 = call someone, ask that they come (or at least call back in 15-20 minutes), and seriously think about glucagon!
1.5 = use the glucagon (although I've hit this low a few times, but pulled out without glucagon... so far)

Going the other way:

5.5 = I'm happy
6.0 = I wait before correcting
6.5 = I wait if I have IOB, but otherwise correct
7.0 = I start feeling crummy and "cloud-headed"
7.5 = definitely feeling bad
8.0 = yucky, yucky, yucky

Also consider testing siblings, parents, children, or other genetically-similar people to see what's "normal" in your family.

[Olidus]

I always carry a 1 or 2 juice boxes with me wherever I go, they work really well for me and they are fairly cheap. Juice is good!:)

HERE HERE!
I do the same thing - I have Juice boxes hidden all over the place as a "JUST INCASE" situation, I find they help really good.

[Eddy]

I always carry a 1 or 2 juice boxes with me wherever I go, they work really well for me and they are fairly cheap. Juice is good!:)


Good call.

I carry (in a little bag): 8 oz. can 7Up, 6 oz. can pineapple juice, and 2x 125 mL Juicy Juice. All told, ~ 80 grams of sugar at the ready. In case that's not enough, I also have a couple glucagon shots along.

I was in a checkout line the other day. When I opened my kit (I keep money/CC in with glucometer), the cashier said, "That's quite a little survival kit you have there." I guess a glucometer, couple doses of glucagon, four types of insulin, and plenty of juice counts as a survival kit. ;)

[Cyborg]

I used to treat my lows with orange juice, but ended up roller coasting too much. Now I treat my lows with glucose tabs. Glucose is much faster at raising bg than food or drink. Knowing my BG:Carb ratio makes it very easy to determine how many glucose tabs are needed.

[silverfrost]

I use either glucose tabs or lifesaver gummies. The gummies are super easy to store, and I only have to take 2-3 of them to correct... and they're fast!

[owlyn]

I go, "Oh darn, I guess I'll have to eat some dark chocolate M&Ms or a Milky Way or something. Drat it all."

[silverfrost]

I go, "Oh darn, I guess I'll have to eat some dark chocolate M&Ms or a Milky Way or something. Drat it all."

lol! It is quite a shame!

[Moveforward]

Viranth, this has always happened to me after hard workouts UNTIL I realized and acted upon the fact that my insulin sensitivity goes up and my BS go low.

I take Novolog for quick acting and the ratio is this (for me):
50mg/DL / 15 Grams of Carbs / 1 unit

I guess Im lucky to have a simple ratio like that BUT! THAT RATIO CHANGES DRAMATICALLY AFTER HARD WORK OUT.

To fix my Low BS I drink gatorade. Yeah, other fruit juices would be better but I know if ...say... My bs is 60 and I drink 15 carbs my sugar goes up 50. Hence my ratio 50/15/1

Again though Everything changes after a hard session
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-MoveForward