Urgent help needed.

[Simonthir]

Hi, my wife is type 1. Her blood sugar level has been 17/17.5 for the last 4 hours. She is sleeping now and is very drowsy, confused and slurring her speech.
I must add that she has just lost her mum and has had alcohol tonight but for what she has consumed she is presenting overly intoxicated and I'm extremely worried. Im watching over her and checking her b/s every hour.
What should I do? Please help.
Simon.

 

[Inka]

Test for ketones @Simonthir If her blood sugar has been persistently high, there’s a risk of ketones developing, which could potentially put her at risk of DKA. If you need to wake her, do so.

There’s information about ketones and levels here:

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.

www.nhs.uk

“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.”

Hopefully, it’s just the alcohol and tiredness, but keep checking her. Alcohol can often lower blood sugar, leading to a hypo later so don’t assume her blood sugar is still high. Always check. Fingerpricks are best to check rather than the Libre, if she has one.

 

[Kopiert]

I hope everything is alright.

 

[everydayupsanddowns]

Sorry to hear about your wife’s elevated glucose levels @Simonthir

And condolences for the loss of her mum / your mother in law.

Hope she is feeling much better today and her glucose levels have returned towards normal. Stressful situations and heightened emotional states can have an impact on glucose levels, so things may be more erratic than she is used to for a while, and she may need to adjust doses, or just check more frequently.

I’m not sure if there is any ‘proper’ clinical evidence to back this up, but my lay observation over the years seems to suggest that some people are more prone to ketones, ketosis, and DKA than others. My clinic warned me about the risk of DKA when I moved to pump therapy, because something like a blocked cannula can put you at risk as you don’t have long acting background insulin as a back up, only rapid insulin is used. The suggestion was that things could escalate within 4-6 hours.

But my experience of cannula fails is that even if I’m in the 20s for hours and hours my ketones thankfully remain low/negligible, and so far I’ve never experienced DKA in my 30+ years of T1.

I’m not sure how prone to developing ketones / ketosis your wife is, and whether DKA has been a problem in the past?

It is always wise to be careful as DKA is so serious, but knowing your wife’s history with ketones may offer some reassurance in the early hours if this were to happen again?

 

[Simonthir]

Hi guys, thank you so much for your help here. I'll be honest, I don't really know what I should when it comes to her illness. She keeps it to herself, never complains and always puts other's needs before her diabetes to the point of it being poorly controlled.
I didn't know about these ketones and @Inka , you were right on the money, a hypo happened this morning.
I panicked so I stayed up all night beside her and checked her blood sugar every hour, it came down in increments then just collapsed. I am going to find out more, learn more and take a more proactive approach to her diabetes.
Again, thank you all so much for taking the time to reply. Amazing info and advice. Not the best first post, not the last. ❤️

 

[Inka]

Just knowing you’re going to support her, will help @Simonthir Type 1 can be a lonely illness and it requires a lot of input to keep it controlled. Being understanding and flexible helps. There are also books about Type 1, if you’re interested, but I think things like simply asking how you can help can be a huge boost emotionally.

Sorry about the loss of her mum. That must be very, very hard. At times like that, the Type 1 is just an added burden and emotionally it’s really hard to have to think about it when you just want to grieve.

 

[everydayupsanddowns]

I am going to find out more, learn more and take a more proactive approach to her diabetes.

What a lovely post @Simonthir - thank you!

You might like this handy little guide to having positive conversations around diabetes management.

http://behavioraldiabetes.org/xwp/wp-content/uploads/2015/12/BDIAdultEtiquetteCard.pdf

My own personal experience is that knowing you have support from those you care about is invaluable, but diabetes can be really frustrating and really mess with your mood and emotions, such that accepting help isn’t always easy.