calcium effect on blood glucose?

  1. 0
    I'm on month 3 of orientation in a SICU that does a lot of open hearts. Had a fresh open heart the other night with blood sugar of about 160 for a few hours. Preceptor was reluctant to start an insulin gtt and instead gave a bolus of 2 units. While I was at lunch she gave calcium replacement gtt. A few hours later his BS was 114 and she told me it was due to the calcium replacement. I know K can cause BS to drop, but I didn't know Ca could, and I can't find any discussion of it in my usual reference books. Can anyone comment? I think my many questions try her patience at times, but there have been occasions where she meant to say one thing and other words came out instead (don't we all, but I want to know the real scoop).

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  2. 5 Comments...

  3. 0
    Quote from utahliz
    I'm on month 3 of orientation in a SICU that does a lot of open hearts. Had a fresh open heart the other night with blood sugar of about 160 for a few hours. Preceptor was reluctant to start an insulin gtt and instead gave a bolus of 2 units. While I was at lunch she gave calcium replacement gtt. A few hours later his BS was 114 and she told me it was due to the calcium replacement. I know K can cause BS to drop, but I didn't know Ca could, and I can't find any discussion of it in my usual reference books. Can anyone comment? I think my many questions try her patience at times, but there have been occasions where she meant to say one thing and other words came out instead (don't we all, but I want to know the real scoop).
    I'm not sure about calcium dropping the glucose, but could your drop have been dilutional? If you were bolusing with lots of fluids, the glucose can get dilated out. Or, if the patient is not an insulin diabetic, then sometimes they will have peaks when the glucose goes up then respond well to the insulin and trend down.
  4. 0
    I wondered about the dilutional effect plus perhaps his own early am insulin kicking in to augment the 2 units given. We gave almost 4L of fluids, and I'm pretty sure the stress of surgery is what kicked his blood sugar up in the first place. He was not a known diabetic but had been on Q6 Accuchecks prior to surgery d/t steroids and a previous open heart surgery less than a week earlier (sad story).

    Mostly, I was looking for any corroboration of her statement about the effect of calcium. My preceptor is generally very knowledgeable, but has occasionally said things I know or suspect to be incorrect.
  5. 0
    Makes NO SENSE AT ALL. If she had some new data she should have presented it. You are right to question that.
  6. 0
    Hey Y'all!!!

    I agree that I've never heard of a connection between 'repleting' Ca++ and lowering the Glucose.

    Thought it's worth the time to just remind ourselves of the connection between giving D50W and K+ levels.

    Giving your Pt an amp of D50 LOWERS the serum K+ for the length of time that the Pt takes to 'equilibrate' from the sugar.

    My 2cents worth.

    Papaw John
  7. 0
    Thanks, Papawjohn, I figured that's what she was thinking of when she said Ca. Interestingly enough, I had a patient in DKA last night and was able to watch his K come down through his Q2hr labs. And then it turned out he was in DKA because he was having an MI, so I learned a whole bunch of things, including how much teamwork there is in the unit! Physically draining, intellectually stimulating and emotionally satisfying--that's what I call a great shift....

    Thanks for all the responses to my question.


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