HbA1c levels normal, but glycemic index measures very high

Dear fellows,

My mother (78) is type 2 diabetic, insulin dependent, 14 u.i. NPH insulin before breakfast. Tests were performed a month ago and HbA1c levels are close to the upper permisive limit. The Doctor said those levels are normal, at least for the time being. Unfortunately, she has been sleepy for most part of the time, much especially right after breakfast and right before lunch. Her being sleepy worried me so much that I decided to measure capilary blood glucose levels in the morning and also right before lunch. Those numbers turned out to be very high such that the glucometer displayed "Hi" as the actual measure. That is indicative of a number level of almost 600 mg/dl . During those episodes she also complained of excessive thirst. Now, the HbA1c test was performed at a Laboratory while the glucometer measures were done at home. My question is: Could there be the case of an HbA1c test being normal, while, at the same time, glycemic index rising up too high after meals? I have to tell that dietary wise my mother has been very careful and no doubt about the carbohidrate intake during breakfast. Second question: could it be the case that she needs injections of R-insulin (human, fast acting) before breakfast and lunch? Your suggestions will be much appreciated, thanks in advance, folks.

Ivan.

Thank you Indy and Spiker for your responses.

I took my mother to the emergency room on Friday afternoon at 5pm. Her tongue showed signs of dehydration, and in light of that, a laboratory blood glucose test was ordered. The result was 408 mg/dL. They administered saline solution, parenteral route. Then the glycemic index started to lower. Now she is getting better. From friday night to Sunday afternoon there has been a great deal of improvement. What I am concerned about is that, even with a glycemic index being normal before breakfast, as reported by nurses, this value rises up again after breakfast and after lunch. The symptoms are now moderate thirst, somnolence, polyuria (this last one,especially during the night). The doctor have just told me that, first, she has to address the episodes of hyperglycemia first so that they don't happen again; then she will consider administering mealtime insulin.. My questions for you folks is: When the body is going through an urinary infection , for example, is the natural way for the body to counteract that infection the building of carbohydrate and protein entities as a manner of defenses and with that, the aparent rising of the levels of glucose in the blood? Is that how it works? Could you all be so kind in providing helpful links on the manner how it works? thanks in advance.

Ivan.

Thanks a lot for the motivational response. Ivan.

Brunneria said:

Well done for getting your mother medical attention! I am so glad she is recovering.

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Spiker said:

I'm very glad your mother has been looked after.

Blood glucose rises normally during infection. This is a problem for diabetics. I believe the reason that blood glucose rises during infection is to supply energy to the immune system and immune cells - I'm not sure.

The problem this causes for diabetics is that, if insulin is short, immune cells cannot use the blood glucose, but the infecting bacteria can use the glucose. This makes defence against the bacteria more difficult. It is one reason why it is very important to monitor blood sugar closely during infection, and provide additional insulin as needed.

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Spiker,

When you say "provide additional insulin as needed", I convey from that "rescue insulin" or did you mean "bolus-insulin" ? Ivan.