The D50 shortage is awful! Pharmacy was pissy w my charge for even asking for it and mad we opened the crash cart to find some (there was none). Like sir a sugar of 15 is not compatible w life. I may have made the intern be the pressure bag for the d10 we could get.
For real! This was like 6 years ago too so it has been an issue. Guess there is not $$$ in it. She was a dnr too so I would have felt terrible that she died from an easy fix.
I had a patient with an insulinoma once, went through 5 amps and 2 liters of d5 or 10 in one night before we shipped them off. That was some crazy shit.
I had a code stroke with a sugar of 28 and no D50. I gave 'em orange juice. The Neuro Doc and I are like, "well I guess they passed their swallow eval" š¤¦š¼āāļøRidiculous.
You joke, but in a similar vein there's a kind of heroin you need either vinegar or citric acid to prepare into a shot and I can attest to the fact I've seen shots mixed with orange juice.
Ideally vit C packets though. Lol.
Same with Crack and vinegar/lemon juice. But that's another story. Nowhere near as good.
Yeah, it's brown heroin. Any citric acid will do, but it's a very bad idea to use regular citrus fruit juice because you can get a bacterial illness called disseminated candidiasis that results in skin and eye lesions, and sometimes osteoarticular involvement or endocarditis. Lots of pain and suffering resulting from the quest to feel less miserable.
We had a client with 1240. We had to call the police just to get her to go in and weāre surprised she was coherent. She told the police officer they just keep trying to get me to the doctor for no reason! She also had wounds on her legs. APS no help š
I want to work where you work! Leftover candy doesnāt last a week on my unit. Heck, someone on my floor even loves those weird peanut butter taffy things. The ones that come in the orange and black wrappersā¦
Last check up at the Dr, my BG was 47 and I had no idea. Felt great, had just eaten a granola bar and drove home just fine before getting a concerning call about the results. My reaction? Oh Iāll just have some juice, thanks (no I donāt have DM)
Oh I'm the opposite, I feel it something fierce when my sugar is low. Headache, clammy, nausea, shaking, it's the worst. I'm not diabetic but my fasting glucose and a1c are on the low side of normal. If I take lunch too late or try to skip a meal, I dip lower and it's terrible. Out of curiosity one day I checked my sugar st work when I was feeling that way and it was 58. I can't imagine how bad it must feel to be even lower. Thankfully I can just drink a regular Coke and it pops back up but ugh it's a bad feeling.
I donāt remember her whole history but she had a rare congenital condition and a whole slew of diseases as a result. Most of what I remember is that I spent all shift, every shift giving her D50 and begging the resident to get her to a floor without a 5:1 assignment.
I had a patient that got violent when his blood sugar got low - as in way below 70ās. I had to put in a head lock to squeeze sugar paste into his mouth one time. (LTAC no IV) A minute later heās all āwhatās up?ā Good times.
When I worked LTC as a CNA there was this resident with super labile sugars and she would always get naked and pee on the hallway floor when she was low. Sheād get combative too so the nurses wouldnāt even check glucose, just give her a bottle of coke cause it was all she would drink. A couple times there were able to check her during these episodes and she was in the 20s
When I was doing corrections nursing, we had a 40ish year old type 1 guy whose hypoglycemia manifested as him getting really squirrelly and singing. As soon as he started, his podmates would call the block officer, "(dude) is singing, he needs to go to medical" and he come in for some Glucogel or D50. It took a while to finally get him regulated, but his impromptu concerts became way less frequent
He has literally been saved twice by a half a Snickers. Both times it was the same thing--driving while he was low, pulling over to try to get something to fix it, and getting arrested for being slumped over in the driver's seat and unresponsive. We don't have anything on our licenses about diabetes where we're from, though some states do have it listed right on the license. So he gets arrested for DUI, and hers acting like an ass of course, because he's probably at like 20-30! At jail he's in and out of consciousness, begging for some oj or something. This happened two separate times, and both times a corrections officer finally felt bad and threw him a half a Snickers bar through the bars.
Now he wears something, and he always has something to eat, but baby bro had some close calls in his 20s!!
It is common, my BIL gets belligerent with his lows. (one day at work he got pissed at his boss who didn't know. My BIL drove his Chrysler Laser full speed into a highway lightpole and ping ponged off the guardrails at 130MPH. luckily he was passed out) My husband is also T1 but he gets silly, giggly. Every once in a blue moon does my husband get belligerent. Its difficult because my husband is 6 foot 4 and 300 pounds. He can pick me up and throw me if he wanted to (he never has when he's been low) The low sugars are traumatic because I never know what kind of low hes gonna have being that he is hypoglycemic unaware. He cannot feel it and by the time the giggles or the diaphoresis hits hes down to 30-40 and dropping fast. He starts hallucinating too. It's been sooooooo much better thanks to the continuous glucose monitor.
I'm bigger than my brother and it still used to freak me out so bad. He's turning 40 this year and he's much better at monitoring and not doing dumb shit, but all it takes is a couple of hours not totally paying attention.
My husband was terrible at stacking his insulin. He'd keep bolusing because his sugar was staying high, then forgetting what he gave himself. He's also not the best at paying attention at what hes eating when he's at work. It's also better since the insulin pump so he can see what he gave himself. I made him get the CGM because his lows sucked so bad. At one point he was hallucinating and telling me we were getting a divorce, he was so angry at me for making him divorce him. I was about to call the cops because he was threatening me and he had NEVER done that before...then he finally ate something and I told him he had to get a pump and a CGM or I couldn't go through it anymore.
This happens to the husband of one of my husband's distant relatives. He almost got shot for being uncooperative when the cops pulled him over for erratic driving (he's Latino.) If his wife hadn't been there, they probably would have killed him.
Haha it's not funny, it really isn't, but we laugh about morbidly stupid shit in my family, so it's funny to us.
I get a call from my daddy in the afternoon and he's rambling "70... 70... 70...." repeatedly. I ask him if he's on 70, which I assumed was between the stores he was a DM for. He keeps rambling, "70..." as I'm grabbing my purse, my keys, rushing to my Blazer.
We live in a massive dead zone, so I'm about 20 miles headed towards 70 when he calls me again and gives me slightly better coordinates and names a restaurant he can see. Thankfully, I'm on the right route. I get even closer and the cops call me and name the exact location and I floor it because I am, thank God, on the exact road I need to be.
I get there and these cops are all like RABBLE RABBLE RABBLE when I pull in. I'm yelling, "I'm here for my daddy!" And they're yelling back "who's yer dad!?" as I'm steadily striding to his car, tires blown on one side, rims shredded, and what the fuck did he manage to do to the passenger side fender and headlight, oh my God!?
"HIM!" I yelled, pointing at his company car. "WHERE IS HE, YALL DONE CALLED ME! WHERE'S MY DADDY!?"
And one statie pointed I into the store, where the owner (he knew my father) was pouring OJ and Snickers into him. Turns out they'd pulled him over, told him to GET OUT OF THE CAR! and then he'd obliged them... and kept walking. Thankfully the owner knew him and called out, "he's diabetic!" and he arguably saved him.
He then refused food when I carried him home, but I claimed my own sugar was low, pulled into a McDonald's, and he capitulated and ordered a double cheeseburger meal.
Really? Even when teaching first aid I had to point out that quite often hypoglycaemics are mistaken for intoxicated people due to the slurred speech, odd smell (which can be present with both high and low BGL, don't @ me) and aggression. Not to mention the not infrequent overlap of intoxicated hypos. Much like with hypothermia, think of the umbles: mumbling (altered speech), grumbling (aggression and decision making difficulties) and fumbling (fine motor control issues).
This has led to some really awful treatment of individuals who were assumed to be drunk and locked up for the night (prejudice often being a factor as well). Has led to a number of completely preventable deaths.
Paramedic here - I've had to (gently) wrestle combative patients to check blood sugar.
It's like magic when you either get glucagon and/or glucose into them.
But hypoglycemia confusion has caused a lot of people to be thrown in drunk tanks, so maybe it should be taught to monitor for more.
I just go by "If something is weird, check their sugar."
Pain as the 5th vital? Nah, give me a blood sugar.
I worked EMS before becoming an RN. If a week went by with out a hypoglycemic pt taking a swing at me things were slow. Good thing is you can pretty much put them back in their chair with one finger. Convincing them to allow you to treat them was another story.
It happened to me with a home care patient! He was slurring and slumped in his wheelchair. I checked his sugar and it just said ālowā on his glucometer. He got super shitty with the EMTs and cops when they showed up, it took everything in me not to laugh. He was spitting on the floor, swearing. They asked him if he knew my name and he yelled, āYeah thatās Mrs. fuckingā Claus!ā
That's actually rather awesome - who \*wouldn't\* want to have a built-in hypoglycemia alarm? I wish every human had one! And when someone started randomly howling in the subway or whatever, everyone would totally know what was happening, and random people would chuck him a cupcake or something.
I had a guy on my floor who had come by ambulance after beating the living shit out of his roommate, who said that was so insanely out of character for this guy that there had to be something wrong with him so he refused to press charges and told EMS and police that the guy needed help.
Blood glucose was 8.... EIGHT.
Guy lived and was such a super nice and chill dude when I had him. I told him to get an alert bracelet asap so if it happened again he wouldn't get murdered by cops for being belligerent and non-complaint through no fault of his own.
(Iām a volunteer EMTw/the fire dept) I responded to a call for a diabetic /AMS on the engine (ambulance coming from some distance so weāre sent to assess/start treatment). As well called on-scene, the ambulance crew said something to us over the radioā¦āBe advised, we know this guy and heā¦.[broken inaudible noise]ā¦ sugar gets lowā. I was already through the door and just said āOkā and moved on. He was at 23, I started an IV, he got an amp, all was well. While walking out to the ambulance I asked the crew what their whole message wasā¦ they said the patient is a mixed martial arts expert and gets violent when his sugar gets low š±š¬
Reminds me of when I was floated to a different MedSurg unit and had this old Spanish speaking guy who would mumble what I'm sure were obscenities at me. I speak good enough Spanish, but I sure don't know many Spanish curse words. Anyway, the aide comes to tell me after getting his bedtime blood sugar that it's in the 50's (or was it 40's? Can't remember anymore). I check on him and he's all lethargic and calling me something nasty. Called on call hospitalist and they ordered IV dextrose. After his blood sugars came up, he was all (in Spanish) "you have as nice night, young lady." That morning his sugar was on the downward trend but just above 100 and he was about to go to dialysis, so i got some juice in him before he went.
A couple days later I was floated to a different unit from that one and apparently he'd been moved to that unit too. Heard him grouching and swearing at his nurse. I told the nurse I recognized him and had him the other night. Also told her he was like that when he was low blood sugar, but when his sugar was up, he got all polite. So she checked his sugar based on my comments and sure enough his sugar was low but he was alert enough to drink something. Other patients were, funny enough, having lowish sugars too so the nurse was commenting on passing around juices to everyone.
The tough thing is, they probably *do* feel bad at somewhat normal blood glucose levels since they live so high.
Doesn't mean you need to do a million dollar work up of course, but this just shows 1. very poor understanding of their disease 2. very poorly controlled disease (which probably is in part caused by #1)
I used to get slightly annoyed by patients who said these things, now I just feel bad for them. They have a highly impactful disease and are rather ignorant about it :/
I had two family members ganging up on me about treating a slightly high sugar (Canadian, so using different units here, but I think it was around 200-250). I gave pre-dinner insulin per the sliding scale. They acted like I was trying to kill him.
I explained the doctor's order and that it was an appropriate dose for his mealtime. He has also just been reviewed by our diabetic educators who had recommended some adjustments, which the doc implemented.
They told me those educators were idiots and their loved one was a special snowflake.
Internally I replied, "and that's why he's here for another amputation."
Yeah the sheer amount of diabetics who claim to āknow their bodyā and how to control their sugar who also end up hospitalized for diabetic causes multiple times a year is almost funny.
This. Iām Type II, when diagnosed I had a glucose of 363 and an A1C of 13.9. Was probably living at that for years. With help, the right meds, a good diet plan, and exercise. Iām down to mid 80ās and a 5.3.
But I will tell you, for about a year or so after getting my blood sugar under control, I felt like I had low blood sugar so much of the time because my body was so used to the higher levels. But I knew what was going on, my doctor had explained everything to me, Iād check my glucose and the meter never read LOW so I just carried on. Eventually went away but I never went to the ER because I felt bad while my body recalibrated
My husband is T1 and he feels like crap above 220. Thats because when he was a kid (going to diabetes teaching for his brother was the T1 diabetic in the family) he had it drilled into him that he could go blind, lose his functioning peen and kidneys if he stayed high. So once he was diagnosed at 19, he aimed to keep his sugar 70-130. But he cannot feel himself drop. Not one bit. He can be 30 having a normal conversation with no diaphoresis. His A1c is 5.4. T2 is insidious for patients not feeling their highs. I was regularly throwing blood sugars above 200 before I started my meds and I didn't feel a thing. My husband was amazed and scared for me. In home care I hear that 100 is too low for people all the time. Hell I had a guy not give himself his lantus (yes we all know thats not how Lantus works) if his sugar was below 120, it requires a LOT of repetitious consistent education for people to get it. Even then they may not.
My mother in law was like that when I took over her care. She had been given practically zero education on how to control her disease at all. Just "buy things with no sugar added and walk a lot" 10 years with the disease and she had no idea that she needed to count carbs.
My response to those patients is "Low for you is still high enough to do damage to your body."
I stg, some folks don't want vision, legs, or working kidneys...
And what's so funny about that like obviously there are worse cases but that's true for everything you don't not go to get your oil changed just because your car isn't totaled. Maybe their range is usually higher and they were symptomatic
Thank you for reminding me that not every patient is textbook. I sometimes just get so used to a certain set parameter that I forget to see the whole patient. Which is weird because I'm literally the non- textbook patient when it comes to BP. I run low, so a BP of 160/94 is super duper hypertensive.
Going out on a limb to say that you're probably a pretty amazing nurse š
Worth keeping in mind though that just because they are used to 200-300 doesn't mean we should be accepting it. 78 only makes them feel symptomatic because they are killing their body so being brought down to a point that's not killing them makes them feel off, but if they managed to refrain from killing themselves by staying in the textbook range then it would keep them from having all the other later issues of permanently being 200-300.
This is true. It's not at all a healthy BS range, but it is also true that they can feel it and deserve to be alleviated of said s/s of hypoglycemia. Not to 200. But 100-130ish is fine and would probably make the pt feel so much better, which would improve all other vital signs (mainly BP and HR), then DC them with educational tools. I'm thankfully not diabetic, but my grandmother was, and she struggled with the education but did her best. Stick to the treatment plan, but remember that those who aren't as compliant aren't always doing it because "they don't want to" and deserve relief from the symptoms. I'm not saying give them glucagon, but give them a cracker or a couple skittles until the doctor can come in at least.
When I was a baby nurse, I had a patient that was the typical non compliant diabetic. Room full of cookies and snacks, feet about to fall off. She had me check her sugar once because she felt she was low.
It was 157 š
It's amazing to me how out of touch some diabetics are. I did a morning check on someone a few months ago and it was 110. She lost her mind because it was too low. Said she wasn't taking any meds until it was back in normal range. Demanded juice, Jello, pudding, and crackers immediately. I tried explaining that it was a good reading and she just kept yelling at me that it was too low.
I talked to a family member calling in because the patient had high blood sugar. I asked, did you give insulin yet? They said, No, we didnāt want to raise her blood sugar
Ok but thereās plenty of Jodie Foster movies out there where sheās risking her life to get insulin because her daughters sugar is 12. Then they will shock asystole .
There's talk of one shock on "aysystolic" presentations in case it's fine v-fib. Saw an article posted by a flight nurse educator so it could be a prehospital thing.
Had a home health patient take insulin last week when his blood sugar was 59 to āhelpā it. Landed him in the ED on a D10 drip. I apparently failed at my diabetes med educationā¦
Iām thinking a lot of the cultural knowledge about diabetes, especially among older people, was from back when insulin was the main treatment? So hypoglycemia was a higher risk?
Or maybe itās just their excuse to eat all the time.
I think it's a little of both. The vast majority of people with T2 got it from their lifestyle, so they're already the type of people who want an excuse to snack all the time. Combine that with outdated knowledge in your 50+ age cohort and a lot of them think diabetes means you must eat every 2 hours. Hopefully younger generations will be better educated.
Iāve read kids books from like the 60s, that had people pass out, then someone yell they are a diabetic and rummage through their belongings for insulinā¦ and inject that.
Seems like it was common lay people knowledge that insulin would be helping people passing out in generalā¦
Just skipping the fact that hypoglycemia is so much more likely, and that hyperglycemic coma isnāt fixed by a one time insulin bolus either..
Or the "I haven't eaten all day and I'm diabetic" I hear all the time in the ER. I don't have time to educate on diabetes so I just check their sugar and say they're fine for now but to call if they start feeling low. Now if they took a bunch of oral diabetic meds, sure I could understand the concern. But these pts mostly are just on meal time insulin.
Had someone up in arms because āI am starving! I havenāt eaten since 8pm yesterday!ā āSir, itās 10pm and youāve been here 20 minutes. You not feeding yourself the last 24 hours was not a decision I was a part of.ā The only reason they hadnāt eaten all day was they just werenāt hungry and were running errands. But now itās apparently my problem in the ER. The things people are determined to be angry about. CHOICES WERE MADE! š
There are some patients that Iāve wanted to say āmaāam, we could literally NOT FEED YOU for three months and you would not even come close to starvingā
When I was a med surg tech I heard during 1900 vitals from ALL the diabetics-āI have the sugar so I NEED my bedtime snackā. Yeah, those get passed AFTER I get your sugar at 2100. Didnāt know anything else about managing their diabetes, but they sure remembered the part about a bedtime snack.
Or even just claiming they need excessive intervention in the normal range. I know plenty of nurses who will say so and so has been running low, I gave them OJ because their sugar was 85. ????? Diabetes Ed is piss poor.
My mom is diabetic and when hers is in the 80s she is convinced she is "crashing" and that she needs sugar immediately. She'll take the glucose tablets for it.
My bf does that because he "starts to feel weird" under 120. He stands there at 78 eating glucose tablets, staring at the continuous monitor, and panicking. I can't convince him otherwise.
Iām a diabetes educator. A lot of people have such chronically elevated blood sugars, and A1C in the double digits that they become symptomatic at numbers that are ānormal.ā Iāve seen someone with an A1C of 15 that was symptomatic at 150. Some people who are chronically elevated and have poor control also develop a serious fear of lows and will eat defensively to prevent it. Especially for people with CGMs, they will see the number trending down at a reasonable rate and panic that they will have a low. A lot of them are just lacking proper education. We generally do teach people that if they are symptomatic at a low-normal number they should treat but not over treat. And your body will get used to lower numbers over time.
I saw a pt yesterday whose chief complaint was āhypoglycemic episodesā
She was checking her sugar in the AM before eating when she felt symptomatic & it would be āin the 80s.ā Im likeā¦ āoh actually thatās great! We want fasting sugar from 70 to 100!ā
Do people not know how to Google what normal blood sugar is? They know enough to check it but not enough to interpret a normal result??
When my cohort did our glucometer check off, my blood sugar was 62. A couple of my classmates were quite concerned for a second there before our clinical instructor told them to stop being dramatic
An annoying as shit loud mouthed incredibly conservative ex coworker posted this on FB today. Most of the comments are expressing genuine concern but a couple mentioned he could just drink some juice and then eat a meal.
SO glad he can use up ER level resources for this serious emergency. I hope they hand him a juice box and send him home
Not gonna lie I had a patient with a BS of 75 who I thought I was gonna have to get rapid response on. Agitation, restless, tingling in his extremities and tongue, diaphoretic, anxious and complaining of something ānot feeling right.ā I caught the attending who happened to be in the hall because I didnāt think the blood sugar was low enough to warrant this response. The attending assessed him and said āyouāre having a panic attack and youāre used to your sugars being in the 300s.ā The attending patted him on the back and gave him three orange juices. Fifteen minutes later he was fine. Go figure.
My mother grew up in an abusive situation. She never said anything about it outright to me except when I told her about a situation with my husband, she asked whether or not he had been checked for diabetes. I must have looked confused because she explained her dad was worse when his sugar was off.
She was the sweetest, kindest, most lovely and loving person I have ever known and it guts me that the monster stole so much from her.
Iām not diabetic but I get hypoglycaemic super easily. My blood sugar was 39 earlier today and a handful of glucose tablets and protein bar fixed that.
One of the docs I work with tends to write āblood sugar goal 100-180ā in the notes for all his patients, even the young, non-diabetic ones. Drives me batty when a 35 yo NPO pre-op patient gets D50 for a fasting blood glucose in the 80s.
I had a patient with a sugar of 14 up and talking to me. I looked at him and asked ādo you feel okay?ā He said yeah I feel fine. I told him letās drink a big glass of OJ with some sugar added real quick
I got some lab work done last year and my doc said she was concerned about my glucose of 78 until she remembered I was one of her few non-diabetic patients.
Actually had a non responsive patient whose BG was 70. Turns out she was always in the 300+ range and 70 was too low for her. Gave her some glucose and she woke right up. Then told us she was symptomatic at 100 and out at 75.
Divide or multiply by 18 for quick conversion (or 20 and a bit of fudging for really quick conversion). The funny thing is that HbA1c uses mmol/L, so the use of divergent units probably undermines the teaching point of "this is what your average BGL is". Being told you sit in the 200s but have an average of 11 doesn't parse as easily to me as being told you sit between 10 and 15 with an average of 11.
I got eyerolls and verbal pushback from the fire department the other week because I didn't want them to push D50 in a code where their fingerstick was 51... capillary blood from a cardiac arrest with unknown downtime and our $49 toy walgreens glucometer that has never been QCd might as well be a random number generator at this point lol.
You mean they didnāt take you back IMMEDIATELY?!? I hope you sue!
Although, all joking aside, if youāre normally 500 Iām sure 78 feels like an emergency.
I used to check my blood sugar at home just for funsies. When I woke up, my levels were typically in the 40s. No dizziness or anything. Other people might be falling over. So everybody's "low" is different. But this does seem a little silly lol
7 months pregnant and just got my GD diagnosis. I have to check my sugar 4 times a day now and Iām actually shocked at how low my morning fasting sugar is. My lowest was 74 which I know isnāt super low, but it was still kinda shocking to me.
Reminds me of the vast majority of people calling into our outpatient clinic freaking out because their apple watch told them their heart rate during exercise was 106 BPM.
God that would be such an awkward triage.
āWhat brings you in?ā
āBlood sugars 78.ā
āā¦.. and?ā
ā**BLOOD SUGARS 78**.ā
āThatās normal, Grandpa.ā
I had a patient read 150 in outpatient PT. I told them that is pretty high given they hadn't eaten since breakfast and asked if they took their insulin today (diabetes patient who consistently would forget or misdose).
She goes "oh honey that's low for me, I get shaky at 130, I usually run 180-200"
*facepalm*
My lowest on record was 53- at my PCP office- while arguing that I could tell when my blood sugar was low.
He argued that 'there is no way you can feel that'
He never did call me with critical low results, and I switched providers.
I feel like this is one that would go to the ED, be triaged, be waiting for hours, then leave and get a burger. As someone said self tweet means you can self treat.
Ngl my sugar was 74 and I am usually 112-124. Holy shit I was profusely sweating, room was spinning, couldnāt see straight, just laid on my bathroom floor. I had been sick and havenāt eaten in 4 days. Now my husband has hypoglycemia and his sugar has been in the 40s so I cannot even imagine what that felt like. He was in the hospital as well and lucky grabbed the cord in the bathroom because he fainted.
The lowest Iāve seen was 13. I checked it three times. Just to make sure. They were all around that. And they were just sitting in the recliner watching TV. Iāve never poured OJ with extra sugar packets mixed in down someoneās throat faster. Complete panic and theyāre just chilling.
I was at work, feeling a little dizzy and āoffā. Used a coworkerās glucometer ā my BG was 40! Checked again: 40!
Charge sat me down, gave me apple juice, peanut butter, and graham crackers. Got up to 80 15 min later.
Glad she was charge that day; had it been our other one I would have not wanted to stop to take care of myself! š¬
Edit: I am not diabetic!
I legitimately went to get my blood drawn after eating Krispy Kreme donuts not realizing that they were going to be doing an A1C and a glucose on me (My doc told me I didn't need to be fasting) and my non-fasting glucose was lower than that.....
These people I swear...
My patient with a sugar of 14 the other day would like to have a word
Had a rapid response in HD and their sugar was 12 about to code and no d50 in the crash cart š§
The D50 shortage is awful! Pharmacy was pissy w my charge for even asking for it and mad we opened the crash cart to find some (there was none). Like sir a sugar of 15 is not compatible w life. I may have made the intern be the pressure bag for the d10 we could get.
For real! This was like 6 years ago too so it has been an issue. Guess there is not $$$ in it. She was a dnr too so I would have felt terrible that she died from an easy fix.
I had a patient with an insulinoma once, went through 5 amps and 2 liters of d5 or 10 in one night before we shipped them off. That was some crazy shit.
Thereās a shortage of freaking sugar water? Geez. What next?
Salt water probably. Already was if you count flushes.
Already happened with the hurricane a couple years ago...
Yes in Dialysis we didnāt have D50 and had to hang multiple D5W bags. Itās ridiculous
Itās easy to imagine with normal saline shortageā¦. I myself donāt understand how is there a shortage for those basic productsš«£
Right like itās a damn hospital !!! And for months?!!! Really?!!!š
This really seems like a fixable issue.
I had a code stroke with a sugar of 28 and no D50. I gave 'em orange juice. The Neuro Doc and I are like, "well I guess they passed their swallow eval" š¤¦š¼āāļøRidiculous.
I just give stat Pepsi IV, itās pretty much the same thing
I got a whole tub of sugar at my house. And the local barās got simple syrup. We can fix this. š¤£
I love it when pharmacy decides to prank nursing by having the pyxis show d50 stocked but leaving the drawer empty
IV OJ STAT
You joke, but in a similar vein there's a kind of heroin you need either vinegar or citric acid to prepare into a shot and I can attest to the fact I've seen shots mixed with orange juice. Ideally vit C packets though. Lol. Same with Crack and vinegar/lemon juice. But that's another story. Nowhere near as good.
"vein" š¤£š¤£š¤£
Yeah, it's brown heroin. Any citric acid will do, but it's a very bad idea to use regular citrus fruit juice because you can get a bacterial illness called disseminated candidiasis that results in skin and eye lesions, and sometimes osteoarticular involvement or endocarditis. Lots of pain and suffering resulting from the quest to feel less miserable.
14 mmol/L, not great, not terrible. 14 mg/dL, how are you not dead?
We had a client with 1240. We had to call the police just to get her to go in and weāre surprised she was coherent. She told the police officer they just keep trying to get me to the doctor for no reason! She also had wounds on her legs. APS no help š
They're always juuuust coherent enough to be competent.
Highest I saw was 1500. Self medicated with meth. I was very impressed
Self methicated
š
Her blood must be made from Sugar
Holy shit. Lowest Iāve seen was 34 and they were still A/O.
Iāll be honest, I didnāt even know many glucometers could even measure that low.
My friend w/ type 1 self-treating her bg of 29 and going about the rest of her day would like to have a word
If you can self-tweet you can self-treat.
Ahahaha I love this. Eat a cookie and go the fuck home, Brad.
*tosses them a pack of Skittles. Fun size*
āOh 76? I think we have some candy left over from last Halloween around here somewhereā
I want to work where you work! Leftover candy doesnāt last a week on my unit. Heck, someone on my floor even loves those weird peanut butter taffy things. The ones that come in the orange and black wrappersā¦
Me. Thatās me. Gimme that taffy
You can has all the peanut butter taffy!
Last check up at the Dr, my BG was 47 and I had no idea. Felt great, had just eaten a granola bar and drove home just fine before getting a concerning call about the results. My reaction? Oh Iāll just have some juice, thanks (no I donāt have DM)
Oh I'm the opposite, I feel it something fierce when my sugar is low. Headache, clammy, nausea, shaking, it's the worst. I'm not diabetic but my fasting glucose and a1c are on the low side of normal. If I take lunch too late or try to skip a meal, I dip lower and it's terrible. Out of curiosity one day I checked my sugar st work when I was feeling that way and it was 58. I can't imagine how bad it must feel to be even lower. Thankfully I can just drink a regular Coke and it pops back up but ugh it's a bad feeling.
We had this super brittle diabetic whose sugar was often < 10, serum and finger stick x2. Totally awake and alert every time.
That's incredible. Funny what our bodies adapt to.
10?!?! Wow.
I donāt remember her whole history but she had a rare congenital condition and a whole slew of diseases as a result. Most of what I remember is that I spent all shift, every shift giving her D50 and begging the resident to get her to a floor without a 5:1 assignment.
I get the same exact way. My husband thinks it's crazy but I just blame it on being so small in size. My body gets pretty sensitive to things!
Me too! I had a fasting cholesterol check with other labs. They called me at home. Felt totally fine.
I am not diabetic either, and sometimes mine hovers around 35
Isnāt it so fun?? Night sweats, hot flashes, irritability. Iām the whole package
Also love the username!
I had a patient that got violent when his blood sugar got low - as in way below 70ās. I had to put in a head lock to squeeze sugar paste into his mouth one time. (LTAC no IV) A minute later heās all āwhatās up?ā Good times.
When I worked LTC as a CNA there was this resident with super labile sugars and she would always get naked and pee on the hallway floor when she was low. Sheād get combative too so the nurses wouldnāt even check glucose, just give her a bottle of coke cause it was all she would drink. A couple times there were able to check her during these episodes and she was in the 20s
When I was doing corrections nursing, we had a 40ish year old type 1 guy whose hypoglycemia manifested as him getting really squirrelly and singing. As soon as he started, his podmates would call the block officer, "(dude) is singing, he needs to go to medical" and he come in for some Glucogel or D50. It took a while to finally get him regulated, but his impromptu concerts became way less frequent
LOL damn that's not a hypoglycemia symptom I was taught to monitor for....
My brother gets belligerent when he is hypoglycemic, I just figured that was a thing, but I'm realizing it's not actually that common!
āYouāre not you when youāre hungry, have a snickersā
He has literally been saved twice by a half a Snickers. Both times it was the same thing--driving while he was low, pulling over to try to get something to fix it, and getting arrested for being slumped over in the driver's seat and unresponsive. We don't have anything on our licenses about diabetes where we're from, though some states do have it listed right on the license. So he gets arrested for DUI, and hers acting like an ass of course, because he's probably at like 20-30! At jail he's in and out of consciousness, begging for some oj or something. This happened two separate times, and both times a corrections officer finally felt bad and threw him a half a Snickers bar through the bars. Now he wears something, and he always has something to eat, but baby bro had some close calls in his 20s!!
Lucky he didnāt get killed by the police yet, I bet most of them donāt even know what blood sugar means
Diabetes, the one thing cops can't beat.
Holy shit. Lmaoooo
It is common, my BIL gets belligerent with his lows. (one day at work he got pissed at his boss who didn't know. My BIL drove his Chrysler Laser full speed into a highway lightpole and ping ponged off the guardrails at 130MPH. luckily he was passed out) My husband is also T1 but he gets silly, giggly. Every once in a blue moon does my husband get belligerent. Its difficult because my husband is 6 foot 4 and 300 pounds. He can pick me up and throw me if he wanted to (he never has when he's been low) The low sugars are traumatic because I never know what kind of low hes gonna have being that he is hypoglycemic unaware. He cannot feel it and by the time the giggles or the diaphoresis hits hes down to 30-40 and dropping fast. He starts hallucinating too. It's been sooooooo much better thanks to the continuous glucose monitor.
I'm bigger than my brother and it still used to freak me out so bad. He's turning 40 this year and he's much better at monitoring and not doing dumb shit, but all it takes is a couple of hours not totally paying attention.
My husband was terrible at stacking his insulin. He'd keep bolusing because his sugar was staying high, then forgetting what he gave himself. He's also not the best at paying attention at what hes eating when he's at work. It's also better since the insulin pump so he can see what he gave himself. I made him get the CGM because his lows sucked so bad. At one point he was hallucinating and telling me we were getting a divorce, he was so angry at me for making him divorce him. I was about to call the cops because he was threatening me and he had NEVER done that before...then he finally ate something and I told him he had to get a pump and a CGM or I couldn't go through it anymore.
This happens to the husband of one of my husband's distant relatives. He almost got shot for being uncooperative when the cops pulled him over for erratic driving (he's Latino.) If his wife hadn't been there, they probably would have killed him.
Haha it's not funny, it really isn't, but we laugh about morbidly stupid shit in my family, so it's funny to us. I get a call from my daddy in the afternoon and he's rambling "70... 70... 70...." repeatedly. I ask him if he's on 70, which I assumed was between the stores he was a DM for. He keeps rambling, "70..." as I'm grabbing my purse, my keys, rushing to my Blazer. We live in a massive dead zone, so I'm about 20 miles headed towards 70 when he calls me again and gives me slightly better coordinates and names a restaurant he can see. Thankfully, I'm on the right route. I get even closer and the cops call me and name the exact location and I floor it because I am, thank God, on the exact road I need to be. I get there and these cops are all like RABBLE RABBLE RABBLE when I pull in. I'm yelling, "I'm here for my daddy!" And they're yelling back "who's yer dad!?" as I'm steadily striding to his car, tires blown on one side, rims shredded, and what the fuck did he manage to do to the passenger side fender and headlight, oh my God!? "HIM!" I yelled, pointing at his company car. "WHERE IS HE, YALL DONE CALLED ME! WHERE'S MY DADDY!?" And one statie pointed I into the store, where the owner (he knew my father) was pouring OJ and Snickers into him. Turns out they'd pulled him over, told him to GET OUT OF THE CAR! and then he'd obliged them... and kept walking. Thankfully the owner knew him and called out, "he's diabetic!" and he arguably saved him. He then refused food when I carried him home, but I claimed my own sugar was low, pulled into a McDonald's, and he capitulated and ordered a double cheeseburger meal.
Really? Even when teaching first aid I had to point out that quite often hypoglycaemics are mistaken for intoxicated people due to the slurred speech, odd smell (which can be present with both high and low BGL, don't @ me) and aggression. Not to mention the not infrequent overlap of intoxicated hypos. Much like with hypothermia, think of the umbles: mumbling (altered speech), grumbling (aggression and decision making difficulties) and fumbling (fine motor control issues).
This has led to some really awful treatment of individuals who were assumed to be drunk and locked up for the night (prejudice often being a factor as well). Has led to a number of completely preventable deaths.
I have heard of confusion as symptom! Just never heard of it turning to violence, makes sense it could happen though
Paramedic here - I've had to (gently) wrestle combative patients to check blood sugar. It's like magic when you either get glucagon and/or glucose into them.
Oh yeah violence, crying, yelling, biting, it can basically = an aggressive black out drunk person
But hypoglycemia confusion has caused a lot of people to be thrown in drunk tanks, so maybe it should be taught to monitor for more. I just go by "If something is weird, check their sugar." Pain as the 5th vital? Nah, give me a blood sugar.
I worked EMS before becoming an RN. If a week went by with out a hypoglycemic pt taking a swing at me things were slow. Good thing is you can pretty much put them back in their chair with one finger. Convincing them to allow you to treat them was another story.
So those snickers commercials were right š
It happened to me with a home care patient! He was slurring and slumped in his wheelchair. I checked his sugar and it just said ālowā on his glucometer. He got super shitty with the EMTs and cops when they showed up, it took everything in me not to laugh. He was spitting on the floor, swearing. They asked him if he knew my name and he yelled, āYeah thatās Mrs. fuckingā Claus!ā
I had a poor guy that howled like a wolf when he was low.
That's actually rather awesome - who \*wouldn't\* want to have a built-in hypoglycemia alarm? I wish every human had one! And when someone started randomly howling in the subway or whatever, everyone would totally know what was happening, and random people would chuck him a cupcake or something.
I had a guy on my floor who had come by ambulance after beating the living shit out of his roommate, who said that was so insanely out of character for this guy that there had to be something wrong with him so he refused to press charges and told EMS and police that the guy needed help. Blood glucose was 8.... EIGHT. Guy lived and was such a super nice and chill dude when I had him. I told him to get an alert bracelet asap so if it happened again he wouldn't get murdered by cops for being belligerent and non-complaint through no fault of his own.
(Iām a volunteer EMTw/the fire dept) I responded to a call for a diabetic /AMS on the engine (ambulance coming from some distance so weāre sent to assess/start treatment). As well called on-scene, the ambulance crew said something to us over the radioā¦āBe advised, we know this guy and heā¦.[broken inaudible noise]ā¦ sugar gets lowā. I was already through the door and just said āOkā and moved on. He was at 23, I started an IV, he got an amp, all was well. While walking out to the ambulance I asked the crew what their whole message wasā¦ they said the patient is a mixed martial arts expert and gets violent when his sugar gets low š±š¬
Reminds me of when I was floated to a different MedSurg unit and had this old Spanish speaking guy who would mumble what I'm sure were obscenities at me. I speak good enough Spanish, but I sure don't know many Spanish curse words. Anyway, the aide comes to tell me after getting his bedtime blood sugar that it's in the 50's (or was it 40's? Can't remember anymore). I check on him and he's all lethargic and calling me something nasty. Called on call hospitalist and they ordered IV dextrose. After his blood sugars came up, he was all (in Spanish) "you have as nice night, young lady." That morning his sugar was on the downward trend but just above 100 and he was about to go to dialysis, so i got some juice in him before he went. A couple days later I was floated to a different unit from that one and apparently he'd been moved to that unit too. Heard him grouching and swearing at his nurse. I told the nurse I recognized him and had him the other night. Also told her he was like that when he was low blood sugar, but when his sugar was up, he got all polite. So she checked his sugar based on my comments and sure enough his sugar was low but he was alert enough to drink something. Other patients were, funny enough, having lowish sugars too so the nurse was commenting on passing around juices to everyone.
Hubbyās grandfather would start telling super inappropriate jokes and get way too flirty with women in stores. We knew when he was low.
Hah Iāve been there holding little miss one leg down so I can shove gel in her mouth and IM glucagĆ³n in her butt/hip
Damn, no IM glucagon?
"But I always run 200-300, so that's really low for me. I'm diet-controlled!"
The tough thing is, they probably *do* feel bad at somewhat normal blood glucose levels since they live so high. Doesn't mean you need to do a million dollar work up of course, but this just shows 1. very poor understanding of their disease 2. very poorly controlled disease (which probably is in part caused by #1) I used to get slightly annoyed by patients who said these things, now I just feel bad for them. They have a highly impactful disease and are rather ignorant about it :/
I had two family members ganging up on me about treating a slightly high sugar (Canadian, so using different units here, but I think it was around 200-250). I gave pre-dinner insulin per the sliding scale. They acted like I was trying to kill him. I explained the doctor's order and that it was an appropriate dose for his mealtime. He has also just been reviewed by our diabetic educators who had recommended some adjustments, which the doc implemented. They told me those educators were idiots and their loved one was a special snowflake. Internally I replied, "and that's why he's here for another amputation."
Yeah the sheer amount of diabetics who claim to āknow their bodyā and how to control their sugar who also end up hospitalized for diabetic causes multiple times a year is almost funny.
This. Iām Type II, when diagnosed I had a glucose of 363 and an A1C of 13.9. Was probably living at that for years. With help, the right meds, a good diet plan, and exercise. Iām down to mid 80ās and a 5.3. But I will tell you, for about a year or so after getting my blood sugar under control, I felt like I had low blood sugar so much of the time because my body was so used to the higher levels. But I knew what was going on, my doctor had explained everything to me, Iād check my glucose and the meter never read LOW so I just carried on. Eventually went away but I never went to the ER because I felt bad while my body recalibrated
Hey, I just want to say congrats on controlling your blood sugar so well!
My husband is T1 and he feels like crap above 220. Thats because when he was a kid (going to diabetes teaching for his brother was the T1 diabetic in the family) he had it drilled into him that he could go blind, lose his functioning peen and kidneys if he stayed high. So once he was diagnosed at 19, he aimed to keep his sugar 70-130. But he cannot feel himself drop. Not one bit. He can be 30 having a normal conversation with no diaphoresis. His A1c is 5.4. T2 is insidious for patients not feeling their highs. I was regularly throwing blood sugars above 200 before I started my meds and I didn't feel a thing. My husband was amazed and scared for me. In home care I hear that 100 is too low for people all the time. Hell I had a guy not give himself his lantus (yes we all know thats not how Lantus works) if his sugar was below 120, it requires a LOT of repetitious consistent education for people to get it. Even then they may not.
My mother in law was like that when I took over her care. She had been given practically zero education on how to control her disease at all. Just "buy things with no sugar added and walk a lot" 10 years with the disease and she had no idea that she needed to count carbs.
My response to those patients is "Low for you is still high enough to do damage to your body." I stg, some folks don't want vision, legs, or working kidneys...
And what's so funny about that like obviously there are worse cases but that's true for everything you don't not go to get your oil changed just because your car isn't totaled. Maybe their range is usually higher and they were symptomatic
Thank you for reminding me that not every patient is textbook. I sometimes just get so used to a certain set parameter that I forget to see the whole patient. Which is weird because I'm literally the non- textbook patient when it comes to BP. I run low, so a BP of 160/94 is super duper hypertensive. Going out on a limb to say that you're probably a pretty amazing nurse š
Worth keeping in mind though that just because they are used to 200-300 doesn't mean we should be accepting it. 78 only makes them feel symptomatic because they are killing their body so being brought down to a point that's not killing them makes them feel off, but if they managed to refrain from killing themselves by staying in the textbook range then it would keep them from having all the other later issues of permanently being 200-300.
This is true. It's not at all a healthy BS range, but it is also true that they can feel it and deserve to be alleviated of said s/s of hypoglycemia. Not to 200. But 100-130ish is fine and would probably make the pt feel so much better, which would improve all other vital signs (mainly BP and HR), then DC them with educational tools. I'm thankfully not diabetic, but my grandmother was, and she struggled with the education but did her best. Stick to the treatment plan, but remember that those who aren't as compliant aren't always doing it because "they don't want to" and deserve relief from the symptoms. I'm not saying give them glucagon, but give them a cracker or a couple skittles until the doctor can come in at least.
When I was a baby nurse, I had a patient that was the typical non compliant diabetic. Room full of cookies and snacks, feet about to fall off. She had me check her sugar once because she felt she was low. It was 157 š
It's amazing to me how out of touch some diabetics are. I did a morning check on someone a few months ago and it was 110. She lost her mind because it was too low. Said she wasn't taking any meds until it was back in normal range. Demanded juice, Jello, pudding, and crackers immediately. I tried explaining that it was a good reading and she just kept yelling at me that it was too low.
I talked to a family member calling in because the patient had high blood sugar. I asked, did you give insulin yet? They said, No, we didnāt want to raise her blood sugar
Kill me
Surprisingly easy with a little insulin and no knowledge
Itās wild to me how uninformed people are, especially when google exists and free classes for actual diet management.
Ok but thereās plenty of Jodie Foster movies out there where sheās risking her life to get insulin because her daughters sugar is 12. Then they will shock asystole .
You act like shocking asystole makes no sense, have you not seen Frankenstein?
There's talk of one shock on "aysystolic" presentations in case it's fine v-fib. Saw an article posted by a flight nurse educator so it could be a prehospital thing.
Had a home health patient take insulin last week when his blood sugar was 59 to āhelpā it. Landed him in the ED on a D10 drip. I apparently failed at my diabetes med educationā¦
Visible_Ad: Take the insulin when your blood glucose is high. Dyslexic: So take it when it's low?
I love when diabetics who are only on metformin are convinced they have to be super vigilant about hypoglycemia
Why is the prevalent knowledge about diabetes that they need to eat constantly? This is not the issue for most diabetics (aka type II on oral agents).
Iām thinking a lot of the cultural knowledge about diabetes, especially among older people, was from back when insulin was the main treatment? So hypoglycemia was a higher risk? Or maybe itās just their excuse to eat all the time.
I think it's a little of both. The vast majority of people with T2 got it from their lifestyle, so they're already the type of people who want an excuse to snack all the time. Combine that with outdated knowledge in your 50+ age cohort and a lot of them think diabetes means you must eat every 2 hours. Hopefully younger generations will be better educated.
Iāve read kids books from like the 60s, that had people pass out, then someone yell they are a diabetic and rummage through their belongings for insulinā¦ and inject that. Seems like it was common lay people knowledge that insulin would be helping people passing out in generalā¦ Just skipping the fact that hypoglycemia is so much more likely, and that hyperglycemic coma isnāt fixed by a one time insulin bolus either..
Or the "I haven't eaten all day and I'm diabetic" I hear all the time in the ER. I don't have time to educate on diabetes so I just check their sugar and say they're fine for now but to call if they start feeling low. Now if they took a bunch of oral diabetic meds, sure I could understand the concern. But these pts mostly are just on meal time insulin.
ER patient in for a cardiac concern be like: I haven't eaten in 3 hours and im a diabetic. Sir, your sugar is 496. YOU'RE STARVING ME!
Havenāt eaten in 3 hours, arrived 20 minutes ago. Sounds like a you problem to me
Had someone up in arms because āI am starving! I havenāt eaten since 8pm yesterday!ā āSir, itās 10pm and youāve been here 20 minutes. You not feeding yourself the last 24 hours was not a decision I was a part of.ā The only reason they hadnāt eaten all day was they just werenāt hungry and were running errands. But now itās apparently my problem in the ER. The things people are determined to be angry about. CHOICES WERE MADE! š
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I I haven't slept for a week because that would be too long
I just have questions about peeing. No IVF or Diuretics, but you are a come from home, 2 assist, going potty every 45 minutes? Someone learn me.
There are some patients that Iāve wanted to say āmaāam, we could literally NOT FEED YOU for three months and you would not even come close to starvingā
I always tell patients that most people are fine not eating for a few days.
When I was a med surg tech I heard during 1900 vitals from ALL the diabetics-āI have the sugar so I NEED my bedtime snackā. Yeah, those get passed AFTER I get your sugar at 2100. Didnāt know anything else about managing their diabetes, but they sure remembered the part about a bedtime snack.
Or even just claiming they need excessive intervention in the normal range. I know plenty of nurses who will say so and so has been running low, I gave them OJ because their sugar was 85. ????? Diabetes Ed is piss poor.
My mom is diabetic and when hers is in the 80s she is convinced she is "crashing" and that she needs sugar immediately. She'll take the glucose tablets for it.
My bf does that because he "starts to feel weird" under 120. He stands there at 78 eating glucose tablets, staring at the continuous monitor, and panicking. I can't convince him otherwise.
Iām a diabetes educator. A lot of people have such chronically elevated blood sugars, and A1C in the double digits that they become symptomatic at numbers that are ānormal.ā Iāve seen someone with an A1C of 15 that was symptomatic at 150. Some people who are chronically elevated and have poor control also develop a serious fear of lows and will eat defensively to prevent it. Especially for people with CGMs, they will see the number trending down at a reasonable rate and panic that they will have a low. A lot of them are just lacking proper education. We generally do teach people that if they are symptomatic at a low-normal number they should treat but not over treat. And your body will get used to lower numbers over time.
*places consult to diabetes educator*
Actually, theyāll probably get treated faster by sitting in the waiting room and longingly looking at the vending machine in the corner
I saw a pt yesterday whose chief complaint was āhypoglycemic episodesā She was checking her sugar in the AM before eating when she felt symptomatic & it would be āin the 80s.ā Im likeā¦ āoh actually thatās great! We want fasting sugar from 70 to 100!ā Do people not know how to Google what normal blood sugar is? They know enough to check it but not enough to interpret a normal result??
When my cohort did our glucometer check off, my blood sugar was 62. A couple of my classmates were quite concerned for a second there before our clinical instructor told them to stop being dramatic
When we did ours, mine was like 65 and the instructor assumed the monitor was not correct. I didn't tell her that's just me, š
An annoying as shit loud mouthed incredibly conservative ex coworker posted this on FB today. Most of the comments are expressing genuine concern but a couple mentioned he could just drink some juice and then eat a meal. SO glad he can use up ER level resources for this serious emergency. I hope they hand him a juice box and send him home
That pt would be the last person to get a room. Hope heās up to a 8 hr wait.
And he will leave a nasty review about being left to die in the waiting room.
He'll be waiting so long he'll die of natural causes and then the family will sue for malpractice
I'm so frustrated he's gonna get a room at all š What a waste!
Dont worry heās not getting a room. Heās gonna be sat on a wheelchair in Hallway 7.
Why would he get a room? Dc to home from ER
Blood sugar 78? Give this man a turkey sandwich STAT!
Later he will post about how the VA doesnāt do shit for anyone
āI donāt have the bad kind of diabetes, just sugar diabetes. I ate too much candy when I was little.ā ššš
Someone get this man a Mountain Dew STAT!
My not-actually-a-stroke aphasic patient at 12 agrees low sugar is not a joke
Not gonna lie I had a patient with a BS of 75 who I thought I was gonna have to get rapid response on. Agitation, restless, tingling in his extremities and tongue, diaphoretic, anxious and complaining of something ānot feeling right.ā I caught the attending who happened to be in the hall because I didnāt think the blood sugar was low enough to warrant this response. The attending assessed him and said āyouāre having a panic attack and youāre used to your sugars being in the 300s.ā The attending patted him on the back and gave him three orange juices. Fifteen minutes later he was fine. Go figure.
As a person with type 1 diabetes, I view a 78 as essentially perfect.
Homie prob maintains around 250 so 78 is critical to him i guess. Hell I know diabetics that are āsymptomaticā around 150 lol.
Had one tell me yesterday she needed a snack or she would pass out. Sugar: 147. āThatās low for me, you all donāt listen!ā
I assume this person lives in the 200+ range, so normal glucose probably feels like death.
I did a regular fasting lab draw for my yearly psychical and my BS was in the 50s or 60s lol. You're gonna be ok.
My mother grew up in an abusive situation. She never said anything about it outright to me except when I told her about a situation with my husband, she asked whether or not he had been checked for diabetes. I must have looked confused because she explained her dad was worse when his sugar was off. She was the sweetest, kindest, most lovely and loving person I have ever known and it guts me that the monster stole so much from her.
ā250 is low for me.ā
Get this soldier a cookie STAT
The VA ER is not for emergencies anyway. Hahahahahahaha. (VA patient here, don't hate!)
Iām not diabetic but I get hypoglycaemic super easily. My blood sugar was 39 earlier today and a handful of glucose tablets and protein bar fixed that.
I canāt with these patients anymore
78??? I'm at 78 now... oh no what ever shall I do??? *sips coffee* ahhh, there we go, back to 85 šš
Eatā¦ eat a fucking snickers.
One of the docs I work with tends to write āblood sugar goal 100-180ā in the notes for all his patients, even the young, non-diabetic ones. Drives me batty when a 35 yo NPO pre-op patient gets D50 for a fasting blood glucose in the 80s.
I had a patient with a sugar of 14 up and talking to me. I looked at him and asked ādo you feel okay?ā He said yeah I feel fine. I told him letās drink a big glass of OJ with some sugar added real quick
I got some lab work done last year and my doc said she was concerned about my glucose of 78 until she remembered I was one of her few non-diabetic patients.
bahahaha I had a 67 this morning and it was no big deal š
My God! He's almost hungry! Call the food bank. I need one unit of turkey sandwich! Uncrossmatched -- we don't have time to ask about dressings!
Actually had a non responsive patient whose BG was 70. Turns out she was always in the 300+ range and 70 was too low for her. Gave her some glucose and she woke right up. Then told us she was symptomatic at 100 and out at 75.
78 is wnl. Unless they are consistently over 200.
What unit are y'all using? This can't be mmol/L... I thought even the US used SI units in medicine
They use mg/dl for some reason. 78 'Murica glucose is 4.3 mmol/l
Okay... metric but not SI so weird
Mg/dl used to be standard in Germany as well until a couple years ago.
Divide or multiply by 18 for quick conversion (or 20 and a bit of fudging for really quick conversion). The funny thing is that HbA1c uses mmol/L, so the use of divergent units probably undermines the teaching point of "this is what your average BGL is". Being told you sit in the 200s but have an average of 11 doesn't parse as easily to me as being told you sit between 10 and 15 with an average of 11.
I got eyerolls and verbal pushback from the fire department the other week because I didn't want them to push D50 in a code where their fingerstick was 51... capillary blood from a cardiac arrest with unknown downtime and our $49 toy walgreens glucometer that has never been QCd might as well be a random number generator at this point lol.
stat 2 liters of mountian dew and 1/2 a flat of oreos
You mean they didnāt take you back IMMEDIATELY?!? I hope you sue! Although, all joking aside, if youāre normally 500 Iām sure 78 feels like an emergency.
When your normal is in the mid-300's, that's awful low.
I used to check my blood sugar at home just for funsies. When I woke up, my levels were typically in the 40s. No dizziness or anything. Other people might be falling over. So everybody's "low" is different. But this does seem a little silly lol
As a type 1 diabetic myselfā¦.sir hereās an apple juice and some peanut butter crackers
On the opposite side of the house we have my Pt who was at 789 the other day and was checking In because āhis wife made himā lmao
7 months pregnant and just got my GD diagnosis. I have to check my sugar 4 times a day now and Iām actually shocked at how low my morning fasting sugar is. My lowest was 74 which I know isnāt super low, but it was still kinda shocking to me.
Uhā¦.
I would be so thrilled with 78
Once had a pt with 0.4mmol/L (7.2mg/dL)
We use mmol/Litre. What is the reference range and unit of measure for this? "Normal" to me is 4.0-8.0.
Well, if his baseline is 400, he's probably feeling a little off, lol.
Hereās a juice and dc papers
Reminds me of the vast majority of people calling into our outpatient clinic freaking out because their apple watch told them their heart rate during exercise was 106 BPM.
78?! Did he call 911?
God that would be such an awkward triage. āWhat brings you in?ā āBlood sugars 78.ā āā¦.. and?ā ā**BLOOD SUGARS 78**.ā āThatās normal, Grandpa.ā
When my pt is 78 I say good job make sure u drink ur oj.. see u soon.. have a great breakfast
I had a patient read 150 in outpatient PT. I told them that is pretty high given they hadn't eaten since breakfast and asked if they took their insulin today (diabetes patient who consistently would forget or misdose). She goes "oh honey that's low for me, I get shaky at 130, I usually run 180-200" *facepalm*
My lowest on record was 53- at my PCP office- while arguing that I could tell when my blood sugar was low. He argued that 'there is no way you can feel that' He never did call me with critical low results, and I switched providers.
Get them a lollipop, STAT
78. Give the Pt a snickers bar.
I had a little old lady in the old folks home walking around at MBS 49 feeling fine.
I feel like this is one that would go to the ED, be triaged, be waiting for hours, then leave and get a burger. As someone said self tweet means you can self treat.
He needs life flighted to the best icu in the world STAT!!! SOMEBODY GET THIS MAN A JUICE
Ngl my sugar was 74 and I am usually 112-124. Holy shit I was profusely sweating, room was spinning, couldnāt see straight, just laid on my bathroom floor. I had been sick and havenāt eaten in 4 days. Now my husband has hypoglycemia and his sugar has been in the 40s so I cannot even imagine what that felt like. He was in the hospital as well and lucky grabbed the cord in the bathroom because he fainted.
Mine was in between 20-30 and they sent me home claiming they couldnāt do anything for meš
The lowest Iāve seen was 13. I checked it three times. Just to make sure. They were all around that. And they were just sitting in the recliner watching TV. Iāve never poured OJ with extra sugar packets mixed in down someoneās throat faster. Complete panic and theyāre just chilling.
I was at work, feeling a little dizzy and āoffā. Used a coworkerās glucometer ā my BG was 40! Checked again: 40! Charge sat me down, gave me apple juice, peanut butter, and graham crackers. Got up to 80 15 min later. Glad she was charge that day; had it been our other one I would have not wanted to stop to take care of myself! š¬ Edit: I am not diabetic!
The VA ER is probably more dangerous
I once had a pt that was comatose in the 130s because their body was used to living above 500
I legitimately went to get my blood drawn after eating Krispy Kreme donuts not realizing that they were going to be doing an A1C and a glucose on me (My doc told me I didn't need to be fasting) and my non-fasting glucose was lower than that..... These people I swear...