Remember that the information presented here is not intended to replace the care of your own doctor. Before making any changes in the management of your own illness, you should consult your physician or other qualified medical professionals.
Question
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.
