I am concerned about my husband who was diagnosed with diabetes just over
year ago. Initially, there was some uncertainty as to whether he had
type 1
or
type 2 diabetes,
but the presence of
ketones
led to the diagnosis of type 1. He has now been taking insulin for about
18 months and maintains his levels at about 4-6 mmol/L [72-108 mg/dL] with
an occasional rise to 12 mmol/L [216 mg/dL] if he has overindulged.
This
weekend (and I know this was not the first time) we were at a wedding and away
for the night. He took his morning insulin, and then did not take any more
until tea time the following day, whereas he normally injects premixed
insulin twice per day. We drank plenty and he ate normally (including
chocolate cake). The next evening, when it came time to take his insulin,
his sugar was only 5.5 mmol/L [99 mg/dL]. (He had not tested his blood
sugar in between.) Should I be concerned about him?
I know that his sugar always seems so controlled (even after eating) that he
feels he has been misdiagnosed. From my point of view as an observer, I
have to agree that it looks that way. What should I be doing? He
insists that the complications resulting from not taking insulin are only long term and
only if he did this
regularly, which he doesn't.
Answer
It appears to me that there's a piece of the puzzle missing here, but I can't put my
finger on it from this limited description. For instance, it's unclear
whether you would have been present at any visits with his physician or if you
are getting your information secondhand. In addition, the presence of
ketones is not an automatic indicator of type 1 diabetes. In any
case, I suggest that your husband be evaluated by a diabetes team that
includes a diabetologist, diabetes nurse educator, and dietitian.
wwq
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