Insulin overdose
Insulin is a hormone that regulates carbohydrate metabolism in the human body and is produced by the Langerhans cells of the pancreas. With its help, tissues absorb glucose, a substance that serves as an energy source in the body. In type I diabetes mellitus (insulin-dependent), the pancreas does not produce its own insulin, so it is vital to inject it from the outside. Insulin preparations contain a synthesized hormone. Their regular injections are the mainstay of the maintenance therapy for type I diabetes.
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Insulin also has an anabolic effect, so it is used in the treatment of some other diseases, it is also used by bodybuilders to increase muscle mass.
How much insulin is needed for an overdose?
For a healthy (ie, non-diabetic) adult, a safe dose of insulin is 2–4 units.
Often, bodybuilders, starting with a safe one, gradually increase the dose, bringing it to 20 IU.
In diabetes mellitus, the dose of insulin is selected by the endocrinologist individually, taking into account the concentration of glucose in the blood serum and the presence of sugar in the urine. The average therapeutic dose for diabetes mellitus is in the range of 20-40 U, in severe cases or with the development of complications (hyperglycemic coma), it can be increased, and significantly.
The main causes of insulin overdose are:
- incorrectly selected dose of an insulin-containing drug;
- mistakes during injection, which are most often observed when changing the drug or using a new type of syringe;
- intramuscular (instead of subcutaneous) administration;
- skipping meals after injection;
- significant physical activity with insufficient intake of carbohydrates after injection.
Certain conditions increase the body's sensitivity to the action of insulin. These include:
- fatty degeneration of the liver;
- chronic renal failure;
- first trimester of pregnancy;
- state of alcoholic intoxication (including mild).
In these cases, even the introduction of the usual dose of the drug, selected by the doctor, can cause the development of symptoms of an insulin overdose.
Signs of overdose
With an overdose of insulin in the blood, the glucose content sharply decreases. If this indicator falls below 3.3 mmol / l, they talk about the development of hypoglycemia.
If an overdose occurs when using short-acting insulin, its symptoms begin to appear within a few minutes after the injection. If a long-acting insulin preparation (depot insulin) was used, the symptoms of hypoglycemia appear later and increase more slowly.
An insulin overdose can be suspected in the presence of the following symptoms that occur some time after the injection:
- growing general weakness;
- tachycardia;
- headache;
- a strong feeling of hunger.
If at this moment the necessary measures are not taken, the patient's condition will begin to deteriorate rapidly, and other symptoms will join:
- heavy sweating;
- tremor;
- numbness of the fingers;
- pallor of the skin;
- hypersalivation;
- dilated pupils;
- intolerable hunger;
- transient visual impairment;
- impaired ability to move independently;
- nervous excitement or, conversely, lethargy;
- clouding of consciousness;
- clonic-tonic convulsions.
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The most severe manifestation of insulin overdose is the development of a life-threatening hypoglycemic coma.
Insulin overdose can be not only acute, but also chronic. The development of the latter is associated with long-term hormone replacement therapy for diabetes mellitus. After the introduction of insulin, even in the correct dosage, the patient's blood glucose level decreases for a while. The body tries to compensate for this by increasing the synthesis of glucagon, corticosteroids and adrenaline - hormones that increase glucose concentration.
Signs of the formation of a chronic insulin overdose:
- constantly increased appetite;
- increased body weight;
- the appearance of acetone in the urine;
- the presence of sugar in the urine;
- frequent cases of ketoacidosis;
- sharp jumps in blood glucose levels during the day;
- hypoglycemia that occurs periodically throughout the day;
- transition of diabetes mellitus to severe form.
Disorders of carbohydrate metabolism associated with chronic overdose of insulin lead to hyperglycemia in patients with type I diabetes mellitus in the morning, and blood glucose levels decrease in the daytime and hypoglycemia develops.
First aid for insulin overdose
In case of insulin overdose, especially short-acting insulin, first aid should be provided immediately. It is extremely simple: the patient should drink sweet tea, eat candy, a spoonful of jam or a piece of sugar. If his condition does not improve within 3-5 minutes, the meal containing fast carbohydrates should be repeated.
Antidote
Since an overdose of insulin causes a sharp decrease in the concentration of glucose in the blood, hypertonic (20–40%) glucose solutions are used as an antidote.
When is medical attention needed?
If, with an overdose of insulin, first aid has led to a rapid improvement in the condition, there is no need for emergency medical care. However, the patient in the near future should definitely visit the attending physician to adjust the dose and frequency of insulin administration.
In cases where an insulin overdose is difficult and the intake of carbohydrate food does not remove the patient from the state of hypoglycemia, it is necessary to urgently call an ambulance team.
Treatment of patients with insulin overdose is carried out in the Department of Endocrinology. With the development of hypoglycemic coma - in the intensive care unit.
In the hospital, patients urgently determine the level of glucose in the blood and some other biochemical parameters. Therapy begins with intravenous administration of 20–40% glucose solutions. If necessary, glucagon is injected intramuscularly.
With the development of coma, correction of the impaired functions of vital organs is carried out.
Possible complications
A slight overdose of insulin does not pose a danger to life and health, mild degrees of hypoglycemia occasionally occur in almost all patients with type I diabetes. However, if hypoglycemia occurs regularly, then the formation of a chronic insulin overdose should be suspected, which can aggravate the course of the underlying disease.
Severe insulin overdose can lead to the development of severe neurological disorders:
- meningeal symptoms;
- swelling of the brain;
- dementia (violation of mental activity with the formation of dementia).
Hypoglycemia is especially dangerous for the elderly, as well as those who suffer from diseases of the cardiovascular system. In patients of these categories, it can be complicated by stroke, myocardial infarction, retinal hemorrhage.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
