[TxBirdNerd]

Hi

I've been a T2 for 5 years. My Dr (an Internist) has that "loose control is ok, within reason" mentality. Most of his patients are older (60+) and have chronic (but common) medical problems. He is comfortable prescribing medications and monitoring quality of life.

I have always had dependable readings (always swinging between 90 and 300). I know that is a huge range - and to be honest, I wasn't totally comfortable with it - but my Dr was. And (he always added) he has the medical degree, while mine is in English.

I have lost 60+ pounds since November 2007 and was on an Insulin-only program, after Actos stopped working for me. I have one working kidney (the other is no functioning due to congenital defect).

Anyway, for NO APPARENT REASON, my BG fell to 60 one day. I was able to correct with Glucose tabs and a snack. Despite recovery, I just didn't feel well after that. A few days later, my BG spiked to over 600 and I had heavy keytones.

I called my Dr and he asked me to bring it down with additional boluses every 2 hours. Long story short, it took me 6 days to get my BG under 300. I did it with the additional boluses, a change to my basal insulin, as well as a bolus (mealtime) scale that was doubled. That was the longest 6 days of my life.

During that time, I spoke with my Dr repeatedly - explaining my concern about my declining condition. He said I did not need to go to the ER, because all they would do was put an IV in and I could keep myself hydrated (more cheaply) at home.

A few days later, I developed a stomach virus that kept me from holding anything down. I lost 7 pounds in 5 days. I called my Dr the second day and (because he was on vacation) saw an associate of his.

She was flabbergasted at the events of the past several weeks. And she said that when my BG gets above 400, I need to go to the ER. She gave me medication for nausea and diarhrea (sorry about spelling there). I did get better after 8 days in bed. I saw an Endo (first time) and he added 3 new meds and re-worked my insulin, and after 3 days - my BG is beginning to normalize (100-185). Yesterday I found out I had Cryptosporidium (explaining why I was so sick - but still not explaining the spike of 600+). There has been an outbreak of Crypto in the Dallas area over the past month. Not sure how I contracted it.

So, I have to ask these questions:
- How high is too high?
- How long is too long with a high (i.e. how long can you go without doing kidney damage)?
- What warrants a visit to the ER?

I fired my Dr (seemed to be the right thing to do) and I have confidence that my Endo is on the same page (tight control is good control).

Any advice will be greatly appreciated

Have a good day!

[Scrabblechick]

I'm sure someone who has more info than I do about this can give you better answers, and it still may vary by individual.

I do know some here on the DF say system damage starts with prolonged BG over 140.

However, congratulations on doing what you need to do to have better control and better numbers!

[matingara]

i strive to keep my 2-3 hour post prandial BGL under 140 mg/dl.

i strive to keep my fasting BGL under 108 mg/dl.

i strive to keep my hbA1C under 6.0% - but i am ok with < 6.5%.

i mostly succeed at these aims due to reducing my carbohydrate intake.



-- Joel.

[ShottleBop]

According to Jenny Ruhl's book, Blood Sugar 101, The AACE recommends that, by two hours after a meal, you be below 140, and that you have a fasting blood sugar of under 110.

Because research shows that neuropathy occurs at levels above 140, however, many people try to keep their blood sugar below 140 by one hour after a meal, and below 120 by two hours.

[Kim_in_TN]

WOW, I sure am glad that you acted in your own best interest! Your former doctor needs to be reported!!! I'm sorry you've been so ill, and hope that you feel better and get things under control very soon!

[Real4]

Originally Posted by TxBirdNerd

A few days later, I developed a stomach virus that kept me from holding anything down. I lost 7 pounds in 5 days. I called my Dr the second day and (because he was on vacation) saw an associate of his.

A lot of your problems are right here. More than likely, it wasn't "A few days later, I developed a stomach virus." Most likely, you had that problem MUCH earlier, but did not openly experience it until "A few days later." A developing infection will give exactly the problems you described: a very high blood glucose reading that is very difficult to bring down. An unexplained high that is difficult to treat is characteristic of a body fighting infection. Your body is pouring out supplies (glucose) so that the cells have the energy to fight the infection, unfortunately a diabetic needs also to properly manage his/her insulin dose so that glucose can be used.

You did right in firing your old doc, but you can't reply on just an endo. Diabetes to be treated well demands self- management.

[TxBirdNerd]

Thank you very much for your replies. I agree I need to rely on myself first, then on my support team (including the docs). And I suspect that the infection was to blame for the unusual high. I've almost completely recovered and have things very close to my goals.

Thank you