Type 1 question about high blood sugar readings

Fleur24

Member
Messages
5
Type of diabetes
Type 2
Just to be clear, I am type 2, but I have a type 1 friend who does not seem to be getting helpful advice from his healthcare professional. He is not the best at monitoring his blood sugars, and guesstimates how much he should inject for a meal. Obviously not that well. Finally he shared some readings with me. 32 on waking, and 24 before dinner tonight. If he goes below 20 he gets symptoms of a hypo. He has problems with his eyes and stomach, and is worrying about it affecting his heart. He has been interested in me putting type into remission through the keto diet, but I don't think he should make drastic changes at the moment. I think reducing his level of blood glucose should be done gradually, but no one has any advice on if it is safe to have hypo symptoms if blood glucose is in the high teens, and give him some guidance on what levels to aim for. I was wondering if anyone has been in this type of position and how they improved things if they were.
 

MeiChanski

Well-Known Member
Messages
2,992
Type of diabetes
Type 1
Treatment type
Insulin
Hello, has your friend been testing for ketones? If ketones are present, he needs to go to the hospital asap. For your friend to lower levels gradually, is to test his blood sugars more frequently, learning how to do basic carb count - either he needs to speak to his dietitian or ask for a carb counting course like DAFNE. Carbs and cals book or app would be a good start and kitchen food scales. Bertie online course is a good start too - https://www.bertieonline.org.uk
He would obviously feel symptoms of hypo because his body isn’t use to lower numbers but he does need to lower his numbers. Ideally type 1s should be between 6-9mmol/l but that isn’t gradual for your friend.
 

NicoleC1971

BANNED
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3,451
Type of diabetes
Type 1
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Pump
Just to be clear, I am type 2, but I have a type 1 friend who does not seem to be getting helpful advice from his healthcare professional. He is not the best at monitoring his blood sugars, and guesstimates how much he should inject for a meal. Obviously not that well. Finally he shared some readings with me. 32 on waking, and 24 before dinner tonight. If he goes below 20 he gets symptoms of a hypo. He has problems with his eyes and stomach, and is worrying about it affecting his heart. He has been interested in me putting type into remission through the keto diet, but I don't think he should make drastic changes at the moment. I think reducing his level of blood glucose should be done gradually, but no one has any advice on if it is safe to have hypo symptoms if blood glucose is in the high teens, and give him some guidance on what levels to aim for. I was wondering if anyone has been in this type of position and how they improved things if they were.

I am sure that if your friend does go to his appointments and is honest about these readings, then his team would be rightly advising him that running this high will damage him in the long term. I imagine he must feel rough running this high but it is easy to get used to feeling bad like this and to get a sensation of 'hypo' when your blood sugar goes below what your body is used to.
As he's on insulin he obviously needs to be careful when reducing carbs so as to get his bolus dose right however the first step is for him to get the basal right otherwise he'll be fighting a losing battle.
This is done by not eating carbs for 24 hours and testing to see what happens usually including some night time tests. No bolus dosing obviously.
You don't say how old your friend is or why he is taking such lax care of himself? Diabetes type 1 is really about self management and getting used to how your body reacts to food/exercise/stress so its an N of 1 experiment.
Personally I find it almost impossible to achieve normal blood sugars (4-7) when eating carbohydrates and guessing insulin doses. If he is willing to eat the same foods/portions daily then this might be possible but I find it easier to minimise starches and sugars.
As for hypo symptoms at blood sugars between 5 and 20, I'd say they are safe and would lessen when his blood sugar normalises. They are not a good enough reason to risk his sight, kidneys, heart and nervous system by running high. Sometimes I mistake a rapid drop in by bgs for a hypo but it is usually a sensation. Again if you are not taking much insulin to cope with carbs you get less of those big drops and rises that can cause panic eating of carbs!

Agree that a ketone check is imperative but it should be noted that some of us can have scary high bgs like this without going into ketosis
 
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Fleur24

Member
Messages
5
Type of diabetes
Type 2
Thank you for your replies. When asked about the advice they give when he asks, he says they are puzzled, but the HbA1c readings must be out of whack so tbh they must know things are not right. I wondered if the sugars are high, but he gets the symptoms of hypo, that the glucose is not getting through so his body feels like it is shutting down. I have not the experience or knowledge to know if this is dangerous, because it actually is, but he seems reluctant to ask his healthcare professionals. I do know that if it continues like this he can only get worse.
 

miahara

Well-Known Member
Messages
1,019
Type of diabetes
Type 3c
Treatment type
Insulin
I suggest your friend asks to be referred to a diabetologist/endocrinologist for some proper advice, and then to get support from a DSN. I'm T2 though now insulin reliant, but it took over 3 years for my GP to pass me over to secondary care and I'm now receiving proper care and support.
 

ert

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2,588
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Type 1
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You are a really good friend. If your friend's blood sugars are above 13 mmol/L for an extended time, it's really important that he tests for ketones.
For type 1''s those sort of results isn't unusual until your friend's diabetes team get to the bottom of what is happening with dosing. The way forward is to keep a diary of our blood sugars, food and dosing four times a day: before breakfast, lunch, dinner, bedtime, to take along to his diabetes team, to pinpoint the changes needed to the insulin regime.