Brain Injury and Blood Sugar

[rickparker]

My daughter aged 26 is recovering from traumatic brain injury and is type 1 diabetic. Her blood sugar has generally been maintained in the 20 to 25 range over the past 4-6 weeks of her recovery. I think that this level of blood sugar would be detrimental to her recovery, and this is supported by several studies that indicate that persistent hyperglycemia is correlated with poor outcome of brain injury.

I would welcome any comments on this and any recommendations for insulin protocol.

 

[Sally71]

Sorry to hear that your daughter is going through this

Who is looking after her diabetes? Is she in hospital? I agree that blood sugars of 20-25 are far too high, however if she is being looked after by normal ward staff then they are usually terrified of low blood sugar and will err on the side of being too high, although as we know that can cause lots of other problems! Is there a diabetes team in the hospital that you can speak to? Basically she needs more insulin, but unless you have been directly looking after her diabetes before now and know all about her doses (which I presume is not the case when she's a grown adult) then you will need to speak to a diabetes specialist for advice on how to adjust the dose. Do you know who she normally sees for her diabetes check ups and could you ask them?

Unfortunately we are unable to tell you exactly what to do as everyone is different, what I would do for my daughter in this situation might well be a massive overdose for someone else and not enough for another person, and of course a lot depends on what insulins she is on and who is responsible for giving her her medication at the moment. Good luck 🙂

 

[Sally71]

It has also occurred to me since posting that low blood sugar might well exacerbate the brain injury, maybe there is a good reason why your daughter's blood sugar had been kept high; I am still inclined to agree with you though that they could keep her a bit lower than 20 without risking hypos! Good luck finding someone who can help you!

 

[mikeyB]

Your instinct and info is right, Rick, she shouldn’t be having persistent hepergycaemia, because of the high osmolality of the blood. All of us on the forum know how you get brain fog when your BG is high, and that’s the reason.

As Sally says, she needs to be seen by a diabetes specialist to assist with control. Can I ask if she is eating, or being fed with liquid feeds via a nasogastric or gastrostomy tube?