Hypoglycemia

SteveDE · Apr 10, 2014

Someone wouldn't be "out" with an A1C of 7, I highly doubt there would be a need for A1C on an EMS rig. Anything is possible, its possible that the meter was correct at 7 and they were still alive, probably not for very long, but its very possible. My dad was able to use his elbow to wake my mom up because he couldn't move anything else and his was 13. Also just because a meter says 7 doesn't mean it is exactly 7, there is room for error, it could have actually been a whopping 15 due to margin of error.

I would strongly suggest this person have a prescription for glucagon, education, and have support of family/friends.

knittern · Apr 10, 2014

My daughter was born with CBG at 6. Took over 24 hours to get it up to 40, was in nicu due to this. I have been working an started not feeling well and mine was in the 30's with mild sx. Don't think that at 7 could maintain that long without permanent damage.

CDEWannaBe · Apr 11, 2014

Someone wouldn't be "out" with an A1C of 7, I highly doubt there would be a need for A1C on an EMS rig. Anything is possible, its possible that the meter was correct at 7 and they were still alive, probably not for very long, but its very possible. My dad was able to use his elbow to wake my mom up because he couldn't move anything else and his was 13. Also just because a meter says 7 doesn't mean it is exactly 7, there is room for error, it could have actually been a whopping 15 due to margin of error.
I would strongly suggest this person have a prescription for glucagon, education, and have support of family/friends.

SteveDE makes a great point about meter accuracy. The current meter accuracy standard is:

"FDA’s standard for glucose meters is the International Organization for Standardization (ISO) requirement of 95% of results within ± 20% for glucose values >75 mg/dL and ± 15 mg/dL for glucose values

So 95% of the time a reading is + or - 20%, as long as it's greater than 75. Definitely wouldn't apply to the situation the original poster described.

The most accurate meters statistically, and in my own experience, are One Touch meters. But because of expense hositals never use them. I currently use a Bayer Contour Next because it feeds the results directly to my insulin pump and the insuarance co-pays are more affordable.

Wave Watcher · Apr 16, 2014

I am a school nurse and work with diabetics all day. If I get a low reading I always recheck. I have one student who will function pretty good with a BS of 35. He is very hyper and tends not to recognize his lows. Of course I'm quick to correct his low BS and keep him with me until it gets back above 70.

SteveDE · Apr 28, 2014

CDEWannabe.....Side question here since you brought up the bayer contour next meter communication with your pump. I currently have a patient on medicare, had been using a one touch, has strips already supplied for his one touch, but he is starting his insulin pump THIS week and the insulin pump uses the bayer contour next to communicate with. Do you or anyone know if or how medicare would work in supplying this patient with the bayer contour next strips even though he has a good supply of one touch strips?

CDEWannaBe · May 12, 2014

CDEWannabe.....Side question here since you brought up the bayer contour next meter communication with your pump. I currently have a patient on medicare, had been using a one touch, has strips already supplied for his one touch, but he is starting his insulin pump THIS week and the insulin pump uses the bayer contour next to communicate with. Do you or anyone know if or how medicare would work in supplying this patient with the bayer contour next strips even though he has a good supply of one touch strips?

Steve-

I apologize for taking a while to reply. It's not worth switching meters if the patient has to pay more to use the meter that's compatible with the pump. The truth is, syncing the meter and pump mostly benefits the CDE and physician. It has little positive impact for the patient, other than getting an "atta boy" at their next doctor appointment because they have a complete log in their pump, along with basal, bolus, etc. reports that the pump will produce. My doctor especially liked this since I use multiple meters (one in purse, one by bedside, one at the office) and they hated having to download and compare 3 separate reports. Once my meters fed to my pump all the results were available on 1 report. I could have just logged, but after almost 38 years with diabetes, I only log if I have glucose patterns that need tweaking.

Since your patient has already started the pump by now you've figured out that he can manually enter his glucose reading if he wants to use the bolus wizard to calculate a correction dose. If he can do the math of a bolus correction in his head, he can also just have the pump give the bolus dose without using the wizard feature.

Hope this helps.