Hyperglycaemia with no ketosis

[Silmarillion]

Hi there
Im a type 2 diabetic and from time to time I have had issues with ketoacidosis. I’ve been very careful with my diet etc and mostly my hbA1c has been under 35.

for the last fortnight I’ve been having very high blood sugars, 30-35 mmols on waking. I have all the usual symptoms of this polydipsia, polyuria, nausea, feeling cold etc I don’t have any symptoms of infection (urine test showed no sign of infection) I am not eating any differently from normal.

I’ve tried excercise (it was really hard but I did go for a walk) this had no impact on my blood sugar. I also increased the amount of glicazide I’m on 3 months ago.

im currently taking metformin 1g twice daily, glicazide 160mg am and 80mg pm.

i went to see the diabetic nurse day before yesterday and she didn’t seem very concerned and just took blood to check my hba1c again….I’m still awaiting results.

Any suggestion as to what I should do? Feeling like something the cat dragged in

 

[DaveB]

Hi. Did you really mean 30-35 mmol on waking? Those levels are low and below the diabetes level. Perhaps the Gliclazide dose level is causing that very low BS? Can you clarify?

 

[Silmarillion]

Hi. Did you really mean 30-35 mmol on waking? Those levels are low and below the diabetes level. Perhaps the Gliclazide dose level is causing that very low BS? Can you clarify?

Hi Dave B
30 to 35mmols on waking is very high. My blood sugar is usually around 7 mmols on waking. I have all the symptoms of hyperglycaemia.

 

[rebrascora]

If you are feeling rough and levels are that high and you have no insulin to inject to bring them down, then contact 111 or go to A&E. Those levels are dangerously high and cannot be ignored. The fact that you are feeling nauseous is particularly concerning. Go get checked out. It sounds like you have reached a tipping point where your system cannot produce enough insulin to maintain a balance.... It's possible your failing beta cells have been flogged to death by the Gliclazde and you may well need exogenous insulin.

 

[42istheanswer]

Hi. Did you really mean 30-35 mmol on waking? Those levels are low and below the diabetes level. Perhaps the Gliclazide dose level is causing that very low BS? Can you clarify?

30-35 is low (I.e. Normal range) for HbA1c but that is measured in mmol/mol.

Finger prick blood glucose for non-diabetics should usually be between 4-7 mmol/litre when fasting

 

[Silmarillion]

30-35 is low (I.e. Normal range) for HbA1c but that is measured in mmol/mol.

Finger prick blood glucose for non-diabetics should usually be between 4-7 mmol/litre when fasting

If you read my note my post it says my hba1c is usually under 35. yes that is low.
it also says my blood sugar level has been 30-35 mmols on waking for the past 2 weeks.that is very high! I have been a diabetic for some time. Unfortunately when I’ve run into trouble in the past my local hospital haven’t been very nice or sympathetic. They just send me home and tell me the community diabetes team should be managing it! If I go to the hospital I’ll end up catching covid again.

i went to see the diabetic nurse 2 days ago, as they wouldn’t give me a gp appointment for 2 weeks.She just gave me a lecture on diet and how I should be doing the no carb thing. I swear she’s obsessed with eating carrot sticks, plain unbuttered oatcakes and plain yoghurt! She told me I have to wait for my hba1c result before they’d do anything……sigh it’s still not in 2 days later and she only works part time and isn’t in till Monday.

 

[42istheanswer]

If you read my note my post it says my hba1c is usually under 35. yes that is low.
it also says my blood sugar level has been 30-35 mmols on waking for the past 2 weeks.that is very high! I have been a diabetic for some time. Unfortunately when I’ve run into trouble in the past my local hospital haven’t been very nice or sympathetic. They just send me home and tell me the community diabetes team should be managing it! If I go to the hospital I’ll end up catching covid again.

i went to see the diabetic nurse 2 days ago, as they wouldn’t give me a gp appointment for 2 weeks.She just gave me a lecture on diet and how I should be doing the no carb thing. I swear she’s obsessed with eating carrot sticks, plain unbuttered oatcakes and plain yoghurt! She told me I have to wait for my hba1c result before they’d do anything……sigh it’s still not in 2 days later and she only works part time and isn’t in till Monday.

It wasn't you I was replying to 😉 I was explaining a little more the differences in measurement unit and expected readings to DaveB.

I agree that your morning readings are very high and concerning, but I felt @rebrascora 's reply covered pretty much what I was thinking.

You said urine test showed no signs of infection, and your title says no ketosis, so does that mean your urine has been checked for ketones?

 

[Silmarillion]

It wasn't you I was replying to 😉 I was explaining a little more the differences in measurement unit and expected readings to DaveB.

I agree that your morning readings are very high and concerning, but I felt @rebrascora 's reply covered pretty much what I was thinking.

You said urine test showed no signs of infection, and your title says no ketosis, so does that mean your urine has been checked for ketones?

Yep I have keytone/ urine sticks at home. My urine has no ketones, the nurse also confirmed this. It just seems a bit unusual having such high sugars with all the symptoms. I usually get keytones with prolonged high sugars.

 

[Leadinglights]

Yep I have keytone/ urine sticks at home. My urine has no ketones, the nurse also confirmed this. It just seems a bit unusual having such high sugars with all the symptoms. I usually get keytones with prolonged high sugars.

I wonder if you have some faulty test strips or your monitor is faulty. Did the hospital do a finger prick test when you went. Have you checked several times.? What about at other times of the day?
If you doubt your monitor then some pharmacies will do a finger prick glucose test.
Your reading of 30-35mmol/l is definitely out of step with an HbA1C of 35mmol/mol