hypers?

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bev

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Hi all,

I have learnt so much on here and about hypo's etc. But i wouldnt know what to do for a 'hyper'! Can anyone give me a rough idea of how to 'treat' a hyper? Thanks. Bev
 
cant help im afraid, see my post on stress and bs levels. Today made me realise i too have had no real advise on what to do in these situations. would imagine you need to increase insulin, drink plenty and monitor. However by how much and how often i have no idea. 🙂
 
I was going to ask you how it was going anyway bev in hyper land...Here we have treated hypers with a) no exercise b) lots of water c) insulin correction between and with meals if at all possible. Like everyone, we also then try to trace back to where it might be originating -- was it a one-off (carb miscalculation or stress) or something more profound, requiring an overhaul...

We seem to have at long last surmounted nine days of too high bgls: in our case, raising levermir by 30% (in a *week*), and tweaking ratios once fasting level is okayish seems to be doing it. Hurrah. Our young man is back (though we are still getting up nights to finalise levels!).
 
Cant say im hugely successful but I usually drink lots water, correction dose and have gentle walk or do somethin like bit of tidying up. Housework and gardening always make my levels drop! So high readings in day are easier than later at night to try and sort out. Dont think Alex would like cleanin much though!!
 
Bev, Steff - pulled the following out of some sources on my book shelves:

Treatment for a hyper abridged from OU text "Living with diabetes" p160

Aims
- correct blood glucose to normal level
- adjust any other imbalances eg dehydration
Treatment
- identify cause: is it sudden as in the case of illness or stress or has it gradually built up perhaps due to a period of over indulgence such as Christmas or lessening of exercise. In the latter case it may be that more medication is needed

Gretchen Becker - Type 2 diabetes: the first year
- Type 1s need to watch for ketoacidosis, unlikely in type 2s who can get another problem but with a slower build up

Fox and Kilvert Type 2 Diabetes: answers at your fingertips p278

"A high blood sugar in someone who feels perfectly well is not a cause for concern. If necessary short-acting insulin can be taken to bring the blood sugar down. If your blood sugar remains high after taking extra insulin, and you are feeling unwell, you may need to be treated in hospital with fluids and insulin given into a vein. If you are worried, seek medical advice"

Managing hyperglycaemia is a lot less straightforward than the quick response necessary for a hypo. Basic problem is working out why it is happening and then managing it
 
ty for that vanessa mine are always sudden so quick as well to turn 1 minute im talking to some one next im gone slurring thirsty and wobbley legs
 
just keep a real eye on how high your sugars on and it is true, you will soon know about it if you are too high as you will start to feel really unwell. 2 years ago i had a really bad experience and ended up in hospital with ketoacidosis which is really dangerous, the warning signs are being sick....alot...so much so that i eventually burnt my oesophugus and now get really bad heartburn. I was so out of it that I dont remember getting to hospital but remember waking up in recuss with a doctor saying to my sister that the next 24 hours were critical. That was a massive wake up call for me as it happened because i forgot to take my nightime insulin the night before and didnt have any the next morning either.....now i never forget to take it!
 
burnt your throat you mean?! How dangerous exactly is ketoacidosis?! I know i spelt that wrong! I've forgotten to take night and morning times before and felt fine, didn't realise that my post about the burning throat may have been ketone problem. What do i do if i test myself and there's traces of ketones? Would i have to go hospital?! Not a major fan to be honest with you! X
 
Steff, the metformin may help you with the sudden onset and will probably change how you react but have you spotted anything in your food/activity routines to see if there were any indicators for your sudden high episodes?
 
well vanessa it was weird because nothing had changed i could put my finger on but i thought back to what i had been eating and got it down to a yogurt i was having daily i stopped having that and i had no hypers for 2 week but just this week they have started up again.:confused:
 
tracey w said:
cant help im afraid, see my post on stress and bs levels. Today made me realise i too have had no real advise on what to do in these situations. would imagine you need to increase insulin, drink plenty and monitor. However by how much and how often i have no idea. 🙂
Click to expand...

As far as my GP is concerned (he has my diabetic care) I don't need to know anything so advice from there is zero unless it is a list of don't dos.

As I am on pills, how do I cover a hyper? There is advice on what to do with a hypo.

These forums have been a valuable source of advice and before I go to my GP I look here first.
 
ketoacidosis is really dangerous, i didnt realise that until i acually got it, i was in intensive care for a few days....seriously if you find ketones you need to phone your diabetes nurse for advice but if you start feeling unwell in any way -- get yourself to the hospital asap.
 
Thanks all,
Once again brilliant advice!
The only question i have left is : What do you determine as a 'hyper'? I thought it was when your levels were over 30! But from what you are all describing - it seems that a 'hyper' is when levels are over 15ish?
I make Alex drink lots of water if he is over 12ish and also exercise - but i dont let him exercise if he is higher as it seems to increase his levels!
Alex did have ketoacidosis when he was 1st diagnosed 4 months ago - but i didnt have a clue how serious it was! He was 38mmols on admission to hospital. Bev
 
Caroline, there seems to be little clear advice for Type 2s who aren't on insulin and so can't adjust their treatment dose.

For me as a Type 2 other than in acute illness I can usually now track increases to things like eating too much carbohydrate for a day or two or not enough exercise so adjustments back to my normal diet and exercise patterns usually restore my levels after a day or two. Tricky balance if I've over indulged is to avoid then going hypo by not eating enough with the gliclazide!

If that doesn't work and higher levels persist for no apparent reason then I would make an appointment to speak to my GP as it may be that the medication I'm on is no longer sufficient for my needs

In case of acute illness where I couldn't eat or drink or the levels kept going higher and higher then I'd ring my practice for advice as they operate and emergency call system during the day, NHS direct or the local community hospital
 
Thanks vanessa, i think if ever I got to the point where I needed help that quickly I'm better off going staright to A&E where I will be seen the same day. Going by what everyone else has said, if it gets to that point i wont be able to wait for two weeks (as is normal with GP) for an appointment.
 
hellbell84 said:
burnt your throat you mean?! How dangerous exactly is ketoacidosis?! I know i spelt that wrong! I've forgotten to take night and morning times before and felt fine, didn't realise that my post about the burning throat may have been ketone problem. What do i do if i test myself and there's traces of ketones? Would i have to go hospital?! Not a major fan to be honest with you! X
Click to expand...

i was admitted to hospital with DKA, { ketoacidosis} i was unconcious and if my daughter hadnt phoned for an ambulance i would of died, it was touch and go for a while. the trouble with ketones are that you can feel fine for a while and you start to feel ill gradually, i didnt realise how ill i had felt and for how long until i went on insulin!! i suddenly stopped drinking and going to the loo every 5 minutes. i have had quite a few HIGHS since but felt fine and didnt have any ketones but its not worth the risk of DYING, and thats how serious DKA is. sorry to sound scary. you should have a plan in place for if you are ill and for if ketones are present, go through it with your diabetes nurse, she will give you an idea of extra insulin to take etc. i always test my blood ketone levels if i am running constantly high.
 
small amounts of ketones can be treated at home with corrections doses and plenty of fluids. if they become high then you could be on the way to DKA so hospital treatment is a good idea.

I deal with highs by doing correction doses, trying not to eat too many fast acting carbs. and I often have a sleep as they made me really tired
 
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