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August 9, 2003

Hyperglycemia and DKA

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Question from Houston, Texas, USA:

I have had type 1 diabetes less than six months, and today when I tried to check my blood sugar, the meter gave me a message that said “HI”. I imagine this means it was above 500 mg/dl [27.8 mmol/L] which is terrible. What are the most common reasons for your sugar level to go up so high when you have done everything you should have?

Answer:

From: DTeam Staff

The first step in these circumstances would be to wash your hands thoroughly and to repeat the test. If it still registered ‘HI’, I would advise testing for urine ketones. You might be in the earliest stages of DKA [diabetic ketoacidosis] and still feel well. If you had ketones, then you might consider the possibility that the insulin might no longer be effective. If that seemed likely you could try the effect on blood sugar of giving a smaller replacement dose of the short acting insulin from a fresh vial, which would depend on the kind of insulin and the time since the first dose. You would then have to check once again to see if the second dose of insulin was effective. If there were no ketones you should test the meter against the control solution and then if it was still high contact the 800 number that should be on the back of the meter about getting a replacement. In any case you should contact your diabetes team for instructions.

DOB