Hyper Alert

Yes, you read that right. Hypoglycmia, or just a hypo, is low blood sugar, which is always a risk when someone takes insulin, and indeed I’ve had three hypos in the last few weeks which is currently causing me to review my dose. Hyperglycemia is the opposite effect – when your sugar goes far too high. I can probably say from experience that this contributed to my stroke!

I happened to have an afternoon nap this afternoon, and for some reason felt really thirsty when I woke up. Purely on a hunch, I tested my blood at 6pm, something I never normally do. Sure enough, my blood sugar was at 20! I immediately took a half of my evening insulin there and then. I waited until about 7:15pm, just before supper, and measured it again. It was still at 19 so I took the other half. I then had a very low-carb supper of cod in sauce, broccoli and cauliflower. I made sure I had very little sauce, and nothing else there should raise my sugar.

So it is now almost 9pm. I need to wait until about 9:30pm, to let the food digest and give a true reading. Then I can decide how much extra insulin to give myself tonight. It’s annoying to have to wait until then, but at least that thirsty feeling has passed.

In one way this is good news. Never before have I “felt” a high sugar level, but this thirstiness is something I can use. Of course, I have to contrast this with the downsides, which include taking more insulin than I usually do and going to the other extreme!

And, of course, the post mortem now begins. What on earth could I have eaten which sent my sugar so high? The two “newbies” today were some crunchy peanut butter (I had peanut butter on toast for lunch), but this was labelled “no added sugar”, and some mint boiled sweets (which were labelled “sugar-free”). So go figure!

This is only the second time that I’ve recognised a hyper since I started taking insulin. The only other time (which I attributed to white bread) was in hospital, where my sugar was tested hourly and went beyond 30! But very scary to know that you have such blunt instruments at your disposal, you just have to inject yourself then wait. At least at hospital, they put me on an insulin drip so we could gradually see my sugar go back down over the next 12 hours or so.

Blood Tests

Today I had Part I of my (annual) diabetes check. The nurse just took some blood to have analysed, so the visit was only long enough to get a sample.

It’s all in preparation for a further meeting on Friday, when the nurse will have the results in front of her.

I pride myself in being quite hands-on these days in terms of my health, and so of course I have a view on what I want to know and what I’m not fussed about.

HBA1C is really the headline value for diabetics, and is well-known. It is glycerated haemoglobin (sugar in red blood cells). This value extrapolates to an average of your entire blood sugar during the last couple of months. Ironically, I’m not too interested in this. I test my blood sugar directly every day with a glucometer, I store every result on the computer, so I know exactly how my blood sugar has been behaving over the last couple of months. No averages required.

One of the things I am interested in, however, is my cholesterol, simply because during my stroke-stay in hospital, I was put onto completely fresh meds, and this included a statin. Just from the perspective of wanting to take as few meds as possible, I’d like to see how it is performing with a view to getting rid. On the other hand, however, the stroke has made me far less active, so maybe I need some help over-and-above diet?

The second particular thing I’m interested in is my level of potassium. During this med-change, I was put on a BP medicine which was also known to reduce potassium. But I wasn’t told this. I wasn’t even told to get a blood test in a few months to make sure that everything was OK. I happened to request a blood test, entirely of my own initiative, about 3 months after the stroke visit. Lo and behold, low potassium! And we found it totally by accident! So this led to a second stay in hospital, right about the time of the Brexit referendum.

So, you know when I’m critical of doctors? Well, this is a big reason.

The upshot from the hospital visit was to change the med to another. This one was known to have the opposite side effect, that of raising my potassium beyond what is considered safe. But in fairness to that particular doctor, he did warn me about this at the time. So I keep tabs on my potassium ever since, certainly for the first six months or so, I requested a couple of blood tests specifically to find this. So now, if I’m having a test anyway, I always ask them to measure my electrolytes (which are the salts in the blood, and include potassium). No side effects seen to date.

The visit was also an opportunity tomeet the new (<1yr) nurse, who seems lovely. It possibly helps that she knows my wife, who, of course, is also a nurse in a doctor's surgery.