Help. I can't figure out what is going on. - Diabetes Message Board

Ackray · 12-11-2005, 03:55 PM

My husband (34) was diagnosed with type 2, three years ago. He's a little over weight, has high B/P... Anyways, last Sunday he was acting funny so I had hom take his blood sugar and it was 560! I sent him to the ER where they gave him fluids, and insulin but only got his blood sugar down into the 400's and then sent him home? I thought he should have stayed.

He saw his doctor the next day and they put him on 3 units of Lantus at bed time. They changed his diagnosis to type 1. His lowest blood sugar since then was 147. Mostly in the 200's and 300's though. They raised the insulin to 5 units.

What I'm not getting is that he has this HIGH blood sugar and never any lows. Now, looking back over the years we think he has had type 1 for 15+ years but not all of the clasic symptoms. He seems to have all high blood sugars so maybe his body is just used to functioning in the 300's so it will take a long time to get it down and under control? He had an a1c done 2 weeks ago and it was 9.5.

I'm scared! What is going on and why can't we get the blood sugars down?

He sees the doctor tomorrow and I'm hoping they put him on a sliding scale for the insulin. We have an appointment at the Joslin Diabetes Center in January.

Help!

Thanks.

desertdiabetic · 12-11-2005, 04:29 PM

This is too dangerous of a situation to comment without more knowledge that what I have with type 1. I do know that type 1's do not go 15 years without being detected. You are unable to live for extended periods without any insulin. Before insulin was used in treating diabetics(only type 1 known back then) being diabetic was the death sentence.

If he is type 2 then you should keep in mind that more insulin to an insulin resistant person does not act at all like the same insulin given to a non-insulin resistant person. That's where the medications come in to make the insulin resistance less. Type 2's, for the most part, don't need more insulin as much as they need the insulin they do produce to work. Yes, one of the stages of type 2 is where you produce less on no insulin. The point being that if he is type 2 and they are not treating the insulin resistance then more insulin is not going to give the same results.

These bg numbers you gave are extremely high. You did not mention the other aspect of treatment - diet and exercise. both are critical. No matter what you do with insulin or medications poor diet or no exercise can do you in.

Ackray · 12-11-2005, 04:39 PM

When he was diagnosed with the type 2 we changed his diet and he exercises (so that's been three years now). The diet part is hard for him. He only got a blood glucose monitor about 3 months ago. So we haven't been doing this very long. His diagnosis was only changed a week ago now. I know that these numbers are very high and dangerous. We live in a place where the heathcare isn't so great and I feel like they aren't helping him at all. Our docs are really layed back and terrible.

He also takes metformin 500mg twice a day.

desertdiabetic · 12-11-2005, 05:07 PM

Well, from what I am learning about the medical profession and diatetes is that you are in the typical situation and not the exception.

Another thing that jumps out is the 500mg X2. My numbers were never that high and I am on 500mg X3. The strange thing is I cannot find anyone that takes metformin 3 times a day. Also I am on Avanda(2mg 2X) along with Metformin. The two together work better than alone. You would think that your husband would be on more than that. I do understand how the diet part is the most difficult. In my case it is the exercise. Diet changes come easier for me. I have gone low carb, no restrictions on fat(except the 'bad fats') and much smaller portions. His bg's will respond. I lost 60 pounds in 9 months and have held to the top of my acceptable weight range..

Because your husband is having the most trouble with diet I suggest you google Richard Bernstein, MD for your education. His diet suggestion will only get your husband defensive and probably won't work. I only say this because you will find so much more than than his low carb approaches. He is a successful doctor that treats only diabetes. The best thing about Bernstein is he teaches about all the aspects of diabetes. There is so much to learn and understand.

Knowing what his bg's are is key to figuring out what he is doing and what is hurting the most. I don't like it either, but it is important to understand where you are.

You, the patient or family, have to take control of the treatment program. The medical profession is out of the loop here. They do their part and prescribe medications and deal with the other parts of your health that you will experience with diabeties.

SamQKitty · 12-11-2005, 08:29 PM

There is a test that can be done to determine if he's a T1 or a T2. It's called a C-peptide test.

It is possible to be T1 and also be insulin resistant. Regardless of whether he's a T1 or T2, if he is insulin resistant, he will need some kind of medication (such as Glucopahge or Avandia) to help him with the resistance, but with blood sugars running as high as his were, it's a good thing for him to be on insulin too.

I think his doctor is being very cautious with the Lantus, not wanting to give him so much that he ends up having serious lows. He should be followed very closely, perhaps checking in with his doctor every week (by telephone probably) until his numbers get better.

If his numbers are staying down in the low 200's and high 100's, he should be okay until his appointment at the Joslin. They are truly experts there, and will probably be able to figure out what's going on and what to do about it. Make sure he keeps testing and keeps a log...it would be a good idea for him to keep a food and exercise diary too, if he's willing, so when he goes to the Joslin he can give them as much info as possible. The food/exercise diary combined with a blood glucose log will help them pinpoint what needs to be done. In the meantime, low carbing is a good way to help keep the numbers down, even if it's not what he wants to do forever.

Ruth