Ask The Expert
Monitoring

I know this was a very frightening experience for you and your mother. A short recap: You wrote this via the internet to our Ask the Expert page during the night. While we normally respond during business hours, the customer service agent who read the message recognized it as an emergency and attempted to contact you. He was unable to reach you so he notified the local paramedics who went to your home to assist. You also called your local ER. After your mother was back to her normal self, you were able to discover that she had taken the wrong insulin—instead of taking her long-acting insulin at bedtime, she took the rapid acting insulin—which would have been in a much larger dose than she usually takes.

You and I already reviewed what happened and why, along with the information below, but the points I want to emphasize for you and our readers are the following:

• Call the doctor and obtain diabetes education: Report this episode to your mother's doctor right away—and also ask for a referral as soon as possible for both you and your mother to obtain diabetes education.
• Know how to treat hypoglycemia: Review the causes, signs, and treatment of hypoglycemia. Anytime hypoglycemia occurs, evaluate the cause and determine if you know how it can be prevented from recurring. If you do not know the cause, always report it to the doctor. Report any severe hypoglycemia to your doctor.
• Glucagon: Discuss with your mother's doctor whether or not you should have a Glucagon Emergency Kit on hand.
• Taking the wrong dose of insulin: As you learned, the wrong dose (in this case, a large dose of the wrong type) of rapid-acting insulin can cause significant hypoglycemia. Had your mother realized it right after she took her dose, you may have been able to call the doctor right then. Depending on the dosage and the situation, the doctor might have advised you to give your mother a certain amount of carbohydrate food (such as juice, a regular soft drink, bread or crackers) every one-to-two hours, while setting your alarm to get up every two hours to check your mother's blood glucose throughout the night.
• Mark the insulin bottle: Talk to your mother's diabetes educator to see what type of tools are available to mark her insulin bottles, or perhaps consider putting a rubber band or colored sticker on the nighttime dose of long-acting insulin, to differentiate it from the rapid-acting insulin.
• Consider online diabetes education: While I think it is very important that you both attend education classes at your local diabetes clinic, another option to supplement what you learn is to do some of your learning online.

You can read more details about the items I listed in the related questions and related links below.