when to go to hospital?

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MollyBolt

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I posted on here a couple of days ago to ask for advice on first seeing the diabetes team (many thanks to those who responded!).

The question I didn't ask is how high blood glucose numbers should be before going back to hospital? When I went in first time my blood glucose was 28 and my keto number was 5 something or other. In hospital when I woke up my blood glucose would be 6 or 7. I got out yesterday afternoon (so happy to sleep well!) but my number this morning was 17 and pre lunch it was 20. But my ketos are 0.1. I have a call with the diabetes team this afternoon (just automatically) but not till 4.30, but I'm wondering whether I should go back to hospital now. I think not because the ketos are low (and tbh by being in the A&E queue I'll likely miss the 4.30 call from the diabetes team) but just wanted to check with more expert people whether this sounds right.

The diabetes team aren't yet able to say whether I'm type 1 or 2 (delays to blood results due to cyber attack) but are treating me as type 1 for now...
 
Anything above 20, I’d call your team/GP or 111 @MollyBolt As you have low ketones you should be fine. Were you given insulin or other meds? If so, which ones?
 
So long as ketones are low I wouldn’t be dashing to the hospital especially as you have an appointment this afternoon but that’s just me
 
MollyBolt said:
Yes insulin - levemir and novorapid. But nothing else.
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You’ll probably have been started on low doses for safety reasons @MollyBolt Make a note of your blood sugars along with when and what you ate, so that you can tell your team when they call. They might increase your insulin slightly or give you instructions on how to add a correction dose if you’re above a certain number.

Have you been told anything about carb counting (counting the carbs in your meal and taking the appropriate dose for those carbs)?
 
thank you so much for this - I feel reassured that sticking here is the right call. I was reading about carb counting but was told that would come a bit later (I have an in person diabetes appointment in a couple of weeks).
 
MollyBolt said:
thank you so much for this - I feel reassured that sticking here is the right call. I was reading about carb counting but was told that would come a bit later (I have an in person diabetes appointment in a couple of weeks).
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It’s a good thing to read about before the appointment, if you read up and grasp the basics then you can ask more questions in the appointment in a couple of weeks.
 
MollyBolt said:
thank you so much for this - I feel reassured that sticking here is the right call. I was reading about carb counting but was told that would come a bit later (I have an in person diabetes appointment in a couple of weeks).
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In the meantime, you can have a read as Lucy says, and also start looking at the carb values of foods so you begin to get into the swing of it. A good set of scales is also useful.
 
Fab, will do some reading. Is there an especially good thread? Or on the website.

I'm on 6 notches of Levemir and 4 of the NovoRapid. Is that low?
 
MollyBolt said:
I'm on 6 notches of Levemir and 4 of the NovoRapid. Is that low?
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Yes that is quite low for the levemir though the novorapid I’d say is a bit closer to average. It’s normal to start on low doses though. By the way we call them units. 6 units of levemir and you’d write that as 6u
 
There’s some basic stuff here @MollyBolt

The nuts and bolts of carb counting

When you live with type 1 diabetes, carb counting is a great way of managing your blood sugar or glucose levels. It can give you more freedom and flexibility in what you eat when you're preparing meals at home, grabbing food on the go or eating out. Carb counting does take some time and effort...
www.diabetes.org.uk www.diabetes.org.uk
 
This is often recommended too


Also download either a supermarket app or the nutracheck app (there’s a fee if you want to log things in it but free to look up foods) or the carbs and cals app (think that still has a basic version free) and you’ll be able to look up the carbs in foods then.

If you don’t have any already you’ll need a digital set of kitchen scales
 
Lucyr said:
Yes that is quite low for the levemir though the novorapid I’d say is a bit closer to average. It’s normal to start on low doses though. By the way we call them units. 6 units of levemir and you’d write that as 6u
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really helpful to know what it's called and also to know current dose is quite low
 
MollyBolt said:
really helpful to know what it's called and also to know current dose is quite low
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I am not sure what is a high or low dose as there are so many things that can affect the dose.
It is often said that the right dose is the one that keeps your BG stable regardless whether it is high or low for anyone else.
However, it is common to start lower than your DSN expects to be able to bring your BG down slowly and reduce the risk of hypos.
Whatever you do, do not judge your "success" based on other people.
 
I am mainly keen not to over panic at the wrong moment (and to take action at the right). So v helpful to know that a normal approach would be a lower dose to start with (since I'll not get the cab to the hospital right now!).
 
Don't be in a hurry to up your dose. It's better to lower your bg slowly or it can affect your eyes (blurring) and other things, your body is used to high levels so slowly adjusting them downwards gives your body a chance to adjust.
 
Just to say thank you for all this advice (and on the other thread). I didn't go to hospital and stuck to my phone appointment, and the nurse was clear that it was right not to go to hospital (maybe less right to have a reasonable amount of pasta last night!). Really grateful to you for coming back so speedily.
 
It wasn’t the pasta @MollyBolt Once you know how to carb count and adjust your mealtime insulin, you’ll be able to eat pasta. It all just takes more thought. Tedious but true. The more you gain experience, the easier it will be with your meals.
 
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