Glucose Control from injury

So I worked out a plan with my Endo’s Nurse coordinator. I’ve wanted an insulin pump for years so that I could micro dose. Before meals. Bolus dosing was’t working for me. DOSE, GO HIGH, GO LOW. RISNSE AND REPEAT. So. I came up with a micdosing plan. It was working quite well.
I wanted to keep my average between 150-140 and this was working quite well. 9 month Clarity average was 144 NO lows A few out of range highs

Well all GOOD THINGS have to come to an end One Sept 11 I tripped over my own feet in the driveway. Ended up breaking my left femur and fracturing my Pelvis… almost instantly Glucoses went from 145 to above 500. Laid up in Masonicare Rehab… with large insulin doses 10 to 16 units, so far maintaing a 200-250 range. And on top of this my Hemoglobin rage has dropped.

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John, I’m so sorry about your recent injury! I encourage you to stay engaged in your glucose control to the extent you are able. As you well know, better glucose levels will help with all the healing you need. Please keep us apprised of your status. Good luck!

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I am so sorry to hear that!!! I fell and broke my wrist last January and insulin was like water especially the first few days. Within a couple of days I did have a plate put in because it was a bad length type fracture. But if I remember correctly my usage did taper off by about a week. But in my case it was just my wrist. I need to have that plate taken out now!

But one of the first things they did at emergency is give me a steroid shot, small dose in my case because I react so badly to them but they wanted the swelling to go down. My wrist was crooked and it got to hang in the air trying to make gravity straighten it out! I figured my higher BG reaction and needing so much insulin was in good part due to the steroid shot than the actual injury because that is how I’ve always reacted to steroids. Do you know if maybe they gave you a steroid shot or oral pills? That certainly makes control a lot harder and you need more insulin.

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Omg, we fell & incurred pelvic fractures only 2 days apart. I’ve had the same experience with BG rapidly shooting high. Spent 4 nights in hospital; once home things started to improve. As I’m healing, BG is also doing much better. Hospital staff wanted to do MDI; I resisted and they agreed to let me use my pump. It was still a battle of high BG readings, but better than with injections. It’s hard–it hurts to walk, sit, cough, move in any way (and you have more bones to heal than I do). I had the same issue with Hemoglobin; mine was still below normal, but “stable”, so was able to be discharged. You know how to manage your BG–don’t concede. I’m confident it will continue to improve as you heal. Keep us updated on this forum—lots of good ideas, true empathy and positive healing thoughts!

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Thanks for the good words. Now home. I stared to stabilize. The issue I hade with the Renab, facility, was the arbitrary stared me on various other, I used navalog. The chose Humalog, and Junnovia as well as blood thinner meds.

John70:
That sounds absolutely awful, I actually winced when reading your first post.

Nothing to add re bg management, but just wanted to add my wishes for a complete recovery.

Yea I was totally unaware of what severe trauma could do our Glucose levels.
I will be a long road home.
Thank for your response

Ow ow ow! I can’t imagine what you are going through! I hope you get better soon!

But this also raises a question that I have had for some time. Has anyone ever injured themselves during a hypo? And without help come out of it due to your body’s response to the injury? I had this happen to me when I dislocated my shoulder. I had blacked out and then came out of it as my blood sugar began to sore. Eventually, stopping at 325. Or was it just a fluke?

May you both heal and recover from your injuries. I believe I am in charge of my numbers,I tell my CDE what I want and prove it with my numbers. Nancy50

I am going to assume you are a T1D??? When you drop in blood sugar, a “normal” releases glucagon when needed. Some T1D’s retain the ability to release glucagon when needed, some don’t, and sometimes you lose the ability over time. In other words you can’t count on it as a T1D. A T2D doesn’t usually have this issue, but sometimes they can if they are on insulin or certain medications.

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Yes I am T1. I have heard of glucagon but to be honest I thought that was a pharmaceutical in a an insulin pen. I wasn’t aware that my body actually made it.

That aside, I have gone Hypo three times that I blacked out. Hospital run and the whole nine yards. When my shoulder came out that would’ve been the fourth time. Also on that occasion I did not have a glucagon kit to help. But it seems like my shoulder injury caused me to come out of it? I don’t know if that makes any sense? Would glucagon work only from time to time?

I’m not sure but there are probably a few people that can answer that! @Eric2 might be one of them!

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@Jup30 This is really a nice article about the possible hormones affected by Type 1.

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A glucagon injection works as long as your liver has sufficient glycogen (stored glucose).

But for most T1s, they do not have a natural glucagon response. They only get glucagon when they inject it.

In the instance you are describing, most likely it was not glucagon that caused your blood sugar to rise, but other stress hormones from the pain.

For example, adrenaline can dampen our pain response a little bit. It helps us negotiate the pain better. And adrenaline will cause your liver to release glucose.

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John–So glad to hear you’re home and starting to stabilize. Being home helps tremendously! Thankfully, I am moving around much better than I anticipated, which also affects BG (there’s just no easy way through all this, as you also know). I’m T1D for 67 years and have been on a pump for 5 years. Was discharged from hospital on a Tuesday and that Thursday started on Control IQ pump program—lots of new stuff to monitor and learn.

Hospitals sure don’t seem “to get it” with BG control. That was my biggest frustration (now it’ll be watching the bills process through Medicare, lol). But, I am home, BG is doing quite well and am healing. I sincerely hope you are in the same position now. It isn’t easy

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Hospitals are the worst place for glucose control. Your meds probably have been added, and your meals aren’t predictable and you are laying bed all day. Not to mention that your body is trying to heal.
Home will be your best place to get those back under control.
Short periods of poor control won’t have long term effects.

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Timothy Also have to note Thai I had stared a new Novalog pen the day before , even though it was kept refrigerated. It was over a moth old when I started to use it again

Yea that’s something to consider. However I’ve use insulin that was 6 months past its date before with no issues at all. I’ve also used insulin that got hot in a car. It’s much more robust than we are led to believe

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I had similar difficulties after my knee replacement (which came after 4 knee surgeries for the usual cartilage breaks, etc (not unusual, unfortunately, for old dancers)…I would just underline what Terry4 has said. My first knee surgery at 16 followed a Snap! heard by the whole studio. Each operation was a little different, of course, but so it goes. I kept performing for a bit and, blessedly, Teaching (my most heartfelt calling) until quite recently. The actual choreographing of new works, I could also maintain because I had gathered to me loyal performers who had a good sense of my Vision. My work has been inspired by and owes much to the work of the German Expressionist, Mary Wigman, through her student and colleague in the Twin Cities, Margaret Dietz…Onward…

Lynn. Thanks for your comments. I too am up and around with a cane. Medicare covered everything for me.