Acceptable blood glucose level - morning

By reneeh63 Latest Reply 2015-01-10 19:09:09 -0600
Started 2015-01-02 14:05:34 -0600

Hi - I'm concerned for my sister who is in a nursing home living situation. She is 52 and has been diagnosed as Type 2 about a year ago. They were monitoring her blood more closely but she's on metformin and is supposedly "under control" now. Yet when I ask her what her readings are - before breakfast - she says they are usually 2 hundred something or even up to 400! Is this really under control? Their diets are a joke - I see very little or no difference in what she eats versus anyone else - just as many carbs and starches, maybe the dessert is half size? I don't know what her a1C level is.

Please let me know if I need to push for more frequent testing, change in meds, diet…thanks!

14 replies

reneeh63 2015-01-10 19:09:09 -0600 Report

Found out after talking with the DON that she'd been prescribed prednisone due to adrenal issue - prednisone is KNOWN to increase blood glucose. She should have been given more frequent checks to see the impact. I'll have to monitor more closely in the future…

reneeh63 2015-01-04 08:04:37 -0600 Report

Thanks for all the replies. My sister is developmentally delayed and does not have a lot of self control diet-wise - that's why I want the nursing home to step up with a reallistic diet plan. Otherwise, I bring high protein substitutes for the starches they serve but it's hard for me to know if she substitutes them or just ADDS them to the meal.

Shawn Grant
Shawn Grant 2015-01-04 07:10:11 -0600 Report

Acceptable blood sugar for a diabetic is the same as acceptable blood sugar for a non-diabetic. That is a blood sugar that stays within 70 to 110 at all times and an A1C below 5.5.

This is very achievable. Need to cut carbs way back. In fact the only source of carbs in the diet should be the few in leafy stalky veggies like broccoli, cauliflower, spinach and the like and the few in cheese. Need to exercise and the Dr. may need to prescribe certain medications that will get he to that level with a low carb diet. If the current dr is unwilling to get he to those level of blood sugars then find another.

RebDee 2015-01-03 17:42:18 -0600 Report

PUSH. Absolutely push!! 200 BS is high, 400 is horrendous. She is definitely not under control.

Get her off starches: no white bread (should have gluten free), white potatoes (sweet potatoes or yams are good), white noodles (spinach or quinoa noodles are fine), no salt, no sugar. She could have jello sugar free gelatin for dessert.

brat-dogs 2015-01-03 13:01:48 -0600 Report

You should go and see her doctor and explain your concerns about your sisters blood sugars. Ask him what he considers a normal blood sugar. Then explain that she has been having sugar counts as high as the 400 and she even has counts in the two hundreds. Let him know that they are telling you that she is running normal

Jibber Jabber
Jibber Jabber 2015-01-02 19:55:38 -0600 Report

As someone who worked as a Case Manager in a Residential Facility in the Bronx..I can tell you MOST residential facilities DO NOT take proper care of their Diabetic residents…We all took turns working in the Med room..and dispensed meds and had our clients take their sugar three times a day…Once in the morning…once at noon and once at 8pm…these times NEVER coincided with when their doctors told them they had to test their sugars…I had one client who had out of control type 2 and would come in to take his insulin hours after eating (and boy did he eat all kinds of crap)…I wasn't even diagnosed yet with diabetes myself but I KNEW this was seriously screwed up…and I brought it up at several staff meeting…management would just say..we have x amount of residents..we have to have some kind of schedule…and don't even get me started on the food…sure it was delicious..( It tasted so good the staff would often raid the kitchen for leftovers)..but for a diabetic it was poison…I had to fight for weeks just to get them to buy 100% whole wheat bread for the kitchen for the residents who wanted it as an option (turned out many of them did and we ended up going through 3 or 4 loaves a day)…My advice if you have a relative in a long term residential to ask to meet with her Case manager to discuss your concerns and possible solutions…but you may have to have your sister sign a release consent for you to do this…good luck..

reneeh63 2015-01-02 18:25:23 -0600 Report

Thanks guys…I think I'll start with an HbA1c test to get a longer view of her condition and then take that result to one of her nurses. Of course they can't do anything without orders from the doctor…he comes in weekly to check on those with a specific need.

Type1Lou 2015-01-02 17:01:57 -0600 Report

Ask whether her doctor intends to request an HbA1c test…and if the answer is "No", ask why not. (If one has been done, ask to be advised what the results were- (if you are authorized to get her test results.) The HbA1c will give you a better idea of her overall control, which I, too, suspect is not good and would benefit from more frequent monitoring. There are also over-the-counter HbA1c test kits that you could do when you do visit her and use that as a starting point if you get stonewalled by the nursing home.

GabbyPA 2015-01-02 15:18:58 -0600 Report

You need to be an advocate or help your sister advocate for herself. 200-400 is way NOT acceptable for a fasting number. That is not even good for post meal readings. Sadly, hospitals and other care facilities are very poorly educated in how diabetes works or how to deal with it. Meals are so often way over carbed just because they don't understand that having a plate of fried chicken with mashed potatoes and corn is not "SWEET" but carb loaded. It is frustrating.

Now some people are higher in the morning and drop during the day. I do that very badly. I can go to be with readings below 120 and wake up in the 200's but it drops as I get going. Is there a possibility that she is snacking late at night?

Do they test her after meals? Before she goes to bed? Can she test herself or do you know how to test her?

reneeh63 2015-01-02 16:31:16 -0600 Report

At first they tested her daily, but always first thing in the morning - now it's only twice a week. I could test her but I only see her once a week so that would not help much. I don't think she has the coordination to test herself. I did ask the nurse to have her checked more often but that only lasted a couple weeks and supposedly the "orders" were changed for less frequent testing…it's very discouraging.

GabbyPA 2015-01-02 18:19:33 -0600 Report

Yes, that cannot tell you anything. Find out what her A1c is and that will help give you some ammo for getting things looked at more closely. Is there a counselor there or someone you can talk to about getting that done for her?

Just Joyce
Just Joyce 2015-01-03 11:59:57 -0600 Report

Unless she is listed as a guardian or her sister signs something for the nursing staff and doctor to share information with her, she won't find anything out due to violating HIPPA. My mom had to sign a release so my sister and I could manage her health and my dad had to sign the same thing for my mom to get his information.

Therefore until this happens there isn't much she can do.

Just Joyce
Just Joyce 2015-01-03 12:21:55 -0600 Report

Depends on if the sister will agree to it. She may have to get a lawyer and the sister will need one. The staff doesn't have to help her do anything. It is not their responsibility. The staff is there for the sister who is a patient not the family.

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