I am afraid that I might forget I have taken my insulin and take it twice, or mistakenly take my long-acting dose for my short-acting and vice versa. What should I do if this happens?

If you think you have taken your insulin twice or taken more or less than you need at that particular point in time, you should not panic, but follow a plan designedto  ensure  that  you  do  not  experience  serious  consequences from  this. First  of all, it  is surprising how often taking too much insulin does not actually lead to a seriously low  level of blood  glucose. Having  said that, a careful response is  needed if you suspect that you have taken too much insulin. In the case of too little insulin, it is often sufficient to monitor the glucose carefully about every couple of hours is generally suf- ficient to detect any problems and address them and be sure to take the right amount at the next scheduled dosage. A brief exposure to high glucose is usually not harmful (unless it is a repetitive event) and the glucose may take 24 hours or so to settle back to its usual pat- tern. If the reduced dosage is noted  quickly, such as before eating the upcoming meal, then the remaining amount can be given. If the meal is underway already, then a slightly smaller meal or subsequent snack can be eaten. If the problem is noted later and the blood sugar is  very  high,  then  some  additional  (supplemental) insulin  can  be  taken  to  bring  it  down.  

The  best approach can vary among  different  patients and your doctor or diabetes educator will have a recommendation for a supplemental scale that may be right for you in these circumstances. of hours and a snack should be kept with you until you feel comfortable that the danger of a serious low blood sugar has passed. You should probably not drive, work at heights, or  operate heavy or dangerous machinery during this time. Many people with insulin-requiring diabetes keep a kit containing a syringe of glucagon, a hormone that counteracts the effects of insulin. If the blood sugar falls rapidly and oral glucose, sugar, or  a snack is ineffective, glucagon can be given and will usually reverse the falling glucose within a few min- utes. Your  doctor can prescribe such a kit for you to keep on hand if you feel it is necessary and reassuring. If you recall that you have taken your insulin twice or taken too much fairly soon after having already done so, then you can take some additional carbohydrate at the meal or a larger-than-usual snack between meals. next scheduled dosage. 

A brief exposure to high glucose is usually not harmful (unless it is a repetitive event) and the glucose may take 24 hours or so to settle back to its usual pat- tern. If the reduced dosage is noted  quickly, such as before eating the upcoming meal, then the remaining amount can be given. If the meal is underway already, then a slightly smaller meal or subsequent snack can be eaten. If the problem is noted later and the blood sugar is  very  high,  then  some  additional  (supplemental) insulin  can  be  taken  to  bring  it  down.  The  best approach can vary among  different  patients and your doctor or diabetes educator will have a recommenda- tion for a supplemental scale that may be right for you