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Is this hyperglycaemia?

Annb

Expert
Messages
9,231
Location
Western Isles, Scotland
Type of diabetes
Type 2
Treatment type
Insulin
Just out of hospital due to a "bad turn" which has not been diagnosed, but from which I have, more or less, recovered.

I take 5 different HBP medications plus insulin and metformin. Also have fairly severe arthritis but try not to take pain relief because it knocks me out and makes me unable to do anything much. I also have problem because I retain too much fluid - so I swell up every day. Fridays are always a busy, painful and stressful day for me but I only take 4 of my BP medications because of their diuretic effect. Every Friday night I feel awful and on the point of collapse, but usually make it to bed-time. Last Friday, I didn't.

I had been feeling a bit "off" for a few days - headachy and light headed, plus a kind of vertigo when a lay on my left side - but was still functioning. When I finished what I was doing on Friday, I felt very weak and very hot but managed to get home and there collapsed into a chair (don't remember sitting, but I woke up 4 hours later, still in my coat. By this time, I wasn't hot but I was shaking and had a bit of pain in my chest. I made it onto the top of my bed, fully clothed and there shuddered and shook for the next 4 hours until I decided to call NHS 24. They sent out paramedics, who decided I needed to be hospitalised.

Doctors didn't find anything definite to tell me but took me off of all my medication and put me onto a fluid drip. BP was, for me, not too high by then and during the next few hours it dropped to a point where they were beginning to be concerned. The only food available was carb rich and my blood sugars were running at around 14 - 15 most of the time, despite, eventually using my normal insulin (Humilin S). Saturday night insulin was Lantus Solostar (62 units) which resulted in BS level of 14 at 0730.

I tried to eat as little carb as possible, but the only thing available on Sunday morning was porridge. (32 units of Hum S). No Metformin. This put the BS up to18+ for a bit. Lunch was 1 slice of roast pork and about half a tablespoon of boiled carrots plus a slightly under-ripe banana - lowest carbs I could see on the menu.

Chest pain went away, they took me off the drip, told me my kidney readings were "a bit high" (which they kind of blamed on Metformin) and my potassium level was just outside the range (5.4 instead of what should be top level of 5). ECG reading was a bit odd, but it always has been with no ill effects. They had no idea what the problem had been, so they sent me home.

Monday now - have an appointment with a GP tomorrow and can't get a reply from the diabetes clinic for immediate advice.

Don't know whether to take my BP medication or the Metformin today, don't know whether I was actually dehydrated - I am always thirsty and often running to the toilet, especially if I have taken diuretic pills. Don't know if my BP is too high or too low. Don't know if, perhaps, I am on the wrong medication.

I am trying to take it easy today - no rushing around and the house can just be a disaster area for now - just to stave off any further problems. Insulin when I eat something, but nothing else. But does this sound like hyperglycaemia?

Any thoughts would be welcome.

Thanks
 
Hi Anne,

What an ordeal! Glad you are home now and feeling somewhat better.

To answer your question, 'hyperglycaemia' is just a medical word for high blood glucose. So anyone with high blood glucose also has hyperglycaemia, if you see what I mean.

I am very glad that you have an appointment for a follow up, and please do continue to take it easy.

Obviously, I am not able to pass comment on your medical treatment or various health issues, especially with the different medications you are on. Your healthcare team are the people for all of that. Hopefully your doctor will do a full medication review with you when they see you.

But I do wonder if anyone tested your ketones?
And whether your health care team mentioned a condition called HSS or HONK (please see the links I will put in below).
There are lists of symptoms included that you may well find interesting.

https://en.wikipedia.org/wiki/Hyperosmolar_hyperglycemic_state

https://www.diabetes.co.uk/diabetes-complications/hyperglycaemic-hyperosmolar-nonketotic-coma.html
 
I can’t comment either on your diagnoses or treatments, however were you given a discharge letter by the staff at the hospital? If so have a read, it should tell you your discharge medications.
 
Thanks for the replies. I don't have the equipment to test for ketones, so can't monitor the levels. Those links were very informative (and I had to learn some new words - always good for me!) My BS levels were nowhere near the 600 figure (which I think is about 30 on the scale I use) described in the articles I have seen, so, although the readings were hyper, that probably wasn't the issue. It seems that the medical assessment unit at our hospital doesn't give discharge letters, but will, presumably, send a report to the GP. Eventually got a reply from the diabetes nurse - she doesn't think it sounds diabetes related and and quite comfortable with the high (to my mind) readings. However, she did agree to leaving out the Metformin meantime.

It also occurred to me that I had a shingles vaccination about a week and a half ago and thought it was too far back to have had any effect, but she says that some effects can take that long to manifest themselves, so it could be that.

I'll ask the GP tomorrow to do a thorough review of my medication and see what that brings about.

Thanks for your help.
 
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