Blood Glucose of 1700!!!
- 1May 18, '06 by brian, ADN Adminshort story: my mother-in-law was diagnosed with type 2 diabetes this week, she ended up in the er, and her blood sugar was 1700!!!!!
what is the highest blood glucose you have seen?
long story: what makes matters worse, is that she had a some labs including a 12 hr fasting blood glucose test on last wednesday at her doctors office, her doctor told her they would call her if there was any problems with the results. (this was all unknown to me until this past monday) she had been feeling sick all week and thought she had the flu.
the first i heard about the situation was monday morning, she called telling us she was real sick, and weak etc... and she thinks she has diabetes.
i said, why do you think you have diabetes? she said, i got some lab results in the mail yesterday and my blood sugar was high, my doctor told me that they would call me if there were any problems but they never called me? i asked her what the result was and she said 359. :angryfire :angryfire :angryfire my blood began to boil, i'm thinking to myself, how could a clinic let this result slip through the cracks and go six days without followup and treatment??? one of her daughters was on her way over there to bring her some things). meanwhile, i called the clinic very upset and wanted to talk to the drs office, to see how this was missed? they said they would leave a message and have the doctors office call me when he was done seeing pts.
shortly after my call, she gets a call from someone, she couldnt remember who telling her that she needs to go to the hospital soon to get checked out for her high test result (6 days latter but about an hour after my call :angryfire ) she ended going to the er via 911 because she was so weak and that is when they found her bg was 1700!!
thankfully the hospital was able to stablize her after several hours and remained monitored in icu and should be going home today or tomorrow. so my questions to you are:
- what's the highest bg you have seen in a patient?
- how would your clinic have handled this?
- what is your facilities protocal for high lab results that obviously need attention?
i plan on contacting the clinic and following up with them so this kind of error does not happen again to someone else. please feel free to offer suggestions. tia!
- 0May 18, '06 by TheCommuter, ASN, RN Senior ModeratorAn uncle-in-law had a blood glucose reading of 1700mg/dL after bingeing on Dr. Pepper sodas for an entire week. This was over 10 years ago.
I think doctors should inform their patients about a condition called prediabetes, where the fasting blood glucose ranges between 101-125. The fasting glucose readings are elevated, but do not quite meet the criterion for diagnosing type 2 diabetes. These prediabetics have a 60 percent chance of developing diabetes in the near future. But prediabetes, unlike diabetes, can completely disappear with diet modifications, exercise, and weight loss. It's my opinion that the public should become more aware of prediabetes so they can fight to avoid a diagnosis of diabetes.
- 0May 18, '06 by AntikigirlHighest I have seen 1200 in an ER.
We do the following protocol automatically...we don't mess around with high CBG values!
Our protocol med surge: Re check right away! Then if over 350 order lab stat (RN order). If results are high MD is contacted stat by lab and nurse and orders are given to treat. If severely symptomatic..ICU transfer immedately (standard order for our facility!!!).
- 0May 18, '06 by TiffyRN, BSN, RNI can't beat 1700. Highest I had heard of before that was 1600 something on a bad diabetic from a nursing home. She had dementia and when her glucose was above 800 or so she made sounds just like a mewing cat.
I also remember a gentleman with known type II diabetes that went to the dr's office with neuro complaints, was sent to the hospital for a CT scan of brain (negative), finally someone in ER did a blood sugar; 40. Instant cure for the neuro deficits with one little (big) injection. This doctor did not have a good reputation in town.
- 0May 18, '06 by limabeanI can not believe they had the nerve to call her right after you had called them on their mistake! Like that would somehow cover their butts! I would raise a major stink about that and insist on speaking with the physician. He needs to know about it so maybe he can set up a different system that will prevent huge lab errors from occuring. I'm surprised she wasnt comatose with a BS that high. Sorry that happened to her.
- 0May 18, '06 by vampiregirlUnfortunately, this situation is not unique to just clinics. Although, I had a similar experience that was not nearly as serious, I was still disturbed by it. I went in for a glucose tolerance test several years ago. They did an initial accucheck (and it was on the low end of normal), but the remaining checks were all VP's. Several days later I got a frantic call from the doctor's office that initially ordered the test to inform me that the final reading they had taken was dangerously low. I had informed the technician at the lab of my symptoms during the test (diaphoretic, cold, clammy, dizzy, shaky, etc), and had been offered a blanket and reassurred that this was normal. My request for an accucheck after the final VP was denied because the tech "didn't have an order for it, the protocol only called for an initial accucheck". I was aware that I was having an episode of hypoglycemia and went to the cafeteria to eat and consequently my symptoms dissapeared. (Oddly enough, my hypoglycemia was the result of food allergies and as long as I don't eat anything I'm allergic to I do not have any episodes of hypoglycemia). When I followed up with the hospital, I was informed that because it was lab techs who dealt with the results, they are unable to do anything further than to forward the results. HIPPA and scope of practice (lab techs can't interpret the results) were cited. While I understand the importance of both of these and respect them, it would seem to me that some type of system needs to be in place to address any critical labs. It's a sad and scary day in medicine when red tape comes before patient care.