Type 2 & Blood sugar over 20mmol/l - what can I do?

[Dogdaisy]

Hi
My mum in her late 70s is Type 2, she was taken off glicazide 4 weeks ago as she was thought to be having low blood sugar episodes. She was also taken off metformin 2 weeks ago as her diabetic nurse said her bloods were good and HCA1 was borderline for requiring metformin (6.1). Within approx a week she developed a UTI which was treated with antibiotics. She then became increasingly tired, having to go to bed straight after breakfast, this was still presumed to be low blood sugar. I found that her carers had started giving her orange juice and hobnob biscuits and mum had also been eating some dextrose tablets which had been left with her meds. on her GPS advice, (mum said she felt so terribly tired she couldn't make a snack so when she was hungry or thirsty she ate one and felt abit better, so she kept having one now and then). Over the past week she had complete exhaustion and unable to get out of bed, increased urination and thirst, night sweats, and I decided to test the blood sugar which the GP was still assuming was low but had not tested, and I found it was 24.7mmol/l. I sought medical advice and mum was put back on metformin on Saturday. On Saturday it rose higher to 25.1 and again sought medical advice from 111 and out of hours dr wanted mum hospitalised, said she may need insulin to bring it under control, said it was dangerous to remain so high. However, by the time the emergency dr arrived it came down to 15.8 and they decided to leave it. Today, it had risen higher to 27.4 and again medical advice was sought from 111, and a different out of hours dr said we would let it rise to 30 or 31 before we would intervene. Does this seem like sound advice? Could mum have become Type 1 over the past couple of weeks?
Friday 3/2/17 23.7 ( 9.31am). 19.1 (10.30am district nurse). 16.5 (2.39pm). 19.9 (7pm.) 17.5 (19.39pm). Saturday 4/2/17 25.1 (8.30am) 21.9 (10.40am). 11.8 (4.30pm). 20.2 (9.15pm). 15.8 (9.45pm paramedic) Sunday 5/2/2016 18.2 (8.48am) 16.4 (1.02pm). 20.4 (9.45pm). Monday 6/2/17 13.3 (9.15am). 15 (10pm). Tuesday 7/2/17 18.2 (6am) 14 (6.15am) 11.2 (10am). 20.6 (4pm). 27.4 (6.30pm). 14.5 (10pm).

 

[Freema]

Oh How scary .... maybe They have seen her better than she really is and giving her treats is a bad devellopment unless she is low in blood sugar Hard to know anything more than What you see only a doctor and some tests can find out if she is at type 2 that only temporarily needs insuline

 

[miahara]

What a mess! And a complicated story. So your mum's BG has shot up and as far as I can judge as a non-medical person, there are three factors involved:
1 - Withdrawal of a medication that had helped keep BG low.
2- A UTI that possibly and very likely influenced metabolism.
3- Feeding her high carb/sugar food/dextrose. (beyond belief!!)
It might be a good idea to press for admition to hospital, for there you will at least get your mum seen by a consultant who should be better able to judge mum's condition. It does seem a bit unlikely that that she's suddenly developed T1 after previously managing T2.

Dave

 

[Bluetit1802]

I agree with everything @miahara said. It sounds like classic high blood sugar symptoms that were treated incorrectly with sugary stuff. Make sure she drinks loads and loads of water, and keep her away from eating anything with sugar or carbohydrates. (no bread, potatoes, cereals or any other starchy stuff.) Eggs cooked any which way are good.

Press hard for an emergency appointment - BS in the 30's is dangerous and life threatening. You really don't want to wait till she is up there.

 

[Dogdaisy]

Oh How scary .... maybe They have seen her better than she really is and giving her treats is a bad devellopment unless she is low in blood sugar Hard to know anything more than What you see only a doctor and some tests can find out if she is at type 2 that only temporarily needs insuline

What a mess! And a complicated story. So your mum's BG has shot up and as far as I can judge as a non-medical person, there are three factors involved:
1 - Withdrawal of a medication that had helped keep BG low.
2- A UTI that possibly and very likely influenced metabolism.
3- Feeding her high carb/sugar food/dextrose. (beyond belief!!)
It might be a good idea to press for admission to hospital, for there you will at least get your mum seen by a consultant who should be better able to judge mum's condition. It does seem a bit unlikely that that she's suddenly developed T1 after previously managing T2.

Dave

Thanks for your reply, if it remains high then I will press for admission. I was reluctant to agree to her being assessed in A&E on the weekend, and now I'm wondering if that might have been best. they offered an emergency dr to assess her within an hour and arrange admission to a ward rather than triage through A&E, the emergency dr who arrived 8 hours later(!) seemed quite dismissive and decided not to arrange admission. :-/ Mum was only discharged from hospital a few weeks ago after a 5month stay post- surgical problems after bowel surgery/chemo/radiotherapy.

 

[Johnjoe13]

Given your mums age and the medical history you have mentioned you should really consider taking her to A&E, there are people in this country calling an Ambulance for less life threatening ailments I think you would be perfectly justified in seeking emergency assistance.

 

[Dogdaisy]

Thank for replying, my mother didn't want to go to A&E and based on previous experience of waiting outside A& E in an ambulance for an hour, then 8 hours on a trolley on a drip, then being discharged at 11pm at night - its not good for an older person. My father died a couple of months ago after being admitted to A&E with pneumonia after being left on a trolley for 18 hours before getting onto a ward, so I quite understand why she wasn't wishing to go to A&E. The GP an arrange a direct admission and I don't quite understand why they don't do this and it may help relieve the terrible pressures on A&E.

 

[donnellysdogs]

As others have also said.. I would consider A&E... especially after reading about your mums op and treatment... she needs better care than what she has been given and to me that would necessitate A&E looking at all her bloods etc and getting her on a drip.
It is important to keep your mum hydrated...

 

[Energize]

It would seem to be that the UTI is causing her glucose levels to rocket and, combined with her just recently being stopped her diabetic medication, her body can't control it anymore.

Personally, I would be insisting that a GP from your surgery did a visit tomorrow to assess her needs. I can understand the issue re going to A/E and, as you say, a GP can arrange a direct admission.

Is your mother on antibiotics? If not, it would appear she needs them so be sure to mention this to the GP tomorrow. Also, I would have thought your mother needs something to get more insulin circulating, ie Gliclazide or maybe insulin. Lots of non-sugary fluids so tea, coffee, water but no sweetner or sugar.

I don't understand why the carers have been giving her so much glucose either. Perhaps a word, or a note, explaining your mother is still diabetic, even though she's been stopped her medications recently.

Is there someone who can check her glucose levels at various times during the day? Again, I would consider this essential, especially before meals and snacks etc.

Wishing you all the best during such a stressful time. {{{ hugs }}}

 

[Dogdaisy]

It would seem to be that the UTI is causing her glucose levels to rocket and, combined with her just recently being stopped her diabetic medication, her body can't control it anymore.

Personally, I would be insisting that a GP from your surgery did a visit tomorrow to assess her needs. I can understand the issue re going to A/E and, as you say, a GP can arrange a direct admission.

Is your mother on antibiotics? If not, it would appear she needs them so be sure to mention this to the GP tomorrow. Also, I would have thought your mother needs something to get more insulin circulating, ie Gliclazide or maybe insulin. Lots of non-sugary fluids so tea, coffee, water but no sweetner or sugar.

I don't understand why the carers have been giving her so much glucose either. Perhaps a word, or a note, explaining your mother is still diabetic, even though she's been stopped her medications recently.

Is there someone who can check her glucose levels at various times during the day? Again, I would consider this essential, especially before meals and snacks etc.

Wishing you all the best during such a stressful time. {{{ hugs }}}

Thank you for your reply, I will contact the GP again in the morning. The carers were given info via the GP that mum had been having what were thought to be low bloodsugar episodes, so they were giving her what they thought was helpful to raise her blood sugar before getting her up in the morning, though I did point out biscuits and orange juice are not part of a diabetic diet and should be avoided. Unfortunately I think this might have been going on for about 10 days since I was last visiting (I live a couple hundred miles away, I stayed for 2 weeks then came away for a break, there are other family members closer by who are also providing day to day support but a care enablement package is in place to support mum to meet her wish to live independently and they come 4x a day to support mealtimes etc. I have repeatedly asked the GP to monitor the blood glucose but they say they only do this for Type 1. I can monitor it when I am there but the care staff are not allowed to for some reason. :-/

 

[Dogdaisy]

As others have also said.. I would consider A&E... especially after reading about your mums op and treatment... she needs better care than what she has been given and to me that would necessitate A&E looking at all her bloods etc and getting her on a drip.
It is important to keep your mum hydrated...

Thanks, yes, I think she should be on a drip and bloods done asap.

 

[Resurgam]

It must be so worrying and infuriating too - My husband had strong words with the carers giving his mother two lots of toast and jam every morning - It was noted down that she'd had breakfast but the second lot did not bother to read the notes and neither took any notice of her being diabetic.
I had dextrose tablets shoved at me by the pharmacy staff as soon as I said diabetic - it is some sort of automatic reflex, because we all know how essential it is for diabetics to be given sugar all the time - NOT.
I hope that your family is giving your mother low carb meals so as to minimise the impact on her blood sugar, and that the carers aren't adding in those foods they think are essential.

 

[gillianwrdl]

Your Mum should be assessed by a good Endocrinologist as soon as possible, as it looks like she has received hit and miss treatment so far. Something has been missed. Her sugar level should be monitored continually..she should have her own meter.

 

[donnellysdogs]

If the carers/nurses cannot accurately assess whether your mum is high or low then it is vitally important that foods in kitchen are suitable for when her bloods are high....the carers as well need educating about diabetes!!

 

[kokhongw]

While the infection and medications may cause the elevated glucose, it would still be helpful to note what she ate and drank before the glucose reading shot up. Would suggest opting for lower carbs meals and snacks where possible to help stabilize her glucose levels.

Friday 3/2/17 23.7 ( 9.31am). 19.1 (10.30am district nurse). 16.5 (2.39pm). 19.9 (7pm.) 17.5 (19.39pm). Saturday 4/2/17 25.1 (8.30am) 21.9 (10.40am). 11.8 (4.30pm). 20.2 (9.15pm). 15.8 (9.45pm paramedic) Sunday 5/2/2016 18.2 (8.48am) 16.4 (1.02pm). 20.4 (9.45pm). Monday 6/2/17 13.3 (9.15am). 15 (10pm). Tuesday 7/2/17 18.2 (6am) 14 (6.15am) 11.2 (10am). 20.6 (4pm). 27.4 (6.30pm). 14.5 (10pm).

 

[Johnjoe13]

Thank for replying, my mother didn't want to go to A&E and based on previous experience of waiting outside A& E in an ambulance for an hour, then 8 hours on a trolley on a drip, then being discharged at 11pm at night - its not good for an older person. My father died a couple of months ago after being admitted to A&E with pneumonia after being left on a trolley for 18 hours before getting onto a ward, so I quite understand why she wasn't wishing to go to A&E. The GP an arrange a direct admission and I don't quite understand why they don't do this and it may help relieve the terrible pressures on A&E.

What a shocking state of affairs with this country and the NHS, and I'm so sorry for the circumstances surrounding your fathers passing, we hear of these things all to often. I think it's utterly disgusting that our elderly in particular are treated in this way and denied the respect and dignity which should be afforded them when they are sick. I have a serious issue with the way our NHS is structured and run, hell I think in some cases sick and dying animals are given better treatment and care. I really hope your mum gets seen and treated very soon.