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My brother-in-law, does anyone know the answer to this?


Daylily

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My BIL is in the hospital. This is the one who just lost his wife. His blood sugar is very unstable and has dropped as low as 22 but the strange thing is, they can't get it to go above 80. They've given him peanut butter sandwiches, milk and even soft drinks and it just goes up and down, say from 60 down to 30, but never above 80. What could cause that? He has a UTI but they said that wouldn't cause it. He has to have someone with him every second because he gets out of bed and pulls the IV's out and is talking non-stop craziness.

 

DH's sister C and her husband W have been with him. I have this crazy cold and sinus mess so I haven't gone. I would be asking the doctors what they are checking for but C doesn't. She just knows they are doing tests but never asks what. Drives me nuts!

 

Any ideas?

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ok, 80 is the low end of normal. I have heard a lot of situations described but I cannot even give you a clue as to this particular situation. This is very unusual. Definitely ask about ketones and what is commonly called DKA , Diabetic Ketoacidosis and if his kidney and liver functions are doing well when you can do so. ( Just so you know they are keeping an eye on that if it may be a factor.

His very low numbers will cause the disorientation and bad decisions. He is probably pretty cranky, and this comes from the lows, if he is removing the IV's and such . It is aggravating him , the sensation and restriction of movement. He is also not thinking clearly of course.

 

 

Ok, so they give him relatively loaded carbs to bring up blood sugar fast, are they then following it with a good healthy meal with protein in it? This has to be eaten within another fifteen minutes to half hour usually. The protein actually helps maintain blood sugar from bouncing back down , combine with healthy carbs in the meal. If they have not tried that, any sensible doctor will tell a diabetic to do so if they had to bring up very low blood sugar , because just the sugar jolt never lasts once they are feeling a bit more normal and not shaky...or out of it, as the case probably is with him. IN this case scheduled meals as per the usual , are not going to work.

Is he on the pump or taking injections and what type of insulin are they giving him , if he takes it or how much metformin daily, he may simply need adjustments to his meds . If he is on the pump, maybe his wife took care of all that , and it really does take a heck of a lot of monitoring and adjusting, often daily and he may not have paid much attention and just let her do it, and now she is gone and its gone whacked because nobody knows what is supposed to be done and its very individual....

also the stress factor of losing his spouse may be part of the factors of course , and it has all snowballed. Or his pancreas is doing something odd or absorption to any insulin he may still produce himself due to the stress.

 

these are the things that come to my mind on the matter here. Print it out if you can't remember and take it with you as it describes some commonly known things about insulin pumps and how much insulin or meds used to treat diabetes .

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They need to test his blood glucose hourly for now. To see how he is reacting to what he is eating and then the 2nd hour helps with indications too. Not wait two hours or four hours pre meal type of monitoring. Or just in the morning when he wakes up.

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Thanks for replies! He only takes glipizide, no insulin. C said they are checking his blood sugar really often but she didn't give a time frame. They gave him lunch after the "snacks" to try and raise his BS but he refused the lunch. He said he was saving it for his BIL. He actually makes no effort to try and control his blood sugar. He eats what he wants, when he wants or did at home. C has fixed healthy food for him while she's been staying with her sister for the past few months and now while she's here and he eats it. Then if she's gone, he'll eat a whole box of Little Debbie cakes and 7 cups of coffee or a whole apple pie. He can't find the stews, meatballs, etc. that C leaves in the freezer for him but he can go to the store and buy junk.

 

I though of reactive hypoglycemia and need to look it up. I also wondered if a tumor on the pancreas could do this or would it be more likely to cause higher bs?

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I think he really has no concept of what he should be doing or not doing. Instant gratification has always been his goal and everything is all about him. It's sad but we have exhausted ourselves trying to keep him safe and healthy. The doctor told C this morning that he is not a candidate for home care, he must go into a nursing home at least for awhile. His son and DIL have invited him to live with them but he didn't want to. Now the dr says it's not possible. C has tried so hard because she promised her sister J that she would see that he got the care he needed. J knew he couldn't live on his own and was worried about him. He is like a spoiled child, really.

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Nursing home sounds like a good idea, considering his behavior. It's too bad because he will lose any independence and privacy he had in a home setting. Might teach him a lot though, he will get intensive type of care there and they will educate him.

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