Insulin is a pancreatic hormone. As a medicine, it was first used in 1922 and since then it has been successfully used for compensatory therapy for diabetes mellitus. What is the mechanism of drug action? Glucose, which entered the bloodstream after a meal, is absorbed by the body cells with its help, and the excess is stored “in reserve”. Under the influence of insulin, excess sugar is converted in the liver to glycogen. If the hormone is not produced enough, the whole carbohydrate metabolism is disturbed. This is typical for type 1 diabetes. Doctors call this pathology - absolute insulin deficiency. The main sign of it is hyperglycemia - an increase in glucose (sugar) in the blood. A strong increase, as well as a strong decrease in glucose (hypoglycemia) causes the development of hyperglycemic or hypoglycemic coma and can be fatal.
Let's talk about what happens when an overdose of insulin, what consequences does hypoglycemic coma entails and how to give first aid in case of such a situation.
Causes of overdose
Insulin is used mainly by diabetics, but its many effects are used in other cases. For example, the anabolic effect of insulin has found application in bodybuilding.
Doses of insulin are selected individually, under the supervision of a physician. It is necessary to measure blood glucose, to master the methods of self-control of the disease.
For a healthy person, a “harmless” dose of the drug ranges from 2 to 4 IU. Bodybuilders bring this amount to 20 IU per day. In the treatment of diabetes mellitus, the amount of medication administered per day varies in the range of 20–50 IU.
An overdose of the drug can occur for several reasons:
- mistakes of the doctor - insulin injection to a healthy person;
- improper dose;
- using a new drug or switching to a different type of syringe;
- errors at the time of injection - the introduction is not subcutaneously, but intramuscularly;
- physical activity without carbohydrate intake;
- patient's errors while using slow and fast insulin;
- lack of food after an injection.
Sensitivity to insulin increases in the first trimester of pregnancy, against the background of chronic renal failure, with fatty degeneration of the liver.
When does excess insulin occur in the body? It can happen, in case of violation of hormone production by the pancreas (for example, with tumors).
You should be very careful about the combined use of insulin and alcohol. In principle, alcoholic beverages are not recommended for patients with diabetes. But since bans of doctors do not stop everyone, doctors advise to reduce the risk of side effects to observe the following rules:
- before taking alcohol, the usual dose of insulin should be reduced;
- before and after drinking alcohol, it is necessary to eat food containing slow carbohydrates;
- give preference to light alcoholic beverages;
- when drinking strong alcohol the next day, it is necessary to adjust the dosage of insulin, guided by measurements of blood sugar.
Death in insulin overdose occurs as a result of hypoglycemic coma. The dose of the drug that leads to death depends on the tolerance of insulin by each individual organism, the weight of the patient, the accompanying factors — the consumption of food, alcohol, and so on. For some, the introduction of already 100 IU of medication will be dangerous; for others, the figures vary between 300–500 IU. There are cases when people survived even after insulin injection in the amount of 3000 IU.
Excess insulin in the blood leads to a decrease in glucose levels. Talking about hypoglycemia can be at a rate of less than 3.3 mmol / l in capillary blood. The rate at which symptoms develop depends on the type of medication used. With the introduction of fast insulin, the symptoms develop over a short period of time, with the injection of slow insulin - over a longer period.
Symptoms of excess insulin in the blood are as follows.
In the first stage, there is a feeling of hunger, general weakness, headache, heart palpitations.
- If at the first stage no measures were taken to increase blood sugar (to eat or drink sweet), then sweating, hand tremors, increased salivation, weakness and hunger progress, pallor, numbness of the fingers, visual impairment, pupil dilation occur. At this time, you can still prevent the development of hypoglycemia, if you eat food with fast carbohydrates - sweets, sweets, pure sugar.
- Further, weakness progresses and the person can no longer help himself. There are inability to move, excessive sweating, rapid heart rate, trembling of the limbs, blackout, depression or agitation of the psyche. Then develop clonic or tonic seizures. If intravenous glucose is not administered during this period, then hypoglycemic coma may occur.
- Coma is characterized by loss of consciousness, a strong drop in blood sugar levels (more than 5 mmol / l from the initial level), pallor, slowing of the heart rhythm, lack of pupillary reflex.
Death occurs with a decrease in all functions - respiration, blood circulation, and the absence of reflexes.
A persistent excess of insulin in the treatment of diabetes mellitus leads to chronic overdose, which is accompanied by the production of hormones that prevent a decrease in blood sugar levels - adrenaline, corticosteroids, glucagon - and is called "Somoggia syndrome". Signs of chronic overdose in patients with diabetes mellitus:
- increased appetite;
- weight gain with a high content of sugar in the urine;
- propensity for ketoacidosis;
- sharp fluctuations in glucose levels during the day;
- more commonly, an increase in blood sugar levels is recorded;
- persistent hypoglycemia (several times a day).
Often hypoglycemia occur hidden. The famous "dawn phenomenon". Hyperglycemia develops in the morning, from 5 to 7 in the morning, which is explained by increased secretion of contra-insulin hormones and weakening of the action of evening insulin injections. Somodzhi syndrome differs from the phenomenon of the morning dawn by the fact that hypoglycemia develops from 2 to 4 o'clock - the sugar level drops below 4 mmol / l, as a result of which the body triggers compensatory mechanisms. As a result, in the morning the patient has a pronounced hyperglycemia caused by an overdose of evening insulin.
Help with an overdose of insulin
What to do with insulin overdose? First aid or self-help with the initial signs of a hypoglycemic state consists in the following actions.
- Eat 50–100 grams of white bread.
- If the symptoms do not disappear after 3-5 minutes - eat a few sweets or 2-3 teaspoons of sugar.
- If after 5 minutes the symptoms persist, then repeat the intake of carbohydrates.
With the development of severe hypoglycemia (loss of consciousness, convulsions), the main remedy for insulin overdose is intravenous glucose. Make an injection of 40% solution in the amount of 30-50 ml, if after 10 minutes the patient did not regain consciousness, then the infusion is repeated.
Consequences of an overdose of insulin
The consequences of overdose depend on the degree of reaction. All diabetics experience mild hypoglycemic conditions. According to medical data, almost a third of patients regularly experience hypoglycemia. The main danger here lies in the development of Somoggia syndrome and, as a consequence, inappropriate therapy of diabetes mellitus, which does not alleviate the course of the disease and eventually leads to the development of ketoacidosis.
Consequences in the case of an attack of moderate hypoglycemia should be eliminated by the introduction of appropriate drugs, which can take quite a long time.
In severe cases, insulin poisoning can cause disorders of the central nervous system:
- swelling of the brain;
- meningeal symptoms;
- mental impairment (dementia).
Also, frequent hypoglycemic conditions in people with cardiovascular disorders can lead to myocardial infarction, stroke, retinal hemorrhage.
In conclusion, it is worth noting that with the timely treatment of an insulin overdose, the consequences in the form of death are practically excluded. Prevention of such situations is a careful attitude to the procedure for administering insulin and constant self-control. A timely noticed attack of hypoglycemia can be stopped by eating foods containing fast carbohydrates - sugar, candy, a sweet drink.