high glucose emergency

m2jpilot · #1 (**permalink**) 02-09-2009, 05:24 PM

I'm a fairly new diabetic. Just tested a couple hours ago and was at 588, an hour later after 30 units was down to 498, some said I needed to go to the ER. When I was diagnosed I was in the 600's. Does a high test really mean I need to go to the ER?

GeishaGirl · #2 (**permalink**) 02-09-2009, 05:28 PM

Give it a little time -- but not too much. Sometimes the sugars will go down slowly for awhile, then crash hardcore. Give it another 1-2 hours, and test your urine for ketones if you haven't already.

I've had that happen where I'm at 400 and give the appropriate amount of insulin. At 1 hour, my sugar is only down to 370, but by hour 2 I'm at 270, and hour 3 sees me around 100.

JediSkipdogg · #3 (**permalink**) 02-09-2009, 05:38 PM

On insulin or not? If on, all the ER is going to do is give you some insulin, watch you a few hours, and bill you (or your insurance) for 2 grand. If you're on insulin, take some and see if it comes down. Test again in 30 minutes and if it doesn't drop below 500 then consider the ER.

m2jpilot · #4 (**permalink**) 02-09-2009, 05:40 PM

thanks all, kinda what I figured, but got an friend nagging me about it, told her thats all the ER would do. Definitly keep an eye on it though.

Thanks again

JediSkipdogg · #5 (**permalink**) 02-09-2009, 05:46 PM

Quote:

Originally Posted by m2jpilot

thanks all, kinda what I figured, but got an friend nagging me about it, told her thats all the ER would do. Definitly keep an eye on it though.

Thanks again

Being a dispatcher (poline only though) you'd be amazed at some of the squad runs we assist on. The calls generally come out as diabetic emergency and then when I read the details it says BG level of 40 or 300. Ok, if 40, grab some OJ, drink it, and call me back in an hour. If 300, take a shot and call me back in an hour. Most think ER is needed when they do nothing more than the average person can do. The only difference is there you have 10 people monitoring you instead of 1 or none.

fairyblood · #6 (**permalink**) 02-09-2009, 05:55 PM

You are doing the right thing. Keep checking and have some low supplies around because 30 units is quite a bit of insulin. I often drop low when I drop 100 in an hour. Just keep your eye on it and you should be fine. Out of curiosity why do you think you got your blood sugar up there.

m2jpilot · #7 (**permalink**) 02-09-2009, 06:05 PM

yeah thats what I told her. Going to the ER was a waste of the ER's time needed for real emergencys. That I could do what they would do, she mentioned the Dr monitering it. Said I could do that myself as well. At work right now and several people around if something happened, let a couple know I was high and what to do if something did happen.

All I can imagine is I got up late today. Really late, and thus was late taking my 1st injection of the day so probably went too long with out injecting. Taking 4 shots a day. Hopefully one day the VA hosp will let me get on a pump.

Subby · #8 (**permalink**) 02-09-2009, 06:19 PM

Bearing in mind you have seem some downward movement now, it seems reasonable to monitor at home - very closely, and extremely important to keep your fluids up. A 588 is hardly cause to be casual nor considered just like a 300, as is a rather worrying line running through this thread. Go to the ER at any time you feel you need to. It is NOT a case of "wasting the doctor's time". I do not know if the description was accurate here as to US response to potential DKA as giving you insulin and booting you out the door in an hour or so, as comprehensive rehydration, possibly through drip, convincing stabilisation and further monitoring should also be part of the response. Do NOT take people's opinions here as authoritative medical advice.

JediSkipdogg · #9 (**permalink**) 02-09-2009, 06:30 PM

Quote:

Originally Posted by Subby

I do not know if the description was accurate here as to US response to potential DKA as giving you insulin and booting you out the door in an hour or so, as comprehensive rehydration, possibly through drip, convincing stabilisation and further monitoring should also be part of the response. Do NOT take people's opinions here as authoritative medical advice.

Sadly in the US alot do that. They will give you an IV to rehydrate and then add insulin to it. The problem is, depending on hospital protocols, some may or may not listen to what your correction factor is. Some will give you insulin for what they think you need and it will either drop you like a rock or do nothing. Then once you are stable for about an hour, it's out the door. In many places it's known as treat em and street em. It's a way to keep insurance costs down since one ER visit can easily cost $2000 without any tests.

m2jpilot · #10 (**permalink**) 02-09-2009, 06:36 PM

I could be way off, but if I do have insulin onboard, a DKA wouldn't be a possibility would it?

JediSkipdogg · #11 (**permalink**) 02-09-2009, 06:40 PM

Quote:

Originally Posted by m2jpilot

I could be way off, but if I do have insulin onboard, a DKA wouldn't be a possibility would it?

Are your levels dropping? If you have insulin on board and it's working, then most likely no. You might have ketones present that could take a while to go away from the period when you had no insulin.

Do you take lantus and that's the shot that was late this morning? I know most doctors recommend doing it at night as it's generally a steadier time that you can give the same time everyday whereas with the morning you can do what you did today, sleep in and forget.

m2jpilot · #12 (**permalink**) 02-09-2009, 06:44 PM

I take 3o units of a long lasting N in the morning and 8 units of short R before each meal.

JediSkipdogg · #13 (**permalink**) 02-09-2009, 06:47 PM

Quote:

Originally Posted by m2jpilot

I take 3o units of a long lasting N in the morning and 8 units of short R before each meal.

There's a lot of your problem. Then I see in another post you're not on insurance, so that must be why you are on N and R. N doesn't really cover 24 hours and it's highly recommended to take twice a day. Once before breakfast and once at dinner. Then the R would be taken at the same time minus lunch unless you eat a super large lunch.

I'll say this, control is very hard on those two. I did it for 20 years and never got below a 9% A1C.

m2jpilot · #14 (**permalink**) 02-09-2009, 06:50 PM

well I just got a new Dr at the VA and he seems like he knows what he is doing.. there is an insulin he wanted to put me on, the name fails me apritane or something like that and another that startted with a G, but he VA is a pain and making him do all kinds of **** before and if they will allow it, want to get on a pump, but don't even know if thats possible via the VA. I cant get my levels below 200 currently. I go back to the DR on the 24th hopefully we can get things changed.

notme · #15 (**permalink**) 02-09-2009, 06:59 PM

My guess is you are talking about glargine or Lantus which is a long acting insulin and Aprida a short acting.

It might be time for you to do some reading about carb counting and adjusting insulin on the amount of carbs you eat. This will help you prepare for pumping insulin as well as controlling your blood sugar better now.

I hope you are feeling better m2pilot.