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Is Fasting Blood Sugar Level Of 300 A Cause For Concern?
Question: my father is 60 years old known diabetic type 2 for more than 15 yrs ago , also have glaucoma in both eyes surgery was don weeks ago , idiopathic epilepsy on Na valproate 200mg TDS , his blood glucose investigated yesterday FBS= 300 , HbA1c = 13% , Lipid profile , renal , Liver = Normal , Urine general has trace albumin and one cross acetone , . Now on Januvia 100mg BiD , Glucophage 750mg Bid , Lisinopril 5mg , and other eye drops for cataract .
I think he may need absolutely an insulin but I now my father he cannot comply with insulin and I afraid from hypoglycemic effects >
Please I need your opinion what can be modified or changed or added regard his glycemic control plan?
I think he may need absolutely an insulin but I now my father he cannot comply with insulin and I afraid from hypoglycemic effects >
Please I need your opinion what can be modified or changed or added regard his glycemic control plan?
Brief Answer:
Insulin is mandatory in his case.
Detailed Answer:
Hi,
Thanks for your question.
Noted your concern.
Considering fasting blood sugar level of 300, presence of urine acetone and post operative status Insulin treatment is mandatory.
I may suggest to consult his diabetologist immediately or go to ER.
Depending upon physical examination there may be need for
Blood evaluation including Arterial blood gases and other investigations.
Depending upon it there may be hospitalization for intravenous insulin treatment and hydration.
Chances of hypoglycemia can be minimized with proper education, frequent blood sugar monitoring.
Persistent high blood sugar levels may complicate his operative wound.
So without delay action need to be taken.
Hope this helps.
Regards,
Dr. Abhay Mali.
Diabetologist.
Insulin is mandatory in his case.
Detailed Answer:
Hi,
Thanks for your question.
Noted your concern.
Considering fasting blood sugar level of 300, presence of urine acetone and post operative status Insulin treatment is mandatory.
I may suggest to consult his diabetologist immediately or go to ER.
Depending upon physical examination there may be need for
Blood evaluation including Arterial blood gases and other investigations.
Depending upon it there may be hospitalization for intravenous insulin treatment and hydration.
Chances of hypoglycemia can be minimized with proper education, frequent blood sugar monitoring.
Persistent high blood sugar levels may complicate his operative wound.
So without delay action need to be taken.
Hope this helps.
Regards,
Dr. Abhay Mali.
Diabetologist.
Above answer was peer-reviewed by :
Dr. Yogesh D
I am anurse practitioner . my father unfortuenately refused after several trials to go hospital how can i start insulin regimen + Rehydration in our home ( he was looked rehydrated till now and no more serious signs and symptoms of DKA
We can only do in our home initiate therapy guided by glucometer check to keep him safe .
How much initial dose and subsequent insulin plan per day?
Your advise and treatment plan
We can only do in our home initiate therapy guided by glucometer check to keep him safe .
How much initial dose and subsequent insulin plan per day?
Your advise and treatment plan
Brief Answer:
Consult diabetologist on OPD basis.
Detailed Answer:
I still suggest to consult near by diabetologist on OPD basis.
Physical examination is important in his case.
If there is no acidosis on Blood gas analysis out door treatment can be suggested.
Blood sugar monitoring with basal bolus regimen of insulin may be suggested.
I may suggest to monitor
- Fasting
- 2 hours after Breakfast
- Prelunch
- 2 hours after lunch
- Predinner
- 2hours after dinner.
May start with once a day injection of long acting insulin like Glargine and Premeal boluses of short acting insulin like regular insulin.
Depending upon blood sugar chart titration of insulin doses can be done.
Staring insulin requires close monitoring with frequent consultation with treating diabetologist.
So better to consult his diabetologsit on OPD basis.
Hope this helps.
Consult diabetologist on OPD basis.
Detailed Answer:
I still suggest to consult near by diabetologist on OPD basis.
Physical examination is important in his case.
If there is no acidosis on Blood gas analysis out door treatment can be suggested.
Blood sugar monitoring with basal bolus regimen of insulin may be suggested.
I may suggest to monitor
- Fasting
- 2 hours after Breakfast
- Prelunch
- 2 hours after lunch
- Predinner
- 2hours after dinner.
May start with once a day injection of long acting insulin like Glargine and Premeal boluses of short acting insulin like regular insulin.
Depending upon blood sugar chart titration of insulin doses can be done.
Staring insulin requires close monitoring with frequent consultation with treating diabetologist.
So better to consult his diabetologsit on OPD basis.
Hope this helps.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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