Once in a while, insulin given after dialysis doesn’t seem to work. My mom never takes insulin until dialysis is over as doing so drops her blood sugar levels during dialysis. She started dialysis earlier today at 6 am rather than her usual time at 11 am due to clinic’s holiday schedule. She didn’t take insulin and when she came back home at 11:30 am, her blood sugar was 170. We gave her 8 units of Novolog with lunch. She ate very little than what she usually eats, and 8 units is sufficient enough for what she ate. Suddenly at about 3:30 pm, she had a very bad headache accompanied with excessive thirst. When we tested her blood sugar, the meter read ‘HI’. We gave her some water to drink and about 13 units of Novolog. We checked the blood sugar at 5:00 pm and the meter was still reading ‘HI’. Again, we gave her 5 units of Novolog. At about 6 pm, finally the blood sugar came down to 360 and then at 7:30 pm, it was 160. We are still puzzled as to what caused the high blood glucose readings. This happens only on dialysis days. This has been happening for the 3rd time now and the doctors have no idea what is going on. They are saying they don’t know what is going on. I am very worried. What could be causing this? Thank you.
Dear John
I would love to be able to help you with this, but the vagaries in and management of blood sugar and insulin dos aging, minute-to-minute and day-by-day, requires such an intimate knowledge of circumstance, diet, medication influences, the presence (or absence) of intercurrent illness or infection, and sometimes the downright ‘orneriness’ of the diabetic state itself, that any advice from the other side of the world via a faceless Internet ‘advisor’ would be (1) most unwise … both from your and my perspectives (2) would like-as-not be incorrect and (3) be far less valuable or reliable than the advice and explanations you will get from your treating team. I can only suggest you seek their input again … though it must be said that - sometimes - in the behavioural see-saw that can be the blood sugar, there may be no certain explanation for the sudden up/down rollercoaster that blood sugars can ride. I know you worry a lot about your mum, and she is lucky indeed to have such a caring and attentive son … but bumps and twists and turns abound for most dialysis patients, and one of the hardest things to manage, as a carer, is the take those obstacles as they come, and not be thrown by them. You need the added support of your treating team to help you through this - perhaps as much as they help your mum - so seek their comfort and care. Again, the Internet is a wonderful (but limited) beast. Face to face always wins out.
Dear John
I would love to be able to help you with this, but the vagaries in and management of blood sugar and insulin dos aging, minute-to-minute and day-by-day, requires such an intimate knowledge of circumstance, diet, medication influences, the presence (or absence) of intercurrent illness or infection, and sometimes the downright ‘orneriness’ of the diabetic state itself, that any advice from the other side of the world via a faceless Internet ‘advisor’ would be (1) most unwise … both from your and my perspectives (2) would like-as-not be incorrect and (3) be far less valuable or reliable than the advice and explanations you will get from your treating team. I can only suggest you seek their input again … though it must be said that - sometimes - in the behavioural see-saw that can be the blood sugar, there may be no certain explanation for the sudden up/down rollercoaster that blood sugars can ride.
I know you worry a lot about your mum, and she is lucky indeed to have such a caring and attentive son … but bumps and twists and turns abound for most dialysis patients, and one of the hardest things to manage, as a carer, is to take those and deal with each of those obstacles as they come, and not be thrown by them.
You will need the added support of your treating team to help you through this - perhaps to help you as much as they are a help to your mum - so seek their comfort and care.
Again, the Internet is a wonderful (but limited) beast … but, having acted as an Internet resource for the Home Dialysis Central team for many years - in particular to explain the dialysis process rather than specific day-by-day medical problem - I have held fast, from the very start, that for the latter, face to face contact with home teams always wins out.
John … One additional source you may find especially useful is the Homr Dialysis Central FaceBook page on FaceBook.
While it’s name suggests it is ONLY for home dialysis patients, that is not so … it is a most helpful, well moderated, user-oriented site that brings you into contact with a huge range of other patients and careers - many with an enormous depth of ‘been there, done that’ personal experience and knowledge to share.
I think that many of your questions, if put to the more experienced users there, would deliver useful, practical advice and comfort to you. Tell them I sent you from this message board site.