Strange hypoglycemic episode after injecting Lantus

Cathleen, is there any chance at all that she injected Humalog instead of Lantus? A few decades ago I was taking a mixture of a small amount of Regular and a large amount of NPH (I think) in the morning. I got the two mixed up and wound up injecting a large amount of Regular. I passed out soon after getting to work. Luckily the campus nurse where I was working knew me well, and was proficient, and immediately figured out what must have happened, and got some glucose into me.

—Keith

Hi @cminer.
I’m sorry you haven’t found a definitive reason for that scary low. Sometimes things happen that remain a mystery, and sometimes there’s an “aha!” moment when we make a connection later.
As you know, the key is to be prepared for what might happen, even when we’ve done all we can to stay in range and something like this seems unlikely.
I’m not going to tell you not to worry about your daughter when she is at college - that would be fruitless to say the very least. But if it helps at all, a few thoughts:

*Anyone with a medical condition should let their roommate know about it, and what a developing issue looks like and what to do. In this case it will help to know about her CGM - what it’s for; the pass code and how to read it; what’s normal etc.; what the alarms/alerts mean and how to turn them off; and first and foremost of course symptoms of lows (good to know even with a CGM) and how to treat them.
We might know we need a certain number of carbs and what constitutes that amount, but keep it simple - maybe package up a few sets of the number of glucose tabs, lifesavers or preferred candy she typically uses; Liquids work faster than solid foods so keep miniature cans of juice or soda to use. They’re between 6 and 7oz and a full can might be too much for her needs so she could say to give half, or give the whole thing and she can correct later.
Keep glucagon or Baqsimi (inhaled glucagon) available and review the steps on how to use it. Baqsimi may be less intimidating than a glucagon kit as you don’t need to mix or inject.

Who she tells will be up to her but she may find it comforting to share with people she gets to know, and her school might have a famous group for other students with Type1 so she could look into that.
The school may make accommodations available in case she needs to reschedule a test or something along those lines due to a diabetes issue, so she should check with them: she’ll need to speak with her professors to introduce herself so they’ll know who she is. I don’t think these discussions need to be very technical and involve a ton of education about Type1 - just let them know she has certain medical needs. But guidance on that might come from the school.

Those are a few thoughts from personal experience as a diabetic who attended college. Forty years ago. For some maybe more helpful and definitely more current information😊 I found a website for students getting ready for college with Type1 and the parents who are about to release them into the world. Posting links is not recommend on the forum but look up
The diabetes link dot org (no spaces of course) for info for both students and parents.
All the best to you and your daughter in this next exciting phase!

Dorie, thank you so much for the college ideas, so helpful and reassuring! I will be re-reading these a few times over as we prepare. I hope she finds some supportive roommates and I think her school will be proactive in providing needed accommodations. As far as managing sudden lows, my main concern, I think she is getting better at catching them and the Dexcom has saved the day more times than we can count.
Thanks again for your thoughtful response!

Wow, Keith, what a nice colleague you had! We keep the Humalog and Lantus in separate spots to try to avoid confusing them. I found the pen needle still on the Lantus (as a teen doesn’t always clean up after giving injections!), so I don’t think that happened this time, thankfully.

Hello
Yes I had a similar experience with Lantus about four years ago.
I took lantus in the morning even though most people take it at night. That’s not important to the story but I mention it only because most people don’t take it in the morning.
Very soon after taking my normal daily dose I began feeling a low coming. I have been Type1 since 1984 and haven’t ever experienced anything like what was about to happen. My blood sugar dropped so fast that I actually blacked out. The last thing I remember was testing my blood sugar and it was 23. When I came to there were two paramedics in my house. My wife had called them.
I have no idea how or why it happened. I had worked out hard the previous day and then hadn’t eaten much, but like I said I’m not new to this disease. I don’t think any of the doctors or nurses believed my story. They all think I took the wrong insulin but I was taking 30 units of Lantus and had I taken 30 units of fast acting insulin I doubt I would be here today.
In the end it was what got me to switch to the pump and the Dexcom CGM thing. I’m terrified of going back on Lantus after that experience. I’m not crazy about the pump but it’s better because you only use fast acting insulin, which decreases the chances of such a serious low. The lows can kill you.

Hi, I just have one quick thought. When I was in your daughter’s age range my BG would drop suddenly when my period started. I wonder if this could be the cause. For me, my blood glucose would run high the week before and drop suddenly once my period started. I learned to not over bolus for the high BGs in order to not drop so low.

Just a thought!

Pam K.
T1D 58.5 years and counting!

Hello, this is not crazy - I’m 44 and diagnosed 3 years ago. I used a new lantus pen and had the same thing happen two injection days in a row. It happened so unexpectedly the other day I had to get my daughter out of bed in case I went unconscious. I thought maybe I hit a vein but there was no blood. I’m a thin person too so maybe thought it was a fluke. I started splitting my daily long acting into 2 doses 12 hrs apart. I finished off a separate pen and was fine but when I went back to the pen that I thought went into my vein it happened again. Since I was paranoid about low I caught it before it went too low but still went from 160 down to 58. Super scary and now I’m wondering if the batch was bad but can’t find a recall for the lot. I’m nervous to do another experience like that.

Would call Lantus and ask for their thoughts while stopping use of that pen. Believe they can track lot numbers to pharmacies and patients for notification purposes. They can also send a code for pharmacy to give you a new batch of 5 free pens. I’ve had pen issues before with humalog but the opposite effect.

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I found this forum through a google search for low sugar after taking Lantus.
I just had it this morning, and once previously a year or so ago, an both times I remember getting blood from the injection site.
Injected 13 units of Lantus before i went to work this moring and dropped from 13mmol to 2.5 within about 15-20 minutes (only noticed due to the CGM i was wearing and had to test via finger prick as I didnt believe i could have dropped that quickly), hadnt had any short acting insulin for over 5 hours before that so no way it should have lasted that long in my body to being me down suddenly.
So seems to be a spot on my stomach that if I inject Lantus into some sort of blood vessel it causes me to absolutely plummet quicker than any short acting insulin in existance, not a bad batch of Lantus either as its a vial ive used for a few days before this happened, and no exercise or different type of dinner/snacks than the night before
Woud be great if they could create a short acting insulin that worked as quick as this Lantus injected into the wrong spot does :smile:

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I’ve lived with diabetes a long time (cough cough 60 years) and I’ve found it takes longer than it used to for insulin to bring down highs (and correct lows) on its own; so while 13mmol to 2.5 (234 to 45mg/dl) within 15-20 minutes is extreme. I would like it to happen more quickly than it does. Thankfully there are ways to speed the process a bit by helping the insulin out:
This 2019 article advises needle length, injection location, and body mass index determine whether insulin is going into fat :+1:t5: or muscle :-1:t5:. https://diabetesjournals.org/clinical/article/37/3/227/32887/The-Injection-Technique-Factor-What-You-Don-t-Know

You clearly don’t need help when using your abdomen but if you want to speed things up in other areas, massaging the site, applying heat, and vigorously exercising the limb can also increase absorption. Table 1. [Factors Affecting Insulin Absorption ()]. - Endotext - NCBI Bookshelf

Hi @Devilz , welcome to Breakthrough T1D. I have a favorite spot where one of the smaller hip muscles are very near the surface of my skin. I put my infusion sets there and get great control. Muscle sites hurt more though so it isn’t “free” but wow I get fabulous absorption.

Your pancreas delivers (used to deliver) insulin directly to the bloodstream. That’s why a normal can eat candy and not have crazy high blood sugars.

Hi again. Another thought: how long has your sensor been in when you got the low reading?
You typically hear about false lows with new sensors but maybe this one was giving a false high and you just didn’t realize it, then you injected Lantus on top of it.

Hi ! This happens to me from time to time, las night it happened , I was a little high before going to bed, I was at 220 and 10 minutes after i injected lantus I started to feel shaky I checked and it was at 160 , since this has happened before I started having carbs and drinking soda , it took 3 hours for it to normalize since it kept dropping . I hadn’t done anything out of the ordinary that day , I just think our bodies don’t react the same way every day and because of this we always have to be prepared. Diabetes sucks but we have to make the best out of each day.

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Hi! This has happened to me twice in 2 months! the crash happens 10 to 15 minutes after my Basaglar injection, with no Humolog in my system. went from 230 to 30 in about 15 minutes and called an ambulance at at about 10 minutes in. Baqsimi and OJ and Skittles saved my life. I like the ‘vein theory’ 100 percent certain it wasnt the wrong insulin, and i was in bed watching tv so it wasnt exercise. Seeing an endo in a couple weeks and i’ll report back.

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Hi @somethingsalty, and welcome to the forum.
Yikes - a 200 point drop in 30 minutes! Even though it’s “only” happened twice in two months I might ask my doctor about switching before my visit in two weeks - I don’t know why doctors prescribe one over another but there are a number of long- and intermediate-acting alternatives available.
Stay in touch, and I look forward to your contributions.

Did you ever figure out why this happened? I had the exact same thing happen and had to take 2 nasal glucagon and had to go to ER and have IV glucose to survive

Hi I’ve been diabetic just shy of 50 years… diagnosed in 76. Back when I was on MDI around 20 years ago, my doctor talked me into Lantus. After a couple months I had a severe hypoglcemic incident. Don’t remember walking out of work at the end of the day but woke up hanging upside down in my car. Luckily you had a sensor. I switched to levimiir for a while and ultimately went to a pump. Be careful and consider other options. I am not a doctor, but only speak from my experiences.