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Consistently high BG

J

JessC

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Hi all,
I was hoping a professional could help me with a question.
I'm a student nurse working with a young guy who is severly autistic with type 1 diabetes. Little effort to control his BG levels is being made. He is consistently well above the normal ranges, regularly taking readings between 15-26...it is unusual for him to be below 9.
The protocol in place suggests that a 'good' reading for this gent should be 9-14...my dietician friend says that's rubbish. Is it possible for someone's 'normal' levels to be that high without it doing long-term harm? From all the reading I've done so far- I can't identify when this would be the case? I am pushing to get him a HbA1c test but due to his autism, it's not easy to persuade him to attend a medical appointment.
Any advice would gratefully received.
Jess
 
A continuous Bg level of 9 - 14 is going to mean an HbA1c over 7.4 %

Why not ask the Care team why they recommend levels this high ?

The NICE guidelines for Type 1 is not to be over 9 mmol/L two hours after meals.

This continuous level will lead to complications which, because of his Autism, will be even more difficult and upsetting for him.
 
Although I am sure there is more to this case than you have explained it sounds frankly shocking!

I understand autistic individuals can be difficult to work with (my younger brother has autism!) and I can also understand diabetes can be difficult to control (being a type 1 myself) but it sounds to me as if the advise that has been given is very poor.

Nice guidelines as Sue suggests state that 9 mmol/l is the highest reading a type 1 should have 2 hours post meal... a lot of individuals on this forum would be uncomfortable with such a reading and I believe a lot of us work to much stricter regime.

Being autistic this poor lad is likely to have trouble enough with his mood / emotions without the additional emotional / mood problems poorly controlled blood sugar is likely to give him, not to mention the untold damage high blood sugars cause in the long run.

Clearly people with autism behave differently however most require a strick and unchanging routine to feel confident in themselves.. I would suggest that once you can include the diabetes management in this routine then his condition itself should help to promote good control.. especially if you can introduce recorded monitoring and the like..
 
I did forget to mention...
If he does get his BG levels below the 9 mark, he tends to bypass the 'normal' range and dips below 3. This tends to happen maybe 3 times a week.
 
JessC said:
I did forget to mention...
If he does get his BG levels below the 9 mark, he tends to bypass the 'normal' range and dips below 3. This tends to happen maybe 3 times a week.
Click to expand...

If this is what happens then it may be that the food and drink he is consuming may not be entirely suitable for a Diabetic. Probably something that needs to be looked at as that in itself can have a detrimental effect on Bg levels.
 
Weetabix for breakfast, Marmite sandwich, crisps and yoghurt for lunch and shepherds pie for dinner...every day. I know it isn't the ideal diet but staff decided trying to make changes would stress him more than the outcome would be worth (that is not a view I share I hasten to add).
 
JessC said:
Weetabix for breakfast, Marmite sandwich, crisps and yoghurt for lunch and shepherds pie for dinner...every day. I know it isn't the ideal diet but staff decided trying to make changes would stress him more than the outcome would be worth (that is not a view I share I hasten to add).
Click to expand...


Jessc.
You really are between a rock and a hard place here. We all know what should be the right sort of diet I think, certainly not what he has at the moment ! However, because of his condition then as the staff rightly say it may cause many more problems ? Something I don't believe anybody wants to see.

Has he been seen by a proper Dietician with experience of both Diabetes and Autism ? A long shot but maybe that might help to change things, maybe even change the attitude that nothing needs to change.......

As far as it goes now, I certainly wouldn't advise anybody to change anything without expert advice. We are only ordinary Diabetic's and you really need professional help which we do not have here.
 
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