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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 52514
Experience:  GP in the United States
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My 87 year old mother was addmitted to A & E with glucose

Customer Question

My 87 year old mother was addmitted to A & E with glucose 28mmol and blood in urine,she was very dehydrated,this was corrected by IV fliuds.She was previously a diet controled diabetic,and had been on ceflex for six days prior to admission but an infection was never confirmed.I had requested a HbA1c test from her GP but she was admitted before it could be carried out.She was semi conscious for four days before coming round, but has been reluctant to eat much.After two shots of insulin(sliding scale?)it was stopped and now her levels are back up to 11-18mmol,the Doctors said that her kidney function has improved and liver is OK. she is slipping back into semi-consciousness but the Doctors will not consider more insulin and want to discharge home to die.I feel that she has not been given a fair chance and would like them to try insulin is this an option ?
Submitted: 4 months ago.
Category: Medical
Expert:  Dr. David replied 4 months ago.

This is Dr. David

as you know, a glucose of 28mmol is super super super high.

she most likely went into a diabetic coma

glucose of 11-18 is much better, but still in diabetic range.

it sounds like she has diabetes and will need insulin daily to keep her sugar level.

if she doesn't get insulin therapy or diabetes therapy, her glucose levels will go back up to 28 range.

how was her diabetes controlled before? with oral medications? it doesn't sound like oral medications are enough at this point.

why won't they give her insulin to take? because it is too expensive?

insulin is not expensive and she should get it to control her blood glucose levels.

it is obvious her pancreas is not able to produce the insulin her body needs at this point.

let me know if you have other questions.

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Customer: replied 4 months ago.
Hi David she was diet controlled before, I think the Doctor is unwilling to give insulin because is a bed bound, stroke patient, I feel she hasn't been given a chance to recover without insulin.How can I ask him to change his mind.
Expert:  Dr. David replied 4 months ago.

you have to ask for a second opinion from an endocrinologist.

she definitely needs insulin

it is crazy they won't give her insulin.

she was in a coma with an insulin of 28.

she will go into another coma if she doesn't get insulin.

you may have to take her to a private endocrinologist or private doctor for a prescription for insulin.

let me know if you have other questions.

if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

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http://www.justanswer.com/medical/expert-dr-david/

Thanks for using JustAnswers.com

Expert:  Dr. Phil, MD replied 4 months ago.

Thanks for this question Lucy

you can get control of this without insulin.

There are other options.

what is she on now?

Customer: replied 4 months ago.
Hi they are sending her home today,her levels in hospital without insulin were 13-18,she hardly ate at all only bit of yogurt They have (on my request) put her on once a day small dose I think 6ml? This hasn't made much difference still 13-19mmol. Dr says he does not want to risk levels dropping too low.What would be the other options?
Expert:  Dr. Phil, MD replied 4 months ago.

oral meds like glipizide and metformin

those might be options depending on kidney function

Expert:  Dr. Phil, MD replied 4 months ago.

Thanks for this question.

Please don't forget a positive rating.

I appreciate it. :)

Customer: replied 4 months ago.
Hi, sorry to say mum died on the 16th.They finally told me that an HbA1c test came back as 100% ?She had been in hospital from the 3rd Why did they leave her levels high at 13-19 wouldn't this still cause inflamation. Her system was flooded with antibiotics;ceflex,co amox-clav,tazasin and amoxicillin.I still do not know if there ever was any infection.Don't know what to think.
Expert:  Dr. Phil, MD replied 4 months ago.

Yes, they should have made an effort that was stronger to get the sugar down.

Sugar feeds infection too

I'm very sorry for your loss

Expert:  Dr. Phil, MD replied 4 months ago.

Thanks for this question.

Please don't forget a positive rating.

I appreciate it. :)

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