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Old 05-18-2011, 12:35 PM   #1
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?'s regarding sugar levels

My mom is a Type 2 diabetic. Her AM blood sugar levels (fasting) have been around 140-150 consistently. My father thinks nothing of this. Everywhere I look it says it should be 70-120. Is this a problem? Also, they did go to an endocrinologist and they said that the dr said nothing about exact times to test. Shouldn't it be in the AM (fasting), then 2 hours after a meal and then random? How many times should she be testing? We're concerned because she's been very tired, not as alert, etc. One night she was 189 before bed..isn't that bad? My dad thought anything below 200 was fine. Any help would be much appreciated!

 
Old 05-18-2011, 12:41 PM   #2
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Re: ?'s regarding sugar levels

In an ideal world, blood sugar should be less than 100 fasting and less than 140 two hours after a meal. However, some recent large studies have suggested that tighter control is not ideal for older people (higher risk of heart attack). What is your Mom's a1c? This latest study suggests that an a1c around 7 or a bit higher is ok.

I wouldn't go so far to say that anything under 200 is ok, but the 189 before bed is probably not so bad. If your Mom is having other problems, I would talk those over with the doc and re-discuss the diabetes management.
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Old 05-18-2011, 12:44 PM   #3
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Re: ?'s regarding sugar levels

I have no idea what the other number is, I haven't heard of that. What concerned the daughters is that the new dr took her off of her other meds and put her on a new med and since then her fasting levels have been higher in the AM. I keep trying to encourage them to give protein but I'm dealing with people who are counting oatmeal as protein because it has a few grams of it on the label! Is it normal to see a new endocrinologist and then not see him for another 4 months? I thought they'd keep a closer eye on her. She was in the hopsital due to levels dropping down to 25 in February, now I'm concerned they're getting too high.

 
Old 05-18-2011, 12:54 PM   #4
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Re: ?'s regarding sugar levels

It is normal to see the endo every 3 or 4 months. It sounds to me (although I'm speculating) that she was on one of the drugs that stresses the pancreas and forces it to produce more insulin and that she was taken off that for one of the ones that increases insulin sensitivity. The numbers, while higher, are not outrageous. And a few months running a little higher while avoiding a dangerous low like 25 is not a bad thing.

The a1c test (aka hemglobin a1c, or glycocylated hemoglobin test) is a blood test that measures how much sugar is stuck to hemoglobin molecules. The result is a % and as long as she is at a reasonable number, then I wouldn't worry overly much. Again, I am speculating as to where she should be as you don't mention her age. Again, if she is older, 7% or so is ok. Younger and it should be lower.

Hope this helps a bit. Keep asking questions as you need to.
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Old 05-18-2011, 01:15 PM   #5
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Re: ?'s regarding sugar levels

Thanks so much for the information! She's 84. So you're thinking they switched her because she was running so low and now averaging 140-150 fasting isn't as bad...We're just concerned because since switching she has "changed" but she also has other health issues going on, and maybe one of those have flared up. How often does someone with Type 2 at her age test? The dr was having them do 3 times per day and now the caregiver has gotten lax and is only doing it 2 times per day, both times basically fasting. Isn't it important to take it two hours after a meal?

 
Old 05-18-2011, 01:44 PM   #6
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Re: ?'s regarding sugar levels

For someone not on insulin, testing a couple of times per day is ok. I would get the caregiver to rotate testing times. Sometimes fasting and after breakfast, sometimes 2 post meal readings, etc. At age 84, her numbers are fine. If she were in her 60s, I would worry about complications (maybe) in 10 or 15 years. But at her age, I don't think she has much to worry. She may feel a bit sluggish because she is used to running lower, but she will get used to the numbers she is running right now.

Again, at her age, I would worry more that she is enjoying her meals, rather than restricting what she ate based on her blood glucose numbers. I know you want good control, and you want reasonable numbers, but you want her to enjoy her life at the moment as well. My grandfather passed a few years earlier than he might have, but he traded enjoyment and joie de vivre for the best control possible. I would discuss this with her and maybe the doc as well.

Best of luck.
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Old 05-18-2011, 01:58 PM   #7
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Re: ?'s regarding sugar levels

This is good to know. Explain to me about her feeling sluggish. She would feel sluggish if her numbers are Low and high? I know when she got really low, at the point of her going to the hospital, she couldn't even move in bed. So that is major sluggish. She gets lots of UTI's and the dr told us it's because her blood sugar isn't regulated. Those UTI's are what bring her to the hospital for a few days and we would love to help avoid them. I agree with her "enjoying" life, I just don't like hearing that upon waking up from a 5pm nap, she wants to go back to sleep by 7. This isn't like her, so we were worried. Here's a question (another one!, sorry). When she is in the hospital, they always put her on insulin and her levels are great. When she leaves, they put her back on regular meds..why? If the insulin helps regulate her, why not keep her on them? Oh, and her diabetes has caused horrible infections, again causing hospital stays, so we're encouraged to get this under control.



QUOTE=Cora1003;4757640]For someone not on insulin, testing a couple of times per day is ok. I would get the caregiver to rotate testing times. Sometimes fasting and after breakfast, sometimes 2 post meal readings, etc. At age 84, her numbers are fine. If she were in her 60s, I would worry about complications (maybe) in 10 or 15 years. But at her age, I don't think she has much to worry. She may feel a bit sluggish because she is used to running lower, but she will get used to the numbers she is running right now.

Again, at her age, I would worry more that she is enjoying her meals, rather than restricting what she ate based on her blood glucose numbers. I know you want good control, and you want reasonable numbers, but you want her to enjoy her life at the moment as well. My grandfather passed a few years earlier than he might have, but he traded enjoyment and joie de vivre for the best control possible. I would discuss this with her and maybe the doc as well.

Best of luck.[/QUOTE]

 
Old 05-18-2011, 02:24 PM   #8
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Re: ?'s regarding sugar levels

It's standard operating procedure for many hospitals to put inpatient diabetics on insulin. They can control unexpected highs that way.

Yes, she may feel sluggish when higher, or when lower. Basically your body can get used to certain levels, and if you are outside of those boundaries, you may feel it. It is possible the doc thinks it may be too much bother for her to start injections at home if the numbers are ok on the oral meds. Why fix it if it's not broken?

Again, at her age, it may be other things and not just the diabetes.
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Old 05-18-2011, 02:27 PM   #9
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Re: ?'s regarding sugar levels

Thank you Cora very much for all of your insight. Makes sense! They did take her in for some overall blood tests and has a regular dr appt set up for her, so I"m happy about that. Again thank you very much.





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Originally Posted by Cora1003 View Post
It's standard operating procedure for many hospitals to put inpatient diabetics on insulin. They can control unexpected highs that way.

Yes, she may feel sluggish when higher, or when lower. Basically your body can get used to certain levels, and if you are outside of those boundaries, you may feel it. It is possible the doc thinks it may be too much bother for her to start injections at home if the numbers are ok on the oral meds. Why fix it if it's not broken?

Again, at her age, it may be other things and not just the diabetes.

 
Old 05-18-2011, 03:27 PM   #10
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Re: ?'s regarding sugar levels

AFrank..Cora gave you some very great advice. Both hubby and myself are type 2, him being it for over 25 years and me just shy of 2 years. Our Drs. always tried to get our A1c under 6, which is the non Diabetic range but as Cora said, new info. out has proven that is NOT a good idea for older folks. Hubby is going on 74 and I am going on 70 so now the Drs. have left us alone.

Hubby's A1c comes back about 6.2-6.3 as does mine, so the Drs. are happy. He is on 2 oral meds. and I am on Metformin 500 mgs. once a day. We were also told to test in the a.m. only as they feel we are well controlled.

I just had a Dr. visit today and even after having oatmeal for breakfast with 2 cups of coffee with a bit of artifical creamer mixed in and a banana..my test at the Drs. was still only 114, this was about an hr. and a half later. Dr. told me if my next A1c is still good she may give me a break from the Metformin to see how I do off.

When hubby was in the hospital in Nov. for a mild heart attack...they also took away the oral meds and only gave him an injection if he went over 200. I asked why and they said it is standard procedure.

Obviously you don't want your mom's numbers too high so a good talk with her Dr. will put your mind at ease.

Best of wishes...JJ....
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