Panic at 21.5 - what would you do?

[Hobster]

When I was 2 years old we moved into my father's parents home to look after his mother who died from the complications of type 2 when I was 7years old.
I could describe the experience if it would help you understand the consequences of the condition if not controlled, but not on the public forum.

I have compassion for what you went through as a child and I'm sorry to hear that your father's mother died from type 2 complications. I do not need any details of that experience, on or offline thank you.

 

[Lucyr]

Here’s the thread that might be useful to refresh on

A broad church - low carb is not the only way

Just a gentle reminder to members that our forum is supposed to be a friendly and supportive place, which encourages members to find their own way through the available options to find a diabetes management approach that meets their ambitions, and is appealing and sustainable for them. While...

forum.diabetes.org.uk

 

[Hobster]

Yes low carb is advised against with flozins because of the risk of DKA. It’s recommended to eat around 130g carb or more per day and to test ketones when feeling unwell even if blood sugar is normal.

@Drummer please stop insisting everyone needs to eat low carb and actually take into account that it is dangerous with some medications. There are sticky’s at the top explaining that everyone is different and different approaches need to be respected. Perhaps you need to reread them for a refresher?

Thank you Lucy. If ketones are shown on pee test even though blood sugar is okay, do I need to seek medical attention? Unfortunately my pee tests don't have numbers on them, so need to get some of those.

 

[Lucyr]

Thank you Lucy. If ketones are shown on pee test even though blood sugar is okay, do I need to seek medical attention? Unfortunately my pee tests don't have numbers on them, so need to get some of those.

Yes, you don’t need to worry much about traces or +, but I’d drink plenty and retest if that happened to me.

If the ketones are ++, +++ etc then you need to drink plenty and seek medical attention. This happened to me just after I started empagliflozin, I can’t give medical advice but I can repeat what she said to me which was if you feel ok stop taking the flozins and speak to GP ASAP, if you feel unwell go to A&E.

 

[Lucyr]

Sorry forgot to say who gave me that advice, it was the pharmacist when I had ketones one week into starting empagliflozin

 

[Hobster]

Sorry forgot to say who gave me that advice, it was the pharmacist when I had ketones one week into starting empagliflozin

Thanks Lucy. I appreciate your time in the information.

 

[Cheyne]

I've been on Dapagliflozin 10mg for the past week. I initally started on 5mg daily for 2 weeks. My BS have become a little more erratic at times, I guess the body is just trying to sort things out. I haven't felt well for the last few days, sleeping very heavy and not feeling refreshed. Anyway, today felt generally a bit worse (nothing specific to add, just feeling out of sorts), took my BS and it was 21.5. Talk about going into panic mode!! This was probably the worst thing I could have done, but I have never had a reading that high before and I've never been told what to do if that reading is high. Spoke to GP who said basically 'worry over 20, but don't worry about it' which is as useful as a chocolate tea cosy. This was 45 minutes ago and prior to this I had eaten half a banana on one slice of sourdough (which I've eaten many many times before and it has never spiked this high). Interestingly, my Libre has also picked up real lows of 3.5 in the past 48 hours too. Is it really possible to go from 3.5 to 21.5 in a matter of 6 hours?

I'm sitting at about 12.2 right now, I've been for a walk and I'm drinking water. I feel so out of my depth and lost and fear I will worry about going out on my own.

I understand no-one can advise me medically and I've spoken to my GP, the nurse is ringing me on Monday for a follow up. But, were yours that high? Do they still get that high at times? Type 2.

Hi,
I know the feelings well. I hit 19.5 regularly and so far have had little option but to wait it out. I'm T2 on slow release insulin and as yet have not been given fast acting insulin. This may well change tomorrow when I catch up with my Dr. My Bg can go balistic within 2 hours only discovering it when I next test the Bg. A rude shock first time around with lots of panic foresure. I average around 150 carbs spread over the day and still experience sudden spikes. I'm betting Autonomic polyneuropathy has something to do with it for me as it does with my BP, lower body function, IBS and a lot of other things I have't figured out so far.
As far as I'm aware without fast acting insulin all that you can do is get to ED. My former medical advice had always been to do just that, not that I have bothered to heed that advice.
My current Dr insisted on ED and that is how it was determined I have Autonomic poylneuropathy. It is not a lot of fun looking at your feet praying they will move, not being able to control below the waist through automatic natural movement or willing the feet and legs to pick themself up to step or just move. I guess this is the result of untreated high Bg for so long.
Get the Bg sorted sooner than later is the smart advice.
Cheers

 

[Dragonheart]

I don’t know if this is of help @Hobster but here is the NHS advice about ketones:

If you use a meter to test for ketones in your blood:

• under 0.6mmol/L is normal
• 0.6 to 1.5mmol/L is slightly high – test again in 2 hours
• 1.6 to 3mmol/L means you're at risk of DKA and should speak to your diabetes care team for advice
• over 3mmol/L is high and means you may have DKA and should call 999 or go to A&E

If you use strips to test for ketones in your pee, over 2+ is high. This means you may have DKA and should call 999 or go to A&E.

Completely true if on a “normal diet”, sick, at risk of DKA because of being type 1, on any of the flozins (as they don’t go well with more than a moderate low carb diet as they can cause DKA without the typical high bgl) or at risk for some other reason.

But I just wanted to add for the benefit of people reading if you are well and doing a very low carb or keto diet up to about 3mmol/L is totally normal and actually kind of the point as it means you are in nutritional ketosis. This would come with normal/lower glucose levels though not high ones. Nutritional ketosis is not the same as a DKA. If you are choosing to do a very low carb diet it’s important to understand what you’re doing to avoid risk or unnecessary panic. This page explains it quite well https://www.dietdoctor.com/low-carb/ketosis