High glucose levels

[ghworker2010]

I was out shopping with the wife and mother in law recently and we went to a restaurant. The MIL ate something from her plate and then got up to get some more food from the buffet. When she returned to our table she collapsed and there were 2 deep cuts on her face. She later said that she felt dizzy and briefly lost consciousness. We took her to a quality hospital and they did blood tests and 30 stiches. The only anomaly with the blood results were

- POCT glucose (non fasting) 189 (range 70 to 140 is normal)

- Neutrophil was low at 51

- potasium low at 3.4

3 months prior she had a full check up at a high end govt hospital in bangas which also revealed a high glucose level.

We live in the sticks in southern thailand. If we go to a government hospital in a morning where MIL has been fasting I presume it would be prudent to do glucose test again? Should we ask for anything else to test for diabetes?

She doesnt do any exercise and her diet is not very good. She eats a lot of rice and deep fried fish washed down with exotic (disgusting smelling thai style salads). Salty noodles are consumed regularly...

I would like to help her resolve this issue. If you can offer any suggestions before we take her to the dr it would be appreciated. Ive noticed the Drs where we live are not very competent.

thanks

[RKASA]

That is likely not high enough to cause a pass out - most likely not enough to even feel sleepy. I can get a number like that looking at food online. Better get a good check up - See a cardio it could be other things. Many people that take meds for blood sugar get numbers like that in the morning after fasting 10 hours.

The real test is a lab test AC1 that looks at the level over time in the blood sample - there is no flash check to know if you have a real problem with your blood sugar - it takes a few follow ups and tests to know that for sure. If it is high on average she may only need to change the way she eats or take a pill after that does not work.

I would think about a stress test . Put her on a treadmill with the EKG hooked up and see if she has problems. Having low blood pressure - could have this happen. Everyone can get a little dizzy now and then when they stand up, but after a short walk and then falling down hard like that is not good.

I do have to be picky when out to eat - no food courts etc - they love to dump tablespoons of sugar into everything and that MSG stuff.

[Lefty]

That is likely not high enough to cause a pass out - most likely not enough to even feel sleepy. I can get a number like that looking at food online. Better get a good check up - See a cardio it could be other things. Many people that take meds for blood sugar get numbers like that in the morning after fasting 10 hours.

The real test is a lab test AC1 that looks at the level over time in the blood sample - there is no flash check to know if you have a real problem with your blood sugar - it takes a few follow ups and tests to know that for sure. If it is high on average she may only need to change the way she eats or take a pill after that does not work.

I would think about a stress test . Put her on a treadmill with the EKG hooked up and see if she has problems. Having low blood pressure - could have this happen. Everyone can get a little dizzy now and then when they stand up, but after a short walk and then falling down hard like that is not good.

I do have to be picky when out to eat - no food courts etc - they love to dump tablespoons of sugar into everything and that MSG stuff.

The test is called AIC

Lefty

[ghworker2010]

Forgot to mention MIL is aged in late 50's and on the day we had travelled a bit in the morning and had been shopping for 2 hours prior to the accident. She had been lugging around our baby here and there and was tried I think. I believe her overall fitness is really poor and her weight is not too obese but getting heavier each year. At E.R they took her blood pressure which at one point the systolic bp was as high as the diastolic. I think a heart check up would be prudent.

[harrry]

Most local hospitals after handling the immediate problem will run a series of tests and they include a diabetischeck. They are quite serious about it. Care is free if you go to the local hospital she is registered at including all medication. They probably will set up a monthly or bimonthly program of checks.

[Sheryl]

More information is needed here, specifically:

- what advice/ treatment was your MIL given for her elevated blood sugar?

- is she on any other medications?

- history of any other illnesses?

The lab results you mention would not have anything to do with fainting. The sugar is high but nowhere near the level that would account for this and in any event what you describe is not diabetic coma. The potassium is only a little low... suggests to me that she may be taking a certain type of BP medication but is certainly not the cause of the fainting. Neutrophil count has no meaning if overall WBC count was normal.

It is also physiolgically impossible to have a BP where the systolic and diastolic BP are identical so that info is off.

As you are not confident in the care at the hospital she is registered at under the government health scheme it might be worth having a private consultation to get to the bottom of it, but for that need to have an idea of the type of specialist she needs (and also to know where you live). A sudden fainting spell like that in someone her age not due to hypoglycemis (which we know from the labs this was not)will usually be due to one of the following:

- sudden drop in BP on standing up (orthostatic hypotension) - much more likely if she is taking medication for high BP, less likely otherwise in someone under 60

- neurological cause (atypical seizure) - if so will likely have a past history of similar events

- cardiac arrythmia (abnormal heart beat). To detect that would need to do a prolonged monitoring of heart rhythm but this is really not indicated for just one isolated incident. If it is has happened before/happens again, or if short of actually passing out she has episodes where she feels dizzy and light-headed then would be worth checking.

- heat stroke - seems unlikely from the description

I suggest you get a fuller history including list of all medications she takes, prior illnesses etc, and whether this has ever happened or almost happened before and post here along with your location in Thailand and which hospital she is registered at. Based on that I can suggest next step.