I m in a bit of a pickle. I met up with a friend of mine for coffee the other day and we talked about my diabetes and so forth since I m newly diagnosed, he was curious when he saw me testing before I ate a meal and asked if he could try. So I let him, and the number was 169 – my metre is definitely ok because I used it before and after he did and my numbers were as I expected them to be. I know, I know, I should not let others use my measuring equipment, I promise I wont do it again - but that aside, I am unsure what to do about my friend. I told him the number was out of the normal healthy range (esp because he hadnt eaten for hours), which is when he started getting anxious, and because I m not really sure myself if a number like that can actually "happen" but not mean anything, I tried to calm him down but told him he should have it checked out by a doctor. Unfortunately he is leaving for a hiking holiday in nepal tomorrow, and I m not convinced he took my advice seriously enough to do anything prior to his departure. I am a bit worried I made it sound not serious enough, is it crucial for him to do something before he is leaving germany? Could he be in acute danger? Or are there people out there who could go this high occasionally without having diabetes - he said he had been battling some infection the previous days? Any advice would be appreciated, since I do not want to be responsible for him going into DKA or something in the middle of nowhere...
Thank you!
Are you sure he washed his hands ? I did a bg on myself yesterday without washing my hands, I can't even repeat what it was, it was 20.4, then when I cleaned my hands it was 10mmols. It is a really tricky question with his going to Nepal and everything. If that is his bg, I have never done one on a normal person who came in this high. Hopefully he'll get it checked out with doc. I doubt he'll go into dka cause he has had a warning now, so it's up to him to get checked out.
I'm in the same boat w/ Mrs. She has T2 in her family but her #s are borderline. I was alarmed to find a sheet of lab test results that were a shade high but they were like a year old. I tested her the other day after some sort of bestial (carb loading...) food and she was up to 150. I'm nagging her about making a f/u appt but, of course, can't guarantee that the numbers will be elevated enough for the doc to do anything and she feels ok so she's not really focusing on it. I think she thinks she can hide behind the docs non-activity however I don't think this is a good long-term solution.
Re your buddy going to Nepal, there's probably not a lot to do. Eat less carbs but I think carbs are somewhat popular in south-central Asia, e.g. India. I'm totally clueless about Nepalese cuisine though. If it's either T2 or LADA, your buddy will probably survive but if it turns out to be T1, it could add considerably to the level of adventure!
Re-testing with clean hands is wise. If the results are accurate and his fasting BG is 169, then he is a type 2 diabetic. Many T2s don’t know they are diabetic and walk around with BGs higher than that, so the acute risk is low. Of course long term risks are greatly elevated walking around with high BGs. Most type 2s do not enter DKA as they still produce insulin, but can develop something called nonketotic hyperosmolar coma.
He needs to see his doctor and be formally diagnosed. He and his doctor can then discuss what is the best treatment for him.
The number is definitely too high. I am afraid he needs a glucose tolerance test and full blood work. Give him a call so he can decide what to do before he leaves. At least he should consult his doctor today.
I actually think what you did was perfectly ok. More of us should do it. There are plenty of people walking around with T2 who don’t know it because they don’t get regular physicals. He has the info and now he needs to decide what to do with it. You’re in no way responsible for his inaction should he not pursue it further. He’s probably fine traveling (T2 develops slowly over many years). And if he’s developing T1 as an adult, that too will likely come on slowly. Hopefully he will follow up with a doctor once he’s back in town.
Definitely get him to wash his hands and do it again. He wouldn't be aware of the dangers of testing with dirty hands and could easily have had some sugar, food, or milk on his hands.
On the very few (probably < 5?) times I've tested other people with my "works," I'm always very scrupulous about cleaning both the gizmos and them before testing. Stuff on the fingers can certainly throw off some results though?
A single number means nothing and everything. A "normal" blood sugar may swing up that high right after a meal, or it could be an error. But it could also be the emergence of diabetes. It turns out the glucose tolerance test is often a more sensitive test for blood sugar problems with issues showing up well before an A1c of fasting glucose tests shows a problem. A good way to catch diabetes early is to test 30-60 minutes after a high carb meal. A reading over 200 mg/dl is a big red flag. Many people will fail this test despite having a normal A1c and fasting glucose reading.
There is no guarantee from the blood sugar that he is Type 2, he could be slow onset type 1, but whatever, it is not normal especially hours from eating. He should see a doctor.
She said it was a fasting result, Brian. I disagree with the people who focused on hand washing. Though it can't hurt, it doesn't happen that often especially hours after eating. I had it happen once in five years and that was when I'd been preparing lunch and went to test and was super high (in the 300s) and looked and there was spreadable fruit on my fingers (jam made without sugar, but nevertheless concentrated fruit). I also agree with those who said if it is type 2 or type 1 adult onset, he will probably be fine until he returns from his trip (assuming it's not a gap year!). Worse comes to worse he can find a doctor who speaks English in Katmandu. I was diagnosed in a third world country as were other people on this board.
And yes, you expressed your concern and he makes his own choices, though control freak that I am if he hasn't left the country yet I would try one more time to convince him to check in with his doctor.
Finally if he is reachable by e-mail you can let him know that if he experience flu-like symptoms he should go to a good hospital (usually private ones in the capitals) and tell them he might be diabetic - not just assume it's the flu.
Good catch Zoe, I didn't see that. A fasting at that level is outright diabetes. I have had high readings in the 200s from things on my fingers including hand lotions.
If he actually has a fasting of about 170 mg/dl, then his A1c is probably greater than 8%. Not exactly the best status to undertake a strenous trip.
No, it's not. On the other hand I was diagnosed two months before I retired and moved to Guatemala and it worked out fine (except for that pesky little misdiagnosis thing!). If anything it kept me from overstressing on the whole thing - I was two damned busy!
Thank you everybody for your great feedback. Just an update: I have called my friend again yesterday and voiced my concern again, he went to a clinic straight away got all the necessary bloodwork done and seems to be in perfect health – I pressume it really must have been something on his hands. A good lesson for the future...NOT cleaned hands can really make a difference!
I cut up an apple for my daughter recently with one of those cut up wheel things, I barely touched the meat of the apple. I tested my sugar was was at 220. My cgm however said 110. So I retested on another finger and it was 275.Then I washed my hands and got a normal reading. I don't think I ever bothered to wash up much before then.
Clearly apple juice is very reactive. Maybe other things are not so much,
But clearly it can throw off a single test.
Back when I used test tape, I would use it to test to see if coke was diet or regular. I gave up all soda a while back, but I guess we cant really do that anymore,
Good that he is in perfect health. So it must have been some sort of bad coincidence. I hope he is not too annoyed now. Due to practical reasons I do not wash my hands for every test. But I do try to remember that I have touched glucose tabs or peeled potatoes or what ever to make sure I will wash my hands afterwards. Occasionally the meter or test stripe can fail to measure correctly. In my experience this is more related to the age of the equipment and yours is new I suppose.
