Why did the insulin die in my pancreas?

“Today i forgot to give my daughter her daily morning insulin doze.  She has been high all day and I am very concern.  What should I do until dinner time?  I have been giving her all day a lots of water but she still not feeling normal.  any suggestion what to do until dinner time.  I feel horrible.”

Thank you so  much for contacting me. I will try to put myself in your shoes and think of everything possible to make today’s error corrected quickly. I hope that I have replied with enough time sparing to help you make a smart decision.

If your daughter is on insulin injections, there is no rule that says she can only have injections at breakfast and dinnertime. I have given my son up to 15 injections a day when he has been ill, just miniscule amounts of rapid acting insulin; enough to keep his blood sugar level out of the danger zone.

If your daughter is feeling terrible, it’s almost guaranteed she feels this way from high blood sugar levels. You have been smart by only giving her water. However, even if your child is sick in hospital, if they are unconscious, if they are hyperglycaemic and sleeping, no matter what- INSULIN MUST BE GIVEN EVERYDAY. As your child doesn’t make any of her own, then she is relying on her insulin injections to continue with good health, and to LIVE.

If you cannot get in touch with her doctor or diabetes educator, try calling your town’s hospital. Don’t feel embarrassed about telling them exactly what happened, it only takes something small to take your mind off track when preparing food, answering questions…..  Many parents AND people living with diabetes have spoken of how they feel when they forget  injections. You are certainly not the first person to forget about giving a morning insulin shot!

 You should do a blood sugar reading with your daughter’s glucometer before you speak to a health professional, so that they can calculate a safe amount of insulin to give her, as well as reduce her blood sugar level and the threat of DKA. (It is a good idea if you can take her temperature as well.)

Do you have ketone strips? ( If you don’t, make it your first job to collect some on Monday morning.) If you do, get your daughter to provide a urine sample in a sterile container or a clean bottle or jar, so that you can test for ketones. The most dangerous thing about this situation is that we don’t want ketones that are going beserk in her blood to spill over into her urine. If she has ketones-the squares on the strip will change colour, and there will be a corresponding match up box underneath. It will have the word, “Trace”, or the numbers: 1+, 2+.3+or 4+. If there is a colour change, you will need to tell the doctor or hospital what level of ketones she has, as well as how much sugar she has in her blood. Take the urine sample along to the hospital with you. (The doctors’ will be grateful that you have thought ahead and they will be able to get an accurate pathology result as quickly as possible.)

I cannot tell you how much insulin to give your daughter.

 I don’t know how old she is, I don’t know her body weight, I don’t know what insulin she is taking, I don’t know if she takes a rapid acting and a long acting dose together before her morning and evening meal. I don’t know what time you realised  that your daughter didn’t receive her morning insulin.

You need to contact the hospital immediately.

You may like to call an ambulance so that they will take her straight to Emergency.

If not, tell the admin staff at the hospital that your daughter has Type 1 Diabetes and is suffering from hyperglycaemia, even before you tell them her name. Let them know that she did not have her morning insulin.

After obtaining some initial information, the doctor will want to know her exact insulin dosages. Take her glucometer and/or record book along with you so that the doctor on duty can see what her levels have been doing in recent times.

The hospital staff will organise an injection of insulin to get her blood sugar level down, and so that she will be safe to take home and not have problems when she has her evening dosage.

Just a quick check list…

1. Do a fingerprick and write down the result to report to the ambulance/hospital.
2.  Collect a urine sample in a sterile container or a clean jar or bottle. Check for ketones with strips-if there is any colour change, report what number is underneath the box. If you don’t know, put the strip in a clip seal bag.
3. Take your glucometer and Daily Record Book for the doctors’ to peruse.
4. Take your GP/specialist’s name and phone number. Record her temperature to pass on to the doctor as well.
5. DON’T PANIC!!

I can imagine how horrible you must be feeling, however you don’t have a computer chip inserted into your neck, therefore, as a human,  you are expected to make the occasional mistake! Most parents of a child with Diabetes learn so much from their mistakes, many which end up on blogs like this one!!

You were obviously aware enough to realise that something was askew. Your daughter is very lucky that you picked up that there was a problem early. Once you seek medical advice, a huge weight will be lifted off your shoulders. You won’t have time to feel horrible for too long, as you will have to plan your and your daughter’s meal for this evening!

You acted and asked for advice regarding a life-threatening problem.

That takes real courage.

You don’t need to feel horrible anymore; by the time your daughter enters slumberland this evening, all will be well. Put today down to experience. Tomorrow is a brand new day and I can promise you that after today’s scare, you will ensure that insulin is administered before any food is consumed by your daughter in the future.

Good Luck!

It’d be great to hear back from you to see how things eventuated!!!