Do you carry glucose tabs with you at all times? 

Do you have a glucogon kit for emergencies? 

Does anyone besides you know how to use it?

A really bad day...

This morning I took my Lantus as usual, but about an hour later I was shaking severely, nauseated, and my heart was pounding like crazy. I could barely speak, and it was hard to think. There's no way I would have been able to walk to another room to get help. 

I checked my blood sugar, which wasn't easy because the shakes were so severe. My blood sugar was 3.0 and dropping fast!  (54 in US scale). Yes I was in insulin shock. 

No idea why it happened except that I must have hit a vein. I didn't see any blood, and there was no vein visible where I injected, but I can't think of any other explanation. I must have nicked something. It was not a new cartridge and I dialed up the right dose.

I didn't accidentally inject my mealtime insulin (that pen records the dose and time, and it hadn't been used since yesterday). So not the wrong insulin.

I didn't inject too much. Just the usual dose in the usual area and suddenly I'm in big trouble.

Fortunately my husband was there and got my glucose tablets out, and helped me get my meter out. I couldn't even open the kit.

I also had him get out my glucogon kit, just in case. I really thought he was going to have to use it this time, it was so bad and so sudden. The glucose tablets just weren't working fast enough.

Insulin shock is nasty. I survived another day, but its still rough. It usually takes me 3 or 4 days to get over this type of thing. I felt NO symptoms until it was severe, no warning at all. If my blood sugar goes down from getting a little too much mealtime insulin, it usually happens slowly and I can feel it coming on and test and treat it. Not this time.  I was suddenly so weak and confused that I couldn't manage the stupid zipper on the kit. I needed assistance.

Normally 1 glucose tablet will bring my blood sugar up enough, but this time I had to keep forcing them down, it took about 12 to 14 tablets, plus a glass of Tang, (I keep Tang powder on hand just for emergencies in case I can't keep the tablets down). 

I didn't take any insulin until late today for supper, and believe me, I was very reluctant to use it. 

If you use insulin PLEASE keep Dex4 tabs on hand at all times. Have at least one large bottle, and make sure its already been opened because at times like this you won't have the strength to get it opened. I keep them in the kitchen, beside my bed, and in the living room beside my chair. If I hadn't been prepared, I'd probably be dead now. My husband wouldn't have been able to hunt them down in time. 

Fortunately I was prepared. 

I'm going to be getting some liquid glucose, and gel too, the dry tablets keep well, but in this type of emergency they're too hard to chew and swallow. 

Please get yourself some glucose tabs, plus gel or liquid,  and a glucogon kit too, someday it may save your life. 

If you need a quick increase in glucose, glucose tablets are the best option, however, in an emergency, if you are not prepared, you can use Lifesaver candies, or orange juice, or regular pop (NOT the sugar free kind!). You can even eat regular table sugar, but its a lot easier to use glucose tablets, and if you carry them, you'll know you're always prepared. 

When you get a glucogon kit make sure someone knows how to use the kit, besides yourself! 

PS. I 've heard that some of the tube icing for cake decorating is made from glucose. I'm going to be checking that out, because I'm sure it would be a lot cheaper than the glucose gel tubes at the pharmacy. Look for icing that has a peel away tab after you unscrew the cap. Some require using a pair of scissors to snip off the end of the tube. This is not something you need to worry about in an emergency! Either way, I'm going to have at least 2 gel tubes in each location, just in case, in addition to the tablets. 

New Mini-Dose Glucagon kit coming soon!  

http://www.diabetesdaily.com/blog/2014/12/update-mini-dose-glucagon-coming-soon/

Standard treatment for Low Blood Sugar   http://www.diabetesnet.com/diabetes-control/low-blood-sugars/treatment

Update: I did hit a vein, I developed had a huge bruise where I did that injection, lots of bleeding under the skin, and it has not cleared up yet (it's been over a month). 

Keeping Insulin Safe During a Heat Wave

Sometimes when you are traveling or even at home or work, your insulin will be subjected to temperature extremes, including freezing, or heat wave temperatures. Since insulin is very sensitive to temperature changes, it needs to be protected.

If you are just going for a short trip during the winter, then the safest place to keep your insulin is inside its case, on the inside of your coat. As long as you don't get overheated, your body temperature will keep your insulin warm enough. However, don't have it too close, or the temperature can get too warm for it. If you'll be in a heated car, not outside, then keeping it in your usual bag or pocket might be warm enough. Just don't store it right next to a heat source. Its a good idea to have some kind of insulin around insulin in any extremes to keep it from getting too warm or too cold so pack it in some sort of insulated pack or bag whenever the temperatures might go outside optimum ranges. Insulin can be very expensive, plus you don't want to be without a vital medication when you need it. Planning is essential.

For summertime, you should check the temperature range that is safe and have a plan for keeping your insulin in use cool during heat waves. You can store your supply in the fridge (as long as your fridge doesn't freeze things). However, for your insulin pen in current use, you need something portable, so read on.

One word about ice. NEVER use ice directly next to your insulin. It WILL freeze enough to make it useless. If you plan to pack your insulin in a cooler with your lunch, make sure your insulin is as far away from the ice pack as possible to avoid freezing it. I wrap a clean kitchen towel around my pen case. I put the ice on the other side of the cooler, as far from the insulin as possible. The towel keeps the insulin pen case where I put it, and protects it if it should shift in transport.

Once you open it, insulin is fine at average room temperatures, however, if its hot enough to use an air conditioner, then you probably need to take precautions about the heat. All insulin packaging comes with an insert that tells you the safe temperature range for your product. Always check the recommendations in the insert.

If you'll be traveling, or live where there are heat waves during the summer, I strongly advise you to get a FRIO wallet for your insulin.

Frio uses water evaporation to keep insulin and other temperature sensitive medications at a cool temperature without risk of freezing during a heat wave, without relying on any type of refrigeration. The wallets are small enough to carry with you, and you can also get larger ones for supplies needed over an extended period such as a vacation.

Frio can be used anywhere that you have access to clean water, its very portable, and simple to use, and you can even get one for a pump if you have one.

I've been using water evaporation to keep my insulin pens protected during heat waves for several years now, and have never had a problem. Frio is a reliable product and the concept is simple and effective.

I highly recommend it!

Here's the link: http://www.frioinsulincoolingcase.com/

I have no association with Frio, other than being a happy customer.

Freezing: As far as I know, the simplest way to tell if insulin has frozen, is to look for changes in appearance. It might have become cloudy or have particles in it that are not normally present. There might be a crack in the cartridge. If there are no observable changes, I test my insulin by using it. If it doesn't bring my  blood sugar down as it normally would, then it has indeed been frozen. The same applies to extreme heat. It renders insulin useless. I don't know of any other way to test insulin other than sending it back to the company.

I once sent insulin to the company to be tested, and it was fine, but instead of returning it, they threw it out! There goes my money! So now I just test by using it. This is how I test it, its up to you to decide if you want to do this or not. Consult your doctor first or call the company and follow their advice.

This blog is for entertainment purposes only. Always follow the advice of your doctor or diabetes nurse educator, or your endo.