Very high BGL .... thoughts?

[KitkatPRN]

I'm a new LPN (Jan. 2012) and I work LTC. I take care of a patient and his main dx is dementia. He had routine labs drawn and had a BGL over 800 (was never diagnosed with diabetes & is over 75 y/0). He was treated @ the hospital & returned to our LTC facility a week later. He now gets Lantus daily (24 units) & his blood sugars continue to spike up in the 500's with no s/sx of other infection: v/s stable, afebrile, UA negative for infection, LCTA, losing weight (probably d/t elevated BGL). Any thoughts/advice?

[victorcr]

If all labs and testing are check and no s/s of infection or anything r/t, the pt should have his insulin regimen changed. Ask to recieve info on basal testing, carb ratios, insulin sensitivety e.ct.

[mammac5]

I realize this case is closed, so to speak, since the passing of the gentleman in question. I would just like to add that I am very impressed with the original poster. Kudos to you for using your critical thinking skills in considering what may have been causing this g'man (previously undiagnosed with DM) to exhibit very high and hard to control blood glucose. I have worked with loads of experienced RNs who do not put that much thought into the care of their diabetic patients and you really are to be commended!

Good job!!