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Thread: HELP!! DH gave son 26 units instead of 2.6

  1. Default HELP!! DH gave son 26 units instead of 2.6

    Please help -- anyone. My son was over 400 for awhile due to an unbolused dinner with my parents tonight (had some lows and pump wouldn't take it). My DH tested ketones (0.0) and changed site. Gave a shot to cover the high and misread the syringe (!!!!!) and gave him 26 units Novolog instead of 2.6. Only realized this about 30 mins ago after giving a number of juice boxes. Called the after hours line and they said give glucagon via syringe and see what happens. He's back up to 125 just now 15 mins later. But 26 UNITS -- am totally scared. What would you do?? Go directly to hospital? I want to but nurse on call said wait.
    Kate, mom to:
    Andrew, age 10, dx'd 4/8/10, PINGing since 12/10, Dexcom G4 since 4/7/13
    Henry, age 8, non-d (cough-variant asthma)

  2. #2

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    You need to "cover" that many grams of carbs. If his I:C ration is 1:10 by example you need to cover 260g of carbs and get there before the insulin peaks. Depending on his carb ratio and insulin sensitivity that may actually be a much higher #.

    Personally if glucagon has already been given and he's only 125 I would probably want help but if you are already past insulin peak time and you think you can get a ton of fast carbs into him then you may be able to manage alone.

    Sorry to be vague, it's a tricky situation.
    Sarah
    Mom to DD now 16, dx @4
    Cozmo pumper @6
    Minimed pumper @13
    G4 @ 15


    "Happy Birthday, Dr. Banting! Now... let's eat cake! Because, we CAN!" - MCS

  3. #3

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    Quote Originally Posted by Sarah Maddie's Mom View Post
    You need to "cover" that many grams of carbs. If his I:C ration is 1:10 by example you need to cover 260g of carbs and get there before the insulin peaks. Depending on his carb ratio and insulin sensitivity that may actually be a much higher #.

    Personally if glucagon has already been given and he's only 125 I would probably want help but if you are already past insulin peak time and you think you can get a ton of fast carbs into him then you may be able to manage alone.

    Sorry to be vague, it's a tricky situation.
    All good advice. Keep the carbs coming, be ready to get more help if needed, and good luck!
    Caroline

    K, 2008, dx 2010-12-02 - blue MM Revel with blue Dexcom G4
    E, 2010
    W, 2013

  4. Default

    Quote Originally Posted by Sarah Maddie's Mom View Post
    You need to "cover" that many grams of carbs. If his I:C ration is 1:10 by example you need to cover 260g of carbs and get there before the insulin peaks. Depending on his carb ratio and insulin sensitivity that may actually be a much higher #.

    Personally if glucagon has already been given and he's only 125 I would probably want help but if you are already past insulin peak time and you think you can get a ton of fast carbs into him then you may be able to manage alone.

    Sorry to be vague, it's a tricky situation.
    Thank you for your reply! His I:C is 1:12, so that means 312 carbs. Yikes. We probably gave him 70 carbs via juice box and sour patch kids before he fell asleep. Insulin was given @ 9:30pm ET so we are past the peak. And about half an hour ago I gave him 15 units glucagon via SC syringe. He's 162 and slight arrow up now on Dexcom (and blood test 15 mins ago showed G4 and blood meter very close in accuracy). Does the glucagon make up for some of the fast-acting carbs? Since past peak, are we okay? Sleeping next to DS now.
    Kate, mom to:
    Andrew, age 10, dx'd 4/8/10, PINGing since 12/10, Dexcom G4 since 4/7/13
    Henry, age 8, non-d (cough-variant asthma)

  5. Default

    Quote Originally Posted by cdninct View Post
    All good advice. Keep the carbs coming, be ready to get more help if needed, and good luck!

    Thank you! Dexcom dipping down again and can get no more fast-acting carbs into him. Getting ready to go to hospital.
    Kate, mom to:
    Andrew, age 10, dx'd 4/8/10, PINGing since 12/10, Dexcom G4 since 4/7/13
    Henry, age 8, non-d (cough-variant asthma)

  6. #6

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    Quote Originally Posted by momof1CWDinohio View Post
    Thank you for your reply! His I:C is 1:12, so that means 312 carbs. Yikes. We probably gave him 70 carbs via juice box and sour patch kids before he fell asleep. Insulin was given @ 9:30pm ET so we are past the peak. And about half an hour ago I gave him 15 units glucagon via SC syringe. He's 162 and slight arrow up now on Dexcom (and blood test 15 mins ago showed G4 and blood meter very close in accuracy). Does the glucagon make up for some of the fast-acting carbs? Since past peak, are we okay? Sleeping next to DS now.
    Glucagon raises bg by forcing the liver to dump it's stored glucose into the blood stream. That raises bg but it is the bodies "last" resort and if he were to go low in the near future he would no longer have that emergency supply.

    So since he was high and you got carbs and glucagon into him and it's been 4 hrs you are likely in the clear. I'd keep a very close eye still and personally I wouldn't correct anything until morning even if he gets quite high from the glucagon.

    Glad it worked out
    Sarah
    Mom to DD now 16, dx @4
    Cozmo pumper @6
    Minimed pumper @13
    G4 @ 15


    "Happy Birthday, Dr. Banting! Now... let's eat cake! Because, we CAN!" - MCS

  7. Default

    Quote Originally Posted by Sarah Maddie's Mom View Post
    Glucagon raises bg by forcing the liver to dump it's stored glucose into the blood stream. That raises bg but it is the bodies "last" resort and if he were to go low in the near future he would no longer have that emergency supply.

    So since he was high and you got carbs and glucagon into him and it's been 4 hrs you are likely in the clear. I'd keep a very close eye still and personally I wouldn't correct anything until morning even if he gets quite high from the glucagon.

    Glad it worked out
    Well, we are here in the ER now because his BS dipped and is now 72 but holding steady. Glad to be here and thankful for your replies!
    Kate, mom to:
    Andrew, age 10, dx'd 4/8/10, PINGing since 12/10, Dexcom G4 since 4/7/13
    Henry, age 8, non-d (cough-variant asthma)

  8. #8
    Join Date
    Dec 2009
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    California
    Posts
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    Keep us posted!
    Susan
    Grandma to Hailey age 11 dx type 1 age 4
    pumping with Omnipod since 8/09
    and Faith age 7
    and now little Macey Ella age 1 year Dx with allergies to nuts, wheat, eggs, and soy

    True heroism consists in being superior to the ills of life, in whatever shape they may challenge us to combat.

    Napoleon I (1769-1821) Napoleon Bonaparte. French general.

  9. #9
    Join Date
    Aug 2007
    Location
    Hamilton, Canada
    Posts
    9,185

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    Quote Originally Posted by momof1CWDinohio View Post
    Please help -- anyone. My son was over 400 for awhile due to an unbolused dinner with my parents tonight (had some lows and pump wouldn't take it). My DH tested ketones (0.0) and changed site. Gave a shot to cover the high and misread the syringe (!!!!!) and gave him 26 units Novolog instead of 2.6. Only realized this about 30 mins ago after giving a number of juice boxes. Called the after hours line and they said give glucagon via syringe and see what happens. He's back up to 125 just now 15 mins later. But 26 UNITS -- am totally scared. What would you do?? Go directly to hospital? I want to but nurse on call said wait.
    Not quite clear from your posts exactly when he got the 26 units. But if I'm reading it correctly it was 9:30 pm ET.

    Given that you started the thread after 1 am, the bulk of the Novolog will have acted by then. But a typical Novolog injection has a small "tail" or residual that lasts beyond the 3-4 hours that we are told the insulin is active. A huge injection like this will have had a much longer and stronger tail, which would account for the significant drop you saw between 1 and 3 am despite having given the 15 units glucagon.

    Anyhow I'm glad this seems to have worked itself out. The one thing I wasn't clear about was why not give him another 15 units glucagon at 2 am, instead of going to the hospital?
    ________________________________________
    Wilf

    Proud Dad of Amy (18), diagnosed Aug. 2006 and getting MDI of Apidra and Lantus..
    and Sylvie (13); very happy husband of Shirla!

  10. Default

    Hoping your son's ok! I I would've went to the hospital too
    Kristen

    Mom to
    DD 5: 10/11/2008- diagnosed 3/31/09 at 1.5 years.
    3/31/09- 01/2012- Humalog and NPH
    01/2012- 04/18/2013- Humalog and Lantus
    04/18/2013- Pumping with a Pink Animas Ping
    09/13- back to MDI with Apidra and Lantus
    Currently pumping with Novolog

    DS born July 29, 2013

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