Hi Everyone,
I really don’t understand something. I’ve heard a lot of stories about people having to go to the ER or the hospital because of a really high, high. Some people talk of their in laws Doc sending them to the hospital with a 435. Ive heard more than 1 story like that, yet, I’d say in the last month alone I’ve gone HI (>650) two times. It got me nervous but I acted accordingly and got myself down. Should I be doing something different when I go that high? Should I call the Doc? What to do?
Thanks, Amy:)
PS. Lows have gone down to the 30’s maybe 1 time even lower, couldnt get to my kit.
i have only been admitted once. i woke up with a “HI” and high trace of keytones. I did a correction and waited an hour. It had gone down some, but i still had a high trace of keytones (my stomach hurt badly, as well). So i called my endo and she said to keep tabs on it and call her back in an hour. So after the hour was up i called her (my level was down in the 300s, but i still had high keytones) so she told me to go to the ER. They hooked me up to an IV to keep me hydrated and flush the keytones out. If you sucessfully treat your highs on your own, it’s ok. But be aware it may do damage you can’t see. I have gone over 400 and treated at home and my keytones came down as well. The main reason i went to the ER was because i couldn’t get the keytones flushed out.
Amy, I had trouble with high blds for a long time, I neglected my health to the extent that I ended up in hospital. This would not happen as the result of a few high readings, this was continuous highs over a period of a few months ( everyone is different ). I would have a word with your doc about your odd spike and the lows, they will, with a few adjustments settle no doubt. When I was younger 12, 13, 14 , 15 yrs I was terrified of highs, thought I was gonna collapse or something, but I didn’t. This is not saying that it’s okay but this D has a mind of its own at times, its not your fault. Perhaps you could check to see if you have any underlying infections if you have a series of highs.
Everyone is different, but it’s not so much a matter of ONE >400 reading - only if it STAYS that high for multiple hours and if you are producing ketones - and this is mainly because it can spiral out of control and send you into DKA pretty quickly. And once you’re that sick, it might be harder for you to get the help you need. Over the last month, I’ve had maybe one or two random REALLY highs but they don’t necessarily bother me if I give myself a bolus and notice it start to go down within the hour. If you’re having >650 and <30 readings often though, sounds like you need to talk to your Dr.
Last autumn I went in to hospital to have my frozen shoulder surgically released. Despite being put on the sliding scale (insulin/saline drip), my BG starting rising prior to surgery and by the evening after the operation I was running at 25.2 mmol/l (approx. 453.6 mg/dl), drinking water by the bucket load, ■■■■■■■ like there was no tomorrow and giving everyone short shrift! Before going in to hospital for the operation and based on previous personal experience of undergoing surgery, I was looking forward to being on the drip knowing that it’s meant to keep BGs beautifully stable.
After that experience, I think I’d try and sort out high BGs myself and bypass the experts ;-))
Hi Josephine,
I’m not really afraid of hi’s either. I feel like I’d much rather be high than low. I feel absolutely terrible when I’m low. I know highs aren’t any good, but I don’t know why I get there so often eitrher. When you say underlying infections what exactly do you mean? What type of ifections should I be aware of?
Amy:)
Ketones are a by-product/or waste product when your body burns stored fat for energy. Ketones can be measured in the urine with a visually read strip, and in the blood by using the Precision Xtra® meter. Before I describe various situations in which a person might have ketones, let me provide a simple review of how the body works:
The foods you eat break down into glucose (sugar). Glucose travels in the blood and into your cells. Insulin is a hormone (or “key”) that “unlocks the doors of your cells” to allow glucose to enter your cells where it can be turned into energy. So without insulin, glucose wouldn’t be able to get into the cells.
Your brain (and the rest of your body) requires glucose to function. When you haven’t eaten for a while, or during the night when you’re asleep, your liver releases stored glucose to keep you supplied with energy.
If you don’t eat for several days, the stored glucose in the liver is depleted, and your body is in a starvation state. In this situation, the body will break down stored fat to get energy, (and ketones can show in the urine, indicating that fat was burned) and also the body will create sugar out of other substances in the body in order to supply the brain with glucose.
So if you keep in mind that fat burns when there isn’t available glucose (that is, when the body is starving) and ketones indicate that fat was burned, then the following situations will be easier to understand.
There are many complications that can occur with diabetes. One serious complication is diabetic ketoacidosis (DKA). It most commonly occurs with Type 1 diabetes and is often the first symptom of Type 1, because it can often strike without warning. DKA is caused when the body has little or no insulin to use. The blood glucose level keeps rising to dangerous levels. This is called hyperglycemia.
If the blood glucose continues to increase, the body goes into an “energy crisis” and starts to break down stored fat as an alternate energy source. This produces ketones in the blood as the fat is burned for energy. As the ketone levels rise, the blood becomes more and more acidic.
DKA progresses from hyperglycemia to ketosis, which is a build-up of ketones in the body. Ketosis can lead to acidosis, which is a condition in which the blood has too much acid. When this happens it is known as diabetic ketoacidosis. This is a medical emergency and must be treated immediately by medical professionals.
Causes of DKA
The sudden start of Type 1 diabetes is only one cause of DKA.
Common infections like pneumonia or urinary tract infections can be a cause of DKA. Infection raises the level of “stress” hormones, such as cortisol and epinephrine, which raise the glucose levels in the blood.
When someone is noncompliant (doesn’t do the things necessary to control blood glucose) or can’t afford their insulin or other medications they can also be at risk for DKA.
Insulin pump failure can lead to DKA. If a person is unaware that their pump has stopped administering insulin, blood glucose levels can rise quickly.
Kids who are going through adolescence can experience endocrine changes that can alter glucose levels and insulin effectiveness.
What are the signs and symptoms of DKA?
The symptoms to watch for are not always obvious. They can start slowly and can be mistaken for other illnesses. Often toddlers do not show the classic signs of DKA.
Treating DKA means medical intervention. It’s important to treat dehydration by replacing fluids that have been lost, so most likely IV therapy will be used. Electrolyte imbalances need to be corrected and insulin therapy started to control hyperglycemia. All of this must be done under careful medical supervision.
Prevention
When you are sick:
Have a plan in place for when you are sick.
Check blood sugar every three to four hours during illness. If blood sugar gets high (usually over 250 mg/dl) check more often and check for ketones in your urine.
During illness, make sure to drink plenty of sugar-free, caffeine-free liquids. Even if you are sick to your stomach, try to sip small amounts of liquid at frequent intervals. If your blood sugar is over 250 mg/dl, do not eat or drink high carbohydrate foods or fluids.
Don’t stop taking your insulin when you are sick, even if you are not eating.
Have your doctor’s emergency number on hand, in case you need to call.
What To Do When You’re Sick
What To Do When Your Diabetic Child is Sick
Preventing DKA that is not associated with illness:
If you use an insulin pump, check it often to make sure that it is working properly and administering insulin.
Check blood sugar often throughout the day, usually four times a day.
Don’t skip insulin doses or if you are Type 2 make sure to take your oral medications as prescribed.
Hi,
That was worth saving for sure, thanks. When I was first diagnosed in Sept my regular gp didn’t even think it was diabetes from what I told him. Only when he tested me and it was HI as it was on the meter I just bought otc, he said I had type 2. Put me on pills and sent me home. He gave me a few days off, thats it. Well, I so happened to have vacation scheduled, wasn’t going to take it but now I was forced to. The whole next week I still didn’t feel better. I could barely get out of bed. It was like my legs didn’t work anymore. I kept calling my Dr. but I think he felt frustrated because he said I should get an Endo. Fine, but I couldn’t get an apt until Feb, this was in Sept!!! So he was stuck with me for a few months. I practically put myself on insulin. Needless to say I was a type 1 not 2. My regular Dr. still doesn’t agree that I am type 1! I got so skinny back then. So I could’ve had DKA. My levels were in the 400’s that whole almost 2 weeks after first going to the Dr. When I practically proved to him that I needed insulin my numbers came down and the weight came back on.
As far as testing for keytones do you suggest the visually read strip or the Precision Xtra® meter. I feel I should go right out and get one or the other for when I go HI.
You made reference to levels over 250. Do you know how often I go well over that? Just before I was over 300. What the hell is going on with me? Last endo visit not long ago, I told him I didn’t want the pump because I was regulated and not taking as much insulin as before. Seems I walked out the door of his office and started going Hi and LOW and everywhere in between again.
