My granddaddy's blood sugar was 959 today...

[Aimeedyan]

after 13 units of insulin.

All the meters stop at 600 so when he got to the trauma unit of the ER, they sent his labs out to be checked and then got word it was 959. He had already given himself 13 units of insulin before going to the ER.

He's never been this sick - he told me that. He's had diabetes for about 50 years and had symptoms today he's never had.

They are (obviously) admitting him but we don't know what they will do. Over the last two years, this has been the routine. He does really well, remembers to eat and take his insulin, and then has an issue (passes out and is found by a family member, passes out at the WHEEL and has 911 called on him, becomes combative to a family member, etc) gets admitted, they get him stable, and he goes back home. It's getting more common now and he's showing signs of dementia.

What is the normal range for blood sugar? The charge nurse seemed to be shocked by his number but I still don't understand this disease well enough to know how serious it was, what next steps are, etc. I think the next step is him not living alone but he won't go for it.

 

[Eeyores Butterfly]

I am so sorry this is happening to you. You all must be so scared.

The normal range for blood sugar is 70-140 ml/dl. For diagnostic purposes anything between 140 and 200 is considered prediabetic, and anything over 200 is considered diabetic. I am pretty new to this, but it seems that many people start to seek immediate help around the 400 or 500 mark. The sugar he had is very dangerous and is putting him at risk for Diabetic Ketoacidosis (DKA) which is also known as Diabetic Coma.

If this has been an ongoing issue, I would suggest taking him to a different endocrinologist as his current doctor is obviously not taking this seriously enough. I will be saying prayers for your grandfather.

 

[moon]

I hope he overcomes this crisis soon

 

[Pea-n-Me]

959 is extremely high. Has he been ill at all? Does he live alone (I see you answered that). It would seem that his diabetes is not being managed well. He will at minimum need closer follow up, perhaps with a visiting nurse and/or family members if he continues to insist on living alone (if he's found competent to make that decision). For now he will most likely be on a continuous insulin drip until his numbers stablilize. He will also be evaluated for overall health and other causes of hyperglycemia. His living status and ability to care for himself will be looked at before he's discharged. Will keep him in my prayers.

 

[Aimeedyan]

If this has been an ongoing issue, I would suggest taking him to a different endocrinologist as his current doctor is obviously not taking this seriously enough. I will be saying prayers for your grandfather.

Thanks for the info.

He seems to have a great doctor that sees him often but we think the problem is that he is not taking as good of care of his body as he used to. He forgets to eat, forgets to take his insulin, forgets to check it, etc. He is determined to staying working (he's 84) and driving and his body just can't take it anymore, I guess.

 

[Aimeedyan]

959 is extremely high. Has he been ill at all? Does he live alone (I see you answered that). It would seem that his diabetes is not being managed well. He will at minimum need closer follow up, perhaps with a visiting nurse and/or family members if he continues to insist on living alone (if he's found competent to make that decision). For now he will most likely be on a continuous insulin drip until his numbers stablilize. He will also be evaluated for overall health and other causes of hyperglycemia. His living status and ability to care for himself will be looked at before he's discharged. Will keep him in my prayers.

Part of me wishes that at this point, his medical team would step in and demand that he have a nurse check in on him, or that he move to a retirement facility that will monitor him. But, when he's good he's GOOD. He teaches classes, works out of his home, drives, etc. But he crashes quickly and each time is worse than the last.

 

[Eeyores Butterfly]

In that case, it sounds like it is time for your family to have some very serious discussion. You have some hard decisions ahead of you.

We went through a similar issue with my grandparents. They couldn't take care of themselves, but they could take care of each other. Then my grandfather broke his arm... All the kids and grandkids insisted that they go to an assisted living facility. It was a very tough decision and one they did not want to make, but it became necessary. The facility was wonderful. It was not a nursing home at all. They had their own little apartment and were able to come and go, but had the asssistance they needed. Perhaps a similar set up would be good for your grandfather?

Do any of you live close enough and have the space that he could move in with you? What about somebody who can check on him daily or live with him? It sounds like he is no longer capable of living on his own.

I wish you the best of luck in this siutation. Please feel free to PM me if you have any questions.

 

[Aimeedyan]

In that case, it sounds like it is time for your family to have some very serious discussion. You have some hard decisions ahead of you.

We went through a similar issue with my grandparents. They couldn't take care of themselves, but they could take care of each other. Then my grandfather broke his arm... All the kids and grandkids insisted that they go to an assisted living facility. It was a very tough decision and one they did not want to make, but it became necessary. The facility was wonderful. It was not a nursing home at all. They had their own little apartment and were able to come and go, but had the asssistance they needed. Perhaps a similar set up would be good for your grandfather?

Do any of you live close enough and have the space that he could move in with you? What about somebody who can check on him daily or live with him? It sounds like he is no longer capable of living on his own.

I wish you the best of luck in this siutation. Please feel free to PM me if you have any questions.

It is hard. My mom and my uncle talked the last time mom was here. She lives in FL and my uncle (local) is caring for his wife who is in poor health. Granddaddy's girlfriend has done most of the caretaking but her health has recently declined and she no longer can. So, I've stepped in and go check up on him and such.

He's told his children that if at any point he is forced to leave his home, he will put himself in a diabetic coma. He's stubborn as a mule and will not live under anyone's care and we all know he has the means to take care of things. This is why my mom and uncle are so afraid of approaching that again (and rightfully so).

I'm a grandchild so I can get away with things his two kids can't so when he goes home this time, I may just tell him I'm coming by on my way to and from work and he'll just have to deal with it I love him the pieces but...

*sigh*

 

[Eeyores Butterfly]

 

[Disney1fan2002]

You need to sit down with your family and do something about this. A man I grew up with went into diabetic shock while he was driving his 4yo to daycare. He crashed the car and they both died. If you Granddad is still driving, and his blood sugar drops quickly, he is putting not only his own life at risk, but other people's also.

 

[monkey68]

I am so sorry this is happening to you. You all must be so scared.

The normal range for blood sugar is 70-140 ml/dl. For diagnostic purposes anything between 140 and 200 is considered prediabetic, and anything over 200 is considered diabetic. I am pretty new to this, but it seems that many people start to seek immediate help around the 400 or 500 mark. The sugar he had is very dangerous and is putting him at risk for Diabetic Ketoacidosis (DKA) which is also known as Diabetic Coma.

If this has been an ongoing issue, I would suggest taking him to a different endocrinologist as his current doctor is obviously not taking this seriously enough. I will be saying prayers for your grandfather.

I guess they must have recently changed the values, because I just finished my endocrinology course, and it was pounded into our brains that less than 100 is normal, 101-125 is prediabetes, and if you have 2 fasting blood glucose of greater than 126, that's diabetes. If you have a random plasma glucose over 200, and signs or symptoms of diabetes, that's also diabetes. Either way, the OP's grandfathers blood sugar is very high.

Does he remember to take his insulin at the correct time, and not mix up the insulins? My grandma has done that accidently a couple times, taken her morning insulin at night, and has wound up hypoglycemic because the morning insulin is a larger dose. You might want to look into getting him a home attendant or someone who can give him his insulin at the correct time at the correct dose.

 

[Laura]

I guess they must have recently changed the values, because I just finished my endocrinology course, and it was pounded into our brains that less than 100 is normal, 101-125 is prediabetes, and if you have 2 fasting blood glucose of greater than 126, that's diabetes. If you have a random plasma glucose over 200, and signs or symptoms of diabetes, that's also diabetes. Either way, the OP's grandfathers blood sugar is very high.

Depends on the test. Your numbers are for the fasting plasma glucose test. For an oral glucose tolerance test, it's higher. I had the tolerance test two weeks ago--they don't want us pregnant ladies to fast for 8 hours.

This shows the difference: http://diabetes.webmd.com/guide/pre-diabetes?page=2 The difference from my test and the one described on the page is that I didn't fast and they took my blood only once; an hour after drinking my "lovely" orange beverage.

 

[DVC~OKW~96]

Yes, the ranges monkey68 provided are the ones in use today. The ranges provided in a previous post are no longer in use, as they are too high.

Now, having said that the ranges from monkey68 are for type II diabetes which means the pancreas is suffering from inability to process insulin correctly, not type I (which used to be called juvenile diabetes) which is the absence of insulin in the body. A different disease with different treatments.

Your Grandfather has had diabetes for a long time. Regardless of how well he has done with the illness for all those years, it does take it's toll on the body and it's organs. Having a bg that high is a critical health situation.

You'll need to respect his position on his lifestyle too. I promise you, sincerely that I know how hard that is. However, forcing, coercing or heaven forbid using the laws of your state to push him into care is not the answer. You may not like his decisions, but unless a court adjudicates him incompetent you must abide by those decisions.

You have a lot on your plate right now and my heart goes out to you. Do take care of yourself! If you would like to discuss this further, please don't hesitate to send me a PM.

 

[Aimeedyan]

Thanks guys.

Well, they think he had a heart attack which threw his sugars so high. They also say his kidneys are now at 50% functioning. He's in ICU now. We have no idea what they will decide to do or what they can do at this point.

 

[Pea-n-Me]

We have no idea what they will decide to do or what they can do at this point.

He is going to be in the hospital for a while. If he had a heart attck they'll likely do tests on his heart and kidneys once his sugars stabilize. They'll also re-assess all the medications he's on and adjust them/add some new ones given his new diagnosis. This has to be managed carefully and sometimes takes a while to get just right. If his heart tests (probably a catheterization) show blockages, which would be fairly likely given his age, longstanding diabetes, kidney function and now heart attack (these are just the ones we know of here), then they will need to intervene on those, usually either with stent(s) or bypass surgery. They'll also probably do an echocardiogram on his heart to check pumping ability - sometimes kidney function is off because perfusion is low if the heart's not pumping strongly enough (also known as heart failure, but I really hate that term). If this is shown to be the case there will be other issues he'll have to take care of at home once he's stabilized medically (re: diet, fluids, meds, follow up, etc.) They will also take a closer look at his kidneys. They may find other problems as they go along. As you can see, it often gets really complex, but there are many patients just like him if that helps at all. While he's in the hospital they should take extra steps to insure his safety since you say he's shown signs of dementia and elderly people with this many problems often do get confused while in the hospital. The last thing you want is a fall, so ask what plans are in place for his safety.

If it's any consolation, your grandad may have reality sink in once he understands all that's going on with him. Don't push him about anything right now, just support him while he goes through this. He may surprise you and come to the realization on his own that he needs help (but if you keep pushing he may resist). It's very hard for such a stong-willed, independent-minded person to accept a seemingly sudden decline in health. You really can't make any decisions right now, you just have to see what happens. You can start to think about options to present to him. You might be looking at short term rehab post discharge which might buy you some time. Assisted living might be a nice option for him (if he'll accept it) but regulations vary state to state on what they can and can't do. Here in MA people have to basically be able to do things for themselves with minimal help. If they need more than that, they need a skilled care facility, ie nsg home.

HTH. Good luck.

 

[Aimeedyan]

He is going to be in the hospital for a while. If he had a heart attck they'll likely do tests on his heart and kidneys once his sugars stabilize. They'll also re-assess all the medications he's on and adjust them/add some new ones given his new diagnosis. This has to be managed carefully and sometimes takes a while to get just right. If his heart tests (probably a catheterization) show blockages, which would be fairly likely given his age, longstanding diabetes, kidney function and now heart attack (these are just the ones we know of here), then they will need to intervene on those, usually either with stent(s) or bypass surgery. They'll also probably do an echocardiogram on his heart to check pumping ability - sometimes kidney function is off because perfusion is low if the heart's not pumping strongly enough (also known as heart failure, but I really hate that term). If this is shown to be the case there will be other issues he'll have to take care of at home once he's stabilized medically (re: diet, fluids, meds, follow up, etc.) They will also take a closer look at his kidneys. They may find other problems as they go along. As you can see, it often gets really complex, but there are many patients just like him if that helps at all. While he's in the hospital they should take extra steps to insure his safety since you say he's shown signs of dementia and elderly people with this many problems often do get confused while in the hospital. The last thing you want is a fall, so ask what plans are in place for his safety.

If it's any consolation, your grandad may have reality sink in once he understands all that's going on with him. Don't push him about anything right now, just support him while he goes through this. He may surprise you and come to the realization on his own that he needs help (but if you keep pushing he may resist). It's very hard for such a stong-willed, independent-minded person to accept a seemingly sudden decline in health. You really can't make any decisions right now, you just have to see what happens. You can start to think about options to present to him. You might be looking at short term rehab post discharge which might buy you some time. Assisted living might be a nice option for him (if he'll accept it) but regulations vary state to state on what they can and can't do. Here in MA people have to basically be able to do things for themselves with minimal help. If they need more than that, they need a skilled care facility, ie nsg home.

HTH. Good luck.

Thanks

He has heart issues already, and has had bypass, and the last time he was admitted they decided another bypass was too risky. We'll see what they suggest this time.