Hi there!
So I came across a video of a type 1 diabetic that apparently hit a vein while injecting treshiba basal insulin and he said that because of that he got a severe hypoglycemia.Does anyone have a similar experience or opinion? Is that a common problem or a possibility? Will it happen even if there is a little blood visible after the injection? I am very new to mdi and now terrified that it will happen any time. Please do me the favor of sharing some knowledge.
Thank you <3
Good luck guys
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Welcome to FUD @Pac-reas! Interesting question. This happens very infrequently, but it does happen. If you inject most basal insulin’s into a vein they will hit you all at once. We have had members report this and I think we had one member that tried to do it to see what would happen. My son uses MDI off and on and he has never had this happen to him. I would chalk it up to it is possible but very unlikely.
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In 8 years of MDI it never happened to me. In any case, if it happens the solution is fast carbs like glucose tablets, taken promptly. Do arithmetic as if the basal was a meal bolus, so that you know about how many grams of fast carbs you likely will need.
Perhaps a more common similar issue happens when we mistakenly take fast insulin when we intended to take basal insulin. It’s a similar situation where lots of fast glucose is needed right away.
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Hi @Pac-reas,
Like almost all basal insulin’s, Tresiba’s delay is from the formation of more complex hexamers after injection.
The only basal insulin that is safe to inject intravenously is Levemir, because it binds to the albumin of the blood, which delays the absorption. All the others - Lantus, Tresiba, NPH, etc. - they are all delayed by the absorption before getting introduced into the bloodstream.
In general though, unless you are trying to inject it into the bloodstream, you will probably never see it happen. It’s the same for the rapid bolus insulin’s, like Humalog or NovoLog. If you inject those in the vein, you would definitely see a difference. But in million’s (maybe billions) of injections, how many times has that actually happened?!?
This is not something to worry too much abouit.
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@Eric Live and learn, I wasn’t aware of the chemical actions you mention above; good information to tuck away for the future. The one aspect that I thought of on reading was what injection needles are being used; if the shorter 4-5MM, I wouldn’t think its a great concern, despite having had a “bleeder” once in a great while. @Pac-reas Welcome to the group! You’ll find most of us aren’t shy about sharing our thoughts/opinions; your job is to sort through it, verify with your own research, and develop your own beliefs over time. For my money, you’ve received good info from the experts above, and most of us here on FUD would agree: Good to be aware of the possibility, know what to do IF it happens, but don’t be overly concerned. We know you’d prefer not to be here, but welcome to the group and don’t hesitate to ask any questions you have.
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I have been injecting subcutaneously MDI for 30+ years and while I have drawn blood many times (i.e., hit a small capillary), it has never resulted in injected insulin hitting my bloodstream and causing hypoglycemia. This is something that I do not worry about – we’ve got enough on our plates! Hopefully the input you receive here can put your mind at ease. 
Jessica
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Just made an account to confirm that this absolutely can happen. I’ve done a nightly shot of Basaglar/lantus for 9 years and never had it happen to my until last night. My phone alerted me that my blood sugar was low and I saw it dropped from 200–>60 in 15 minutes. Thank god I had multiple sodas and ice cream, but even with that I went down to 30 for about 10 minutes before recovering. From what I have read and what my dr told me, all of your nightly insulin seems like it acts like fast acting and after a few hours your body basically has no more nightly insulin left. Currently treating with fast acting until I can do nightly shot again tomorrow. One tip I heard is to spread your nightly shot into 2-3 locations around your body to avoid all of it hitting a vein. This was the final straw for me switching to a pump as soon as a I can. I can’t believe nobody warned me this was a possibility even though it’s so rare because it’s SO dangerous. Google “lantus lows” and there some Reddit posts about people discussing
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That’s so scary
Glad you’re ok💪
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One of the great things about Levemir was that even if it was injected directly in a vein, it would not significantly alter the absorption speed.
I wish Levemir was still available.
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