Blood sugar

I was just got told my blood sugar was 380, My dialysis nurse said it had been over 300 for four months. I was not diabetic, looks like I am now. Isnt that a long time to wait before you treat someone when thier blood sugar is that high?

How often do you have blood drawn? Was your last blood test drawn after fasting or right after you’d eaten?

Typically when a high blood sugar is noted on a lab test, it is a good idea to repeat the test on a different day to see if it’s still high. It’s best if blood sugar is measured when someone hasn’t eaten for at least 8 hours because food, especially high carbohydrate meals can affect blood sugar levels. According to the American Diabetes Association a random blood sugar test result over 200 indicates diabetes if other symptoms are present. Do you have other diabetes symptoms? -

I have not been told yet I am diabetic, as a matter of fact my A1c test came back normal(5%). For a week now I have been checking my blood sugar every morning and every evening, In the mornings it runs between 350-380, in the evening between 210-260. Is there anything other than diabetis that could make my blood sugar run that high?[/b]

Not that we’re aware of, KJ. In the U.S., they don’t use A1c’s diagnostically (although they do in Europe). It’s possible that your problem began recently enough that your last A1c didn’t show it. Here’s what the American Diabetes Association says:

"With the FPG (fasting plasma glucose) test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT (oral glucose tolerance test) test, a person’s blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes."

If I were you, I would make an appointment to see an endocrinologist or diabetologist. While most family practitioners treat people with diabetes, they aren’t necessarily up to speed on current best practices the way these specialists are.

What kind of PD solution are you using? Icodextrin (also called Extraneal) can raise blood sugar on certain testing meters. The FDA has a warning at that states:
“If you monitor your blood glucose, you must use a glucose specific monitor and test strips. If your glucose monitor or test strips use a glucose dehydrogenase pyrroloquinolinequinone (GDH PQQ) method, using EXTRANEAL may cause a falsely high glucose reading. A false high blood glucose reading could cause you to give more insulin than you need. Getting more insulin than you need can lower your blood sugar unnecessarily and can cause a serious reaction including loss of consciousness. You or your health care provider should contact the manufacturer(s) of the monitor and test strips you use to make sure that Extraneal, icodextrin or maltose will not interfere with the test results.”

Is it dangerous for me to go around with my bllod sugar over 300? My kidney Dr. gave me some (glipizide er 5mg) and I have been taking it 8 days. When I called him he said to keep that up for a couple of more weeks and we would see what happens.I got people telling me I need to be in the hospital with blood sugar 340-380.

The solution I am using is dianeal low calcium 1.5% and 4.25% dex peritoneal dialysis solution.

Again, is it dangerous for me to be walking around with blood sugar that high?

Dianeal is a peritoneal dialysis solution that uses dextrose (a kind of sugar) to remove extra fluid. Blood sugar readings with Dianeal should be accurate. Based on your blood sugar readings, I would suspect that you do have diabetes. You may have had it for some time but it was not detected. This happens a lot. High blood sugar can lead to damage to your blood vessels throughout the body, vision changes, and damage to organ systems. I’ve read that when blood sugars rise over 180, damage can occur so you definitely want to get your blood sugars down. However, you need to avoid low blood sugars as well because having low blood sugar (less than 70) can cause problems too.

Here are things you can do:

  1. Talk with your dialysis nurse about your blood sugar and ask him/her about when you should seek emergency treatment.
  2. Talk with your nurse or doctor about getting a blood sugar meter, lancet (pricks the finger), and test strips so you can test your own blood sugar at home. Most meters are easy to use. If you have diabetes, Medicare Part B will pay for these. The new Medicare Part D plans can pay for drugs and supplies for diabetics.
  3. Ask your nurse or doctor if you can use less of this solution and more of the 1.5% and/or 2.5%. The 4.25% dianeal contains the most sugar of any of the PD solutions.
  4. Ask the dietitian at your clinic for a low carbohydrate diet and limit your intake of sugar and other sweets. Pills alone may not lower your blood sugar enough. If you’re overweight, losing weight and following a diet may help you lower your blood sugar with or without oral drugs or insulin. You might want to look at the nutrition module on There is information on PD for people with diabetes separate from people who don’t have diabetes.
  5. Ask your doctor what exercise you can do safely. Exercise is helpful in losing weight and controlling blood sugar. However, if your blood sugar is over 300, your doctor may not want you to exercise. For an exercise booklet for people on dialysis, see

Actually, most of the newer meters on the market use practically microscopically small drops of blood and allow “alternate-site” (non-finger) testing on your arm, which is completely painless (I’ve tried it at a diabetes meeting–and believe me, I have an annoying tendency to pass out when blood is involved). I can’t actually figure out why anyone with diabetes would want to test their fingers (which have lots of nerve endings so it hurts a lot) when it’s so much better not to. Alternate-site testing is less accurate for very low blood sugar, so in those cases, you would need to test on your finger.

My husband is on PD and not a diabetic.
Lately his blood sugars are elavated.
Is this from the glucose in the diaysis solutions? Thanks Del

Unless your husband is using icodextran solution, his body should be producing normal serum glucose levels by making insulin to “cover” the extra sugar in his PD solution. (Icodextran can falsely raise glucose levels in the blood). If this isn’t happening, he may now be diabetic. Type 2 diabetes occurs when the pancreas is “burned out” from overuse. Two things happen:
– The worn out pancreas makes less insulin
– Cells in the body become less sensitive to the insulin that is present

Diabetes is usually detected in this country with a fasting glucose test done first thing in the morning. If your husband hasn’t had this test done, he should.

Type 2 diabetes is often treated with pills, diet changes, and exercise (very important, as exercise helps sensitiize the body’s cells to the insulin that is present). In time, many type 2 diabetics progress to the point where they need insulin.

Other things that can help your husband get his blood sugar under control include losing weight if he’s overweight and limited carbohydrates and simple sugars in the diet. In addition to talking with the doctor about getting a fasting glucose, I’d suggest talking to the dietitian at the dialysis clinic about what your husband has been eating and ways to modify his diet.

Here’s the website for the National Diabetes Education Program. They may have tips to help as well:

Recently my father passed away. He’d been diabetic for many years and started peritoneal dialysis almost 3 months prior to his death. After he went on peritoneal dialysis, his blood sugar was always elevated. He was very thin and ate very little. He did drink the diabetic type “ensure” but he continued to have very high blood sugar. He compensated with insulin shots. His may have been an extreme case but certainly, the dialysis solution was a major factor in his elevated blood sugar.

Some clinics have patients who are diabetic inject insulin into the dialysate bags to compensate for the sugar in the dialysate. I found this article from Germany in 2002 that states that intraperitoneal administration of insulin in peritoneal dialysis is better than subcutaneous administration (shots) of insulin.

The conclusion of the article states:
The advantages of intraperitoneal insulin administration include a more physiologic effect of insulin in patients with diabetic nephropathy during CAPD or IPD treatment. Major fluctuations of blood glucose, hyperinsulinemia, and the formation of insulin antibodies can be minimized. In the final analysis, a better adjustment of blood glucose levels results. Disadvantages include a raised insulin requirement in intraperitoneal insulin administration, which is based on the dilution effect and in particular on insulin binding to the plastic surface of the dialysis fluid reservoir. This disadvantage can be eliminated in part by instilling the insulin into the empty abdominal cavity. However, this requires in more elaborate manipulation. If the insulin is instilled into the abdominal cavity along with the dialysis solution, switching from subcutaneous to intraperitoneal administration entails an increase of the insulin requirement by approximately 30%. However, the resulting increased costs are compensated by the advantage of optimized adjustment of blood glucose levels. As expected, the rate of peritonitis in intraperitoneal insulin administration is mainly increased in CAPD. However, it is still in an acceptable range compared with patients without diabetes.

I am a type-2 diabetic, using an insulin pump (about 150 units of insulin per day). Are there others out there who also need a high dose of insulin and use (or have used) PD? Please share your experience/advice with me. How much more insulin do you take? What problems have you encountered?

Thank you!

What kind of PD do you do–CAPD or CCPD? What kind of dialysate do you use and what it the sugar content (1.5%, 2.5%, or 4.25%)? Do you put any insulin into your dialysate bags in addition to using your insulin pump?