My MIL was diagnosed with diabetes a few years ago. She takes glypizide (sp)…you know, that pill that kind of jump starts your insulin.
Anyhoo…for the past few days, she’s had really bad numbers; one day this week her blood sugar was around 250. She’s had crappy numbers all week. Today it was 180. She’s pretty damn careful about what she eats. She watches her carbs very closely and buys only sugar-free stuff.
She called the doctor (who normally has a shit fit when she reads in the 130s) and she told her not to worry about it.
How long should she go with these crappy numbers before she should be concerned?
Would her doctor consider increasing her medication?
Is failure to make insulin an eventuality amongst those who are on the glypizide?
What should she be asking her doctor? Her doctor has an extremely busy geriatric practice and I’m always afraid she’s too busy to address everything adequately.
I’d be worried about numbers like that if they lasted a week. What was her last Hemoglobic A1C, and how long ago? Any signs of infection?
It’s pretty normal for diabetes to progress. More slowly if aggressive measures are taken to control it, more rapidly if not.
She should ask why her numbers are up, whether she needs a medication change (or increase), and she should ask why she’s not on Metformin. Also, is she on an Ace inhibitor or an ARB? If not, she should ask if it’s time to start one (to reduce the risk of diabetic kidney damage).
She should ask for an appointment with a diabetic education nurse, if her doctor can’t/won’t take the time to educate her. And she should get the nurse’s phone number and not be afraid to use it to ask these sorts of questions afterwards.
She also shouldn’t get too panicky about those numbers. They’re very much not ideal for long-term control, but don’t pose much risk over the short run (like several weeks).
It’s pretty much the first drug considered these days when drug therapy is needed for Type II diabetes. Lowers glucose nicely, without lowering it too much. Causes some weight loss, rather than weight gain, which is what most other diabetes meds have as a side-effect. Works somewhat synergistically with glipizide to help get better control.
It’s not right for everybody, but it sure is an effective drug.
This may have no bearing on anything but - how much “sugar-free stuff” does she eat?
Sugar free things that are supposed to taste very sweet use a variety of different artificial sweeteners that, as I have read, effect peoples’ bodies in different ways. I’ve read that it is important for diabetics to check themselves after consuming such products to know how these sweeteners effect them and not just trust the label that the product is sugar-free and thus will not affect their insulin.
I am also making a WAG that the mixture of sweeteners may change in a product over time (they’re always coming up with new sweeteners) and something that didn’t effect you last year might effect you today.
Just a friendly note from someone who’s bought a lot of “sugar-free” stuff in the past and done a bit of reading on what “sugar-free” actually means.
One of the key symptoms for the development of any infection in someone with diabetes is worsening sugar levels. Are you sure the bladder infection is finished? Could it have spread higher up into kidney/bladder system?
Since this is not medical advice, I won’t give a list of all the many other causes of the sudden development of worsening glucose levels in someone with diabetes. The list ranges from new medications to heart attack, from lack of exercise to gall bladder disease. If the sugar is still high today, she should see her doc tomorrow, or at least ASAP.
Also “sugar-free” is sort of meaningless for some products. Shari’s (a chain restaurant) has “sugar-free pies,” but the fruit still has sugar, and pie crust is a simple carb and might as well be sugar for diabetic purposes. I’ve also found a couple of products labeled “no added sugar” that are very high in simple carbs and other sugars that are in the food naturally. Similarly, getting “no syrup added” canned fruit is great, but canned fruit is high carbohydrate even without the syrup. I’ve also seen products labeled “no added sugar” that have added high fructose corn syrup. Finally, “low sugar” or “lower sugar” are relative terms. Lower than what? An ice cream with 25 net carbs per serving is still over the recommended limit.
The “sugar alcohol” products may not increase blood sugar, but they are still caloric and need to be accounted for.
Huh. Interesting. I’ll have her take a closer look at her labels.
She eats sugar-free ice cream, pop, candy, and cookies. She also eats Muenster cheese, which she says isn’t too bad for diabetics. She eats English muffins, as her doctor said it’s less dense and better for the carb count. She also eats thin sliced rye bread, which effectively cuts her carbs in half. She eats plain broiled chicken breasts and steaks. And fish. One thing I think she’s doing wrong is eating sweet potatoes. Rather frequently. But she’s been doing all these things for a long time, so it doesn’t look like she’s added a glaring mistake to her diet.
If anyone sees something in this array that looks like it needs to go, please share.
This is good to know. She was pretty sick when she had it and has perked up to the point where she can go shopping, hang out with the dead people, etc. So that makes me think she’s probably over the infection.
My MIL, if you’ve been following the saga, has a prolapsed uterus that she refuses to deal with. It resides completely outside her body. I’ve googled this condition and there are tons of other problems that could be connected to this issue. I believe that this is at least partly responsible for the bladder infection (which she’s had a couple times in the last six months or so).
One of the SILs is in town. I am going to call her and have her read the information I gave her yesterday (she said thanks and set it aside when I gave it to her). Maybe we can get her to schedule an appointment with the doctor.
Actually, sweet potatoes aren’t all that bad for diabetics; depending on the variety they have a low to medium glycemic index, which means that she’s getting slow release carbs, which has to be good.
I started to take metformin (500 mg, twice a day) and my blood sugar went from 8.1 to 6.0 (multiply these numbers by 18 to get the US equivalent) and also lost 20 lb without even trying. I have stopped losing weight unfortunately. In addition to the metformin, I have stopped eating things with added sugar, but I eat lots of sweet fruit and a fair amount of multi-grain bread.
Could you say a little more about the heart attack deal? My brother went in with a heart attack and they found he has Type II diabetes, as his blood sugar was 400. He didn’t know he was a diabetic, and they said people often find this out when they go in with a heart attack. So the heart issue also raises already “bad” sugar?
Well, she was doing a bagel every morning, and the doctor said that was too much, but the English muffin is thinner, and with the nooks and crannies, it is less volume, and therefore fewer carbs. That was the logic, anyway.
Yes, that’s not an uncommon event. There are two major reasons why - as you correctly said, about 50% of people with diabetes don’t know they have it. So, their first manifestation can be a diabetic complication such as a heart attack. But it works the other way, too. That is to say, that anyone with diabetes (diagnosed or not) or even so-called “pre-diabetes” or “impaired glucose tolerance” can experience a rise in blood sugar in association with a heart attack. That occurs because the “stress” of a heart attack (or, for that matter, an infection, or a stroke, or surgery, or a gall bladder inflammation, etc.) leads to an elevation in a person’s adrenalin and cortisol levels. Those two substances directly elevate blood sugar levels. You can view them, in some sense, as “anti-insulin” hormones.
All of those things have sugar alcohols (except maybe the pop). The sugar alcohols aren’t always the same in every brand or flavor. Or they could have changed. Or her metabolism could have changed and is processing the alcohols differently.
I am not saying that this is the root of her problem. But I would say in order to get an accurate insulin count on her she needs to cut out any sweets for a bit.
My SIL (who recently died) said her doctor told her that her asthma meds increased her blood sugar. Her numbers were often in the 300 range. It scared the hell out of me, but they told her not to wory about it.