Insulin related calls to poison centers increase 279%

Annual calls to poison centers regarding insulin have skyrocketed by 279 percent over the past 10 years, according to a new study authored by medical professionals at four U.S. poison centers.

“There is a growing epidemic of diabetes in the United States in part due to the growing epidemic of obesity”

The study, published in the January edition of The Annals of Pharmacotherapy, finds that the mean annual increase in insulin overdoses and other calls to poison centers regarding insulin was 18 percent, and that the majority of the increase was caused by unintentional errors in dosing. Unintentional dosing errors rose by 495 percent during the same 10-year period.

"This study shows a striking increase in the number of insulin errors in the home," said Henry A. Spiller, managing director of the Kentucky Regional Poison Center and lead author of the report. "We believe this is the first study to document the size of this growing problem."

The study also indicates an increased need to educate patients about the medications they use to treat the chronic disease.

"We would urge diabetics to double-check the insulin they are using," said Tama Sawyer, managing director of the University of Kansas Hospital Poison Control Center and one of the five authors of the report. "We've seen quite a few insulin errors occur when patients use the wrong insulin."

The study found that most errors in dosing occurred late at night. The vast majority (73 percent) of errors occurred in adults over the age of 40. Poison centers, which are open 24 hours a day, are ready to receive such calls in part because of their late hours. "We found the majority of these insulin errors happen at night, when many of the usual resources such as doctor's offices are closed and unavailable," Spiller said.

Poison centers are ideal facilities to field such calls, said Mark Ryan, managing director of the Louisiana Poison Center, who also helped author the report.

"We want patients to know that poison centers can answer questions about their medications and potential adverse effects, especially when their physician or pharmacy is unavailable," he said. "We always say that we would much rather answer a question and prevent a bad situation than have a bad situation develop because of a lack of information."

Of the 3,819 insulin exposures reported to the nine poison centers that participated in the study, more than half of the patients either saw no effect or a minor effect as a result of the error. Two-hundred and ninety-nine saw a moderate medical outcome, and 10 saw a major outcome. None of the insulin overdoses examined in the study resulted in a death.

Study authors said the increase in insulin overdoses is not entirely a surprise - the proportion of the U.S. population with diabetes is increasing rapidly. In October 2010, the Centers for Disease Control and Prevention predicted the number of new diabetes cases per year will increase from eight per 1,000 in 2008 to 15 per 1,000 in 2050.

"There is a growing epidemic of diabetes in the United States in part due to the growing epidemic of obesity," said Doug Borys, managing director of the Central Texas Poison Center. "As the number of patients increases, so will the number of accidental medication errors, including errors in all medications used to treat diabetes. By calling your poison center to treat a medication error, you can prevent an unnecessary trip to the emergency room and effectively treat such errors without leaving your home."

The study also demonstrates how diabetics are increasingly using poison centers to treat therapeutic errors in insulin therapy. Study authors said 70 percent of the cases in the study were treated without having to go to a health care facility, thus avoiding an unnecessary expense and trip to the doctor's office or hospital. Calls to poison centers are free, staffed by medical professionals, confidential and open to the public 24 hours a day, seven days a week, 365 days a year.

"Poison centers treat everything from children who get into the household cleaners to people who are suffering from a reaction to prescription drugs that are supposed to save their lives - and often without the caller ever having to walk out the front door," said Jim Hirt, executive director of the American Association of Poison Control Centers. "If you've taken medicine and had a bad reaction, or maybe taken too much, your poison center is ready to help."

The report examined insulin exposures for nine poison centers in four states - Kentucky, Texas, Louisiana and Kansas - between 2000 and 2009. Study authors are Spiller, Borys, Ryan, Sawyer and Brooke L. Wilson of the Kentucky Regional Poison Center.

The American Association of Poison Control Centers supports the nation's 60 poison control centers in their efforts to treat and prevent poisoning. Poison centers offer free and confidential services 24 hours a day, seven days a week.

If you have questions about something that could be bad for you, or if you've been exposed to something that you believe is poisonous, call your local poison control center at 1 (800) 222-1222.