How high have you seen??

You win. I think the highest I have seen is 25 in an outpatient setting. I did once see a DKA pt with a glucose over 1000 in the MICU though.

I can't remember what the a1c was, but I had a pt that came in for chest pain, and routine lab work showed a glucose of 1700. This guy knew he had diabetes, but wouldn't take insulin because if you start in insulin you can't have a cdl license. Oral agents just weren't cutting it. What doc keeps supplying oral meds to a guy whose blood sugar consistently runs above 1000?

The highest I've ever seen was a 4 year old in DKA with a blood glucose of 1,500. She survived, but with some permanent neurological deficits. This was new onset Type 1, though, and not known but uncontrolled Type 2.

Just had a pt last night who came in with DKA.. Blood glucose was 1900!!

Brought a girl in by ambulance the other night. She was unresponsive, snoring respirations, had near sine waves on her EKG. No IV access to be had. She had a port but we had no huber needles. She coded about two minutes after we moved her to the ER stretcher. They accessed the port, gave calcium chloride and worked it. About an hour later we came by on the way out with another pt. They were still working her. Had gotten her back a few times. Labs had come back - her blood glucose was 2400.

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in nursing school during my ER rotation, a 20 something woman came in unconscious. the glucometer reading just said "HIGH". took a venous sample and it was 1200!! new onset type 1... she turned out okay thankfully!

Brought a girl in by ambulance the other night. She was unresponsive, snoring respirations, had near sine waves on her EKG. No IV access to be had. She had a port but we had no huber needles. She coded about two minutes after we moved her to the ER stretcher. They accessed the port, gave calcium chloride and worked it. About an hour later we came by on the way out with another pt. They were still working her. Had gotten her back a few times. Labs had come back - her blood glucose was 2400.

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WHOA!

1208.

Holy moly! I've only seen in 700-800 range, didn't even realize you could have 4 digit BS and still be alive!! Yikes!!

Is there a point at which a BS becomes incompatible with life?

I had a DKA transferred to my floor from ICU. Initial blood glucose 1100.

1600 in a frequent flier in our ED & ICU. Type 1 Diabetic who just insists on not using his pump. Every other week he comes in at death's door, we get him stable, ship him to ICU for a week with his sugars looking awesome, then he's back over 1000 a week later. Idiot. When EMS calls with a 20-something, male diabetic, we're all like, "I bet it's Fred (name changed)." I feel like smacking my head against the wall each time. So many resources for someone who really doesn't give a crap. I posed the question of ordering an inpatient psych consult for him next time because he seems passively suicidal if you ask me.