February 26, 2005
Diagnosis and Symptoms, Hyperglycemia and DKA
Question from Des Moines, Iowa, USA:
My boyfriend was diagnosed three days ago with type 1 diabetes with a blood his sugar of 516 mg/dl [29.7 mmol/L]. We were in the emergency room the next night with a blood sugar over 600 mg/dl [33.3 mmol/L] that we could not get done with the “prescribed dose” of insulin, according to the sliding scale from his doctor, nine units of NovoLog, plus another three to attempt to lower it.
For these past three days, his sugars have been running 300 to 500 mg/dl [16.7 to 27.8 mmol/L] and the doctor is not particularly concerned. Should we try and find a different endocrinologist?
I have now learned that the crystallization of urine can be a sign that one is spilling ketones. I made him test himself yesterday and he said it was negative, but for about three months, I was seeing crystallized spots when I cleaned the bathroom. Is this something I need to make his doctor aware of even though it is not happening now?
Answer:
I do not think the issues with the urine are very specific. As far as the blood sugars running 300 to 500 mg/dl [16.7 to 27.8 mmol/L], they are a concern if they stay there. Hopefully, your physician is working with you to lower these on a daily basis so that he is adjusted to the appropriate dose of insulin.
JTL
