My mom has diabetes type 2, and has been having trouble breathing when she lies down for the last month. She finally admitted it, and after much nagging, she and dad went to an ER since they couldn’t get in with a dr.
When they did her glucose level it was 360 (this is 2cd hand, I called dad). She also has fluid in her lungs. They admitted her for test, but I couldn’t get more info from my dad.
What are normal glucose levels? And can diabetic complications cause the lung problem? Thanks in advance for any answers, I’m going back to chewing my fingernails.
Normal glucose levels are generally under 110. A level in the 300’s is definitely strong evidence for diabetes mellitus. (Type II, or insulin-resistant). The fluid on the lungs is generally not a primary complication of diabetes, and could come from a tremendous variety of causes, including heart disease (could be diabetic heart disease), Lung disease (emphysema, cancer, others), kidney disease (possibly from diabetes) and a whole host of other things. Best to let the docs determine the cause of the fluid on the lungs, and work out a regimen for treating that and her DM.
Diabetes Mellitus II is where the body (generally the fat cells) become resistant to the body’s own insulin, and no longer act to take glucose out of the bloodstream to normal levels of insulin secreted by the pancreas. Best way to treat is to lose weight, and exercise, as these both increase the body’s ability to utilize the insulin the body produces. Drugs like glyburide and glipizide work by stimulating the pancreas to produce more insulin, while metformin (glucophage) and the glitazones (actos, others) work to change glucose metabolism and lower insulin resistance. Amaryl works by preventing the body from converting sucrose (table sugar) into glucose. Finally, insulin can be given in whopping doses to override the body’s resistance to it.
I am not a doctor. However, a blood sugar of 360 is dangerously high. I’ve got type II diabetes myself, and my doctor is happy if I keep my blood sugar below 170. I believe that the normal range (for people without diabetes or hypoglycemia) is 70-115, fasting. I’d have to look it up, though. I don’t know if diabetes causes breathing problems. Is your mom seriously overweight? She might be retaining fluid, especially in the sac around her heart. You’re really going to have to find out more from the doc…I don’t think that anyone can really diagnose this sort of thing over a message board with the info you’ve given so far, not even a doctor.
Sometimes, type II diabetes can be controlled by diet and exercise alone. Sometimes it can’t. In your mom’s case, she’s probably not going to be able to control it with just diet and exercise. There’s a wide variety of oral anti-diabetic medicines out there, if she needs medication. She WILL need to see a doctor regularly, and watch her diet, and exercise, and monitor her blood sugar herself. The newer glucose monitoring machines are pretty easy to use. If at all possible, your mom should go to a diabetes education class. If your dad can go with her, that would be VERY helpful.
DO NOT become the food police for your mom. Your mom is the one who should be making decisions about what she is going to eat. If you are fixing a meal, then definitely make stuff that she can eat without problems. A diabetic diet is healthy for everyone, including non-diabetics. Once she has her diabetes under control, it’s perfectly OK for her to have a SMALL serving of a rich dessert. I find that it’s better for me to go out to have a dessert, rather than make one and have it in my house. But this is between your mom and her doctor.
Thanks, Qadgop- still want to talk books…got sick this past week and had to catch up with school stuff.
Lynn-
I just wanted enough info to know if I could stop nailbiting at the quick, or go down to my fingernails :(. She is overweight…a little over the ‘obese’ level, I’d guess, and has been on diabeta(sp?) for years. She refuses (apparently on principle) to do the machine/strip thing…and believes that going to see an MD is just a little preferable to having her fingernails pulled out.
The food police thing I know …it can be hard not to nag when you find the candy bar stash when you’re tidying the kitchen cabinets, though.
Handy: Thanks, I’m heading there
Going on the 3-hr drive to see her tomorrow, and try to find out what the docs say and see what I can do…just panicked when dad told me she’d let herself be admitted(very unlike her)
Perhaps. “Whopping doses” may not be needed. Sometimes insulin resistance is not the primary cause. It’s possible that the islet cells of the pancreas don’t create enough insulin, in which case administration of insulin in less than whopping doses can lower blood sugar levels. There are various causes for this decrease in insulin production, possibly a viral infection or an autoimmune problem where the body attacts itself.
Much more sugar is burned by muscle cells than fat cells. A small increase in muscle mass with a corresponding decrease in fat can go a log way to lower blood sugar levels.
If blood sugar levels remain uncontrolled, a person can look forward to wonderful things like heart, kidney, and liver diseases, blindness, ketoacidosis, and coma.
I, too, hate the sadistic bugger that created that finger-sticker device, and I thought as a youth that I could never learn to inject myself with anything. It’s amazing what you can learn when you have to survive.
Can’t add much to the sound advice and comments above. It’s worth pointing out though that type II diabetes is often present but silent for years before it’s finally diagnosed. During that time, diabetic complications can result.
Perhaps the most common complication of type II diabetes is atherosclerosis (hardening of the arteries). This can lead to (silent) heart attacks which, in turn, can lead to heart failure (an inability to pump fluid out of the lungs).
About 5 percent of Americans have type II diabetes, and half of them don’t know it. The numbers are increasing at an epidemic rate. If you have a close relative with type II diabetes, your chances are at least 1 in 4 of developing it. The more affected relatives you have, the greater your chance. Maintaining close to ideal weight and keeping active will reduce those odds.
If you have a family history of type II diabetes, or are overweight, or have (had) relatives who developed hardening of the arteries (brain, heart, feet) for no known reason, then get checked for type II diabetes.
Actually, a thinking on one cause of type II diabetes seems like it’s gone great evlolution over the last ten years. Insulin resistance was considered a problem of a defective insulin receptor, i.e. the receptor didn’t respond to insulin signaling.
I’ll have to dig up the articles and provide links, but the journal Science recently had some research regarding this. Basically, an unresponsive insulin receptor is too simple a model to account for this.
What was scary was the fact of the claim that receptor resistance might not account for insulin resistance. My father has this, so I take an intrest. The claims being made are that the signaling block is farther downstrean and tied to glucose metabolism and storage. This means treatment might not be so simple as bypassing a defective receptor for insulin.
I agree with Karl Guass that numbers of diabetics are increasing at an epidemic rate. This is a disease of the 21st century.
I’ll try to post the Science articles, so people can judge for themselves, but one quote from a researcher was that:
“everything that we’ve thought we’ve known about this disease over the last 10 years, has turned out to be wrong” [my paraphrase].
That’s true, I just had a patient last week, new diagnosis of DM at 43, thin as a rail, he burned out his pancreas with alcohol. But he remains the exception to the rule for adult onset diabetics. For every one like him I’ve seen, I’ve seen 500 insulin-resistant patients. And it was a bit of hyperbole on my part to say “whopping” doses of insulin, as that is not even true for all insulin resistant people, but it is the general rule.
My knowledge comes from years of treating diabetics, and from being diabetic. As such, I have my own biases.
Although a simple numerical deficiency in insulin receptors is a plausible hypothesis to account for insulin resistance, I don’t think people in the area have put their bets on it for a long, long time. There are many potential ways (at the molecular level alone) to explain insulin resistance.
One thing that is seldom appreciated, or at least seldom mentioned explicitly, is that the insulin resistance disproportionately affects muscle cells (after all, most obese people are very insulin resistant, yet clearly their fat cells are responding to insulin).
It is also interesting to note that much of the “epidemic” in type II diabetes is occurring in populations that, until recently, were often on the verge of starving or had limited caloric intake (eg. Asian subcontinent, Ethiopia, many native North Americans). It’s as if there’s a gene (or genes) that is advantageous to the individual if times are tough (calorically speaking) but predisposes to diabetes in times of plenty. This is called the “thrifty genotype hypothesis” of diabetes and makes for interesting reading and reflection.
Karl Guass–no, that wasn’t it, I just became aware of the resistin paper, after I posted. The Lazar and Steppan paper was in last week’s Nature. (I’m home now so I don’t have the Science paper link here, but it’s a few months old).
Acutally, it’s my turn to present a paper next week at the journal club among the labs where I work, and I’m picking that one to get the debate going. New hormone discovered? That doesn’t happen that often. Haven’t had time to read it yet, but it should be good to examine in detail with critical minds in attendence.
Good points and I agree, although it’s not necessarily deficiency in receptor number that was the thought, but a lack of those receptors’ reponse to insulin (IIRC, this was the classic model of type II). And when one talks about obese people, the interaction of leptin (and other factors) also has to be taken into account.
If I or anyone could lay out the precise causes of type II diabetes, NIH could just send me shitloads of money, and maybe the Nobel prize might be awarded.
Diabetes is probably becoming more common because more populations/people are having access to high-fat Western diets.
I’ve notice some Chinese grad students porking out since they’ve arrived in the US; McDonalds and Taco Bell take their toll when you use their fare to replace the rice-based diets that you’ve grown up on at home. Ten pounds of extra fat a year isn’t farfetched weight gain, from what I’ve seen.
