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July 27, 2004

Complications, Hyperglycemia and DKA

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Question from Algoma:

My grandmother is 78 years old. She has had type 2 diabetes since she was 30. Recently, she had a stroke. Since her stroke, she has not been able to control her sugars well and had to be put back on insulin. She had been doing great until two days ago. She woke up and appeared to be disoriented, had speech problems and couldn’t walk very well. It was like as though all the progress she had made since her stroke disappeared. My aunt takes care of her. Worried about low sugars, my aunt checked her. Her glucose was 18.6 mmol/L [335 mg/dl]. She was taken to the emergency room (ER) for fear of another stroke. At the ER, she was given less then satisfactory care. She didn’t even get to see a doctor. They did some blood work and came back and said she is bleeding. She had bleeding in her stomach previously, while in the hospital recovering from her stroke. They sent her home stating that she was fine.

My aunt then took my grandmother to her doctor for an appointment that same day. The doctor told my aunt that high blood sugars can cause some of the symptoms and upped her dose of insulin in the morning from 20 to 25 units and night time from 10 to 15 units. That was yesterday. This morning she woke up and her blood sugar was 6.5 mmol/L [117 mg/dl], but by lunch time it was 22.5 mmol/L [405 mg/dl]. My aunt chose to skip my grandmother’s afternoon snack and about an hour after snack time, my grandmother’s right side of the body went limp and she started staring off into space. Her sugar was checked and it was still high 19.7 mmol/L [355 mg/dl]. My aunt gave her a snack anyhow and my grandmother came around.

This doesn’t make any sense to me and the doctor’s don’t see too worried about it. I know my glucometer works fine so I am taking mine over tomorrow to compare with hers. Is there anything we should be asking for?

Answer:

From: DTeam Staff

I am sorry about your grandmother. It sounds like she has had a tough time of it. I am not clear if this is hypoglycemia or recurrent episodes of stroke or mini strokes. For instance, the sugars were never really low, yet, she had neurological symptoms. I would be concerned about recurrent neurovascular episodes the physicians need to concern themselves with. I agree you should check with your meter. However, the sugars sound like they have been high most of the time.

JTL