When to call the doctor


(Nicole) #1

I’ve been T1D for just shy of a year. I’ve had good control of my levels and my doctor has been happy with where I’m at. I’ve noticed that my numbers seem to be going up, consistently over 200 the last 2 days. My next appointment is in about 2 months. I realize lots of factors can mess with my levels but how long do I monitor before reaching out to my endocrinologist. I’m still not sure at what point I worry about being too high. It’s all still very confusing.


(Dennis J. Dacey, pwD) #2

Hi Nicole @NSTrim16. Call your doctor if you are uncomfortable with your abilities ibn managing YOUR T1D or if you suspect that something might be going on in your body - such as infection, etc. Go with what your doctor has told you to do in situations like this; it is common for doctors to tell newly diagnosed like you to call when BGL is constantly over 250 mg/dl.

Is your “over 200 the last 2 days” only at one time of day or are you over 200 all day long? It is possible that you are leaving the so called “honeymoon period” and that your insulin levels need adjustment, and also the change of season could be a factor - I need more insulin in cooler weather. In time you will be your “own doctor” and will be tweaking your insulin levels but if you are not sure what to do, make the call and get siome assurance.


(Bill) #3

Hi, Nicole @NSTrim16,

Let me add just a bit to what @Dennis offered. There are two “general” conditions when it is important to “do something” (e.g., call your physician if you’re new to T1D, or make adjustments if you have been living with T1D for several years).

The first situation is when your blood glucose level has become elevated and, despite your best efforts, it has remained elevated for more than eight hours or so. Now, by “elevated,” I’m referring to blood glucose levels of more than Dennis’ 250 mg/dl.

When blood glucose levels deviate from “your” normal, and when they stay above 250 mg/dl, “something” is going on. This change may indicate that you are fighting off an infection of some sort, or that you’ve made several mistakes in a row as you’ve estimated the glucose loads in snacks/meals. Whatever the case, a “persistent” elevated blood glucose level indicates that you need more insulin. Persons who are new to diabetes should call their physician for guidance. Us “old timers” will likely add a bit more to our basal/long-acting insulin, and take an “adjusting bolus.”

The other time to “do something” is when you see a “pattern” emerging in your blood glucose measures. A “pattern” is loosely defined as problematic measurements that appear at about the same time three days in a row. Such a “pattern” indicates that there is a need to adjust the amount of insulin you are taking that is meant to cover that time of the day. So, if your blood glucose is running “high” at 11:00 a.m. three days in a row, then it’s time to raise the basal that covers that time of day (assuming you are not eating a snack at 10:00 a.m. or so).

So, a persistent elevated blood glucose level for more than eight hours is one reason to “call for help.” The other time to call for help is when a pattern is developing that indicates there is a need to change your insulin dose for a certain time of day…

Be aware that there are some of us who have a variant of diabetes (and other systems in our bodies) that cause our blood glucose levels to “bounce around” like a basketball in the NBA. For us we have to constantly make tiny corrections throughout the course of a day. But, if we’re lucky, our basals/long-acting insulin doses can be held generally constant until a “pattern” develops - then we make the needed change in our basals/long-acting insulin doses…

All of this can seem bewildering. Just hang in there. You’ll learn how to do this.

Bill


(Nancy) #4

I agree generally with Dennis and Bill - it’s never too early to call your doctor. If you’ve exhausted your bag of tricks, call the doc or an NP and get some more. There is always room to learn something new.

To your health,

Nancy


(Nicole) #5

Thank you all! I will reach out.