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Errors of Insulin Commission?

The first 20% of the full text of this article appears below.

	Introduction

 
All medical care providers caring for patients with diabetes have had the midnight call from an embarrassed patient who says, "Doctor, I’ve made a mistake with my insulin and took the wrong dose. What should I do?" The answer, of course, is, "Eat something, and monitor your blood glucose level."

We can’t eliminate mistakes completely, but how can we make taking insulin safer?

Millions of people take insulin injections several times a day, and with the advent of new insulin analogs and premixed insulin combinations, the potential for errors has increased. If there is any doubt about patients’ knowledge of the kinds and actions of the insulins they take, this issue should be explored, and the opportunity to teach them should be taken to help reduce the chance of future errors.

Following are some of the more common types of insulin errors and some hints for ensuring the safety of patients who use insulin.

	Mistaking Dosages of Different Insulins

 
Probably the most common error is when someone mixes up the dosages for two different kinds of insulin. Generally, this involves an intermediate- and a rapid-acting insulin, with the former nearly always at a higher dose than the latter. Often, patients realize their mistake immediately and can take steps to avoid severe hypoglycemia. This type of error is also suspected when patients have an unexpected low blood glucose level unrelated to their activity or food intake and outside of their usual pattern.

This type of error can be disastrous when it is not realized, especially for patients who have little warning of dropping low blood glucose levels (hypoglycemic unawareness). Likewise, when the wrong dosage is taken of a 24-hour long-acting insulin (glargine [Lantus]), the hypoglycemic effects can be long-lasting indeed. However, a more common mistake seems . . . [Full Text of this Article]

	Identifying Insulins by Their Appearance

 

	Drawing Up Inaccurate Doses

 

	Confusing Various Premixed Products

 

	Inappropriately Handling Insulins

 

	Omitting Insulin During Illness

 

	Insulin Safety Tips

 

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