Insulin, a hormone from the pancreas, is responsible for the uptake of glucose in the bloodstream to either muscle or fat tissue. When the body is unable to naturally regulate proper levels of glucose in the bloodstream, you may require exogenous insulin to maintain normal blood sugar levels. Insulin is a difficult medication to correctly dose. Patients may accidentally overdose if they misjudge the amount required, take in an excess of alcohol, skip eating after administration or perform excessive activity without replacing calories.
Signs and Symptoms
The signs and symptoms of insulin overdose are caused by hypoglycemia. You may experience agitation, confusion, tachycardia, blurred vision and sweating. In more severe cases, you may experience difficulty speaking, seizures, loss of consciousness, coma or death. It is important to note that these manifestations may not be present in patients who are taking beta-blocking medications, making the diagnosis more difficult.
Diagnosis
Diagnosis of insulin overdose requires awareness of the signs and symptoms. Once they are noticed, take your blood glucose levels. Many health practitioners also check serum magnesium, potassium and sodium, as electrolyte levels may be disturbed. A c-peptide level can be useful to determine whether the insulin overdose is due to excess administration of medication or excess endogenous release.
Treatment
Patients on insulin therapy should carry glucose tablets or juice to reverse mild symptoms. You can also carry an emergency glucagon kit in the event of an overdose. Insulin overdose can be a medical emergency. Patients who are not showing any signs or symptoms should still go to the hospital for observation if an overdose is possible. For those who are experiencing symptoms, management is largely supportive -- maintenance of breathing, fluids and cardiac activity -- followed by treatment of hypoglycemia with glucose. Blood glucose levels should be taken every two hours.
Summary
Insulin overdose is not an uncommon occurrence. Many patients taking insulin therapy should be aware of their unique signs and symptoms of hypoglycemia. All patients should carry a source of glucose or a glucagon injection to rapidly reverse symptoms. In the event of insulin overdose, you should consult with your physician to discuss management strategies to prevent such situations.
