Anyone up? Sat in A&E with DH

[tumblingdowntherabbithole]

DH has just been taken to hospital with seriously high blood sugar - undiagnosed diabetes but he has a family history so we’re pretty sure that’s what we’re dealing with.

Not really after any advice just someone to chat to! They’re about to put him on fluids and try to get his sugar levels down.

Hope you can catch up on some sleep today.

I guess if he has developed T1 diabetes they already know his pancreas is failing.

Are they starting him on insulin ?
It's scary but it sounds like you got him to hospital before he went into DKA

There are different types of Diabetes, my son has type 3c because he had acute necrotizing pancreititis two years ago which destroyed his pancreas, his case was extreme, but type 3c is caused by pancreas damage.

Yes, they will be - he has a GP appointment at 5.30 this afternoon to discuss treatment and meds!

Very scary (especially as they rang an ambulance out for us) but he’s feeling much better now.

Yes it's awfull my son was diagnosed in DKA so i understand how terrified you must have been
Ask about CGM,s at your appointment, my son has a Dexcom funded by the NHS which is very reassuring.

How was he diagnosed in such a sudden "and this is immediate emergency" way, OP, was it a healthcheck or routine test for something else at GP surgery maybe? How old is he?

T2DM takes a lot of active management and support from partners can be super helpful, it's great to hear he has your support. x

T1 diabetes is caused by your body self destroying its pancreas in most instances, hence the presentation (it isn't influenced by lifestyle factors like t2 is)

Sorry autocorrects meant sentences make no sense!

Just hopping on to wish you both well. Type.2 is unlikely with those sugars.much more likely tonbe type 1. I'm slightly concerned they are sending you home.with nothing but a 530pm gp appointment to sort this out. Je will need daily or more frequent insulin which should be sorted before you go home. GP can sort out all the other bits not done so eye and foot screening and on going monitering. Dh is type 1 and it's not as a rule well managed by GPS unlike type 2. They are very different beasts

I thought that surely without insulin before eating his Blood sugars are going to shoot back up ?

Well done on recognising the signs of him becoming so unwell. DH has type 2 (although family history might suggest not typical t2) had a similar crisis a few years ago due to an infection and we are currently dealing with another. The speed of decline and seemingly masking the extent of it until very poorly is the biggest concern so you do need to react fast. Hope his gp is helpful and he, and you, recover soon.

Just popping in with a handhold as I was in your shoes a few years back with DH, only I was at home with our newborn panicking rather than at the hospital with him.

The first few days, weeks, months will be a blur as you all adjust to the new normal. I’d strongly recommend looking at diabetes UK for any clinical trials that your DH may be eligible for. There’s such a slim window for admittance as they often need you to be within a few weeks of diagnosis, but DH was part of one for his first year and honestly the amount of help and support he received was invaluable. He also got a better CGM than he’d have had through the NHS which really helped with monitoring in the early days.

When he speaks to the doctor he should also ask about the DAFNE course. He might not be eligible just yet, but there’s often HUGE waiting lists to join so worth getting the ball rolling early.

The other thing we learnt through bitter experience was not to try to bring his HBA1C down too quickly. The hospital didn’t really give us a huge amount of guidance outside of the figures when he was admitted being “catastrophic” so we went on a full health kick, as even though he was T1, so not remotely down to diet, we’d been eating all kinds of crap whilst trying to survive the early weeks with a newborn. Long story short, DH had all kinds of nasty side effects from bringing his levels down too quickly and was later told they’d only encourage such speedy adjustments if he needed life saving surgery.

Feel free to pm me if you ever want to chat, or need someone to lean on. 2 years on DH can mostly eat what he likes, it’s well controlled (though he’s just out of the honeymoon phase now, which is coming with a few new surprises) and whilst the mental load of it does take its toll on DH, life has generally carried on as it did before.

If possible I would request a blood test to check C-peptide and autoantibodies.
These would help differentiate between Type 1 and Type 2 diabetes.

Type 2 sounds likely due to previous health, BUT plenty of adults can develop Type 1. T1 diabetes would require a referral to a specialist diabetes clinic to manage insulin needs/sugar control. GP support can be woeful, inadequate at best for Type 1.

Either way, having diabetes will require a lot of lifestyle changes, and is hard work for both the patient and supporting partner/spouse. I'm glad he has you in his corner for support.

Hi there I hope you are back home by now .At least your DH will be given some medications to help and will be referred to your GP's diabetic team who will give him a lot of info . In the meantime I hope you can catch up on sleep. You can both go home and meet up with your dog .I think you are as well to stay off work today as you will want to spend time with each other. It will have been a worrying time for you. All the best to you all and I include your doggy friend. Great news that FIL looked after him for you,

We’ve found same with T2support. Surgery diabetic nurse is not proactive.

that’s a very fast discharge with a diagnosis of type 1 diabetes and such high blood sugar. It takes time to meet the diabetic team and sort out a regimen and to ensure he’s confident injecting himself and finger prick testing, as he’ll need to do several times a day for the rest of his life, until he gets an insulin pump/blood glucose monitor.

Unfortunately the nhs at the moment is focussed on dealing with immediate issues, getting patient stable and sending them home to free a bed for those waiting on trolleys in ED, often same day. Life on a ward can be so miserable that patients are keen to leave even if vulnerable. If you need an underlying issue treated or further investigations you have to go back to gp for a referral. I suspect there is an increase in readmissions as a result.

T1 diabetes is not something you can just he sent home with until you’ve been taught how to manually keep yourself alive 24/7. There’s no getting stable then coming back.

Sending hugs op.

I imagine they tend to have a basic knowledge/advice & cover the NHS checklist to tick off annual eye/feet checks, etc. That's all I've ever attended GP surgery for to do with my Type 1. A referral to a specialist diabetic clinic is a must for the proactive support & advice.

My specialist diabetes nurses have been amazing over the years, but even they are not infallible. I've found lived experience and advice from longer-diagnosed diabetics can be priceless!

He hasn’t been diagnosed with either type yet - just diabetes and sent home to meet with the GP later on today to discuss further.

Thank you SO much to everyone for all your lovely and helpful answers! We finally got home to a very excited (and well looked after) dog at just gone 8am this morning after six-odd hours in A&E.

Both absolutely exhausted and very overwhelmed with everything but we have an appointment to see the GP at 5.30 so hopefully we’ll get some more answers then. The doctor in A&E said that his sugars were okay on discharge (well down from what they had been) and that the most important thing was getting him to eat and drink something during the day, which he’s done.

I suspect it’s T2 due to family history and his own health and diet but I suppose we’ll find out this afternoon.

The first symptoms my dad had of what turned out to be pancreatic cancer was diabetes. Had we known then that it was an indicator we would have pushed for tests to try and catch/ rule out pancreatic cancer.

Yes I know. It sounds like OPs DH has T1, which would also mean a failing pancreas.

If it is T1 I second what @NormaNormalPants said:
When he speaks to the doctor he should also ask about the DAFNE course. He might not be eligible just yet, but there’s often HUGE waiting lists to join so worth getting the ball rolling early.
This was a game changer for us.

Hi op how are you both doing. I hope the GP was able to help. I agree type 2 is a possibility but we are seeing a significant increase in late onset type 1's Dh has met 3 i clinic and has two close friends who have been diagnosed with type 1 in there late 40's often not fully picked up by GPS untill there are real issues under the assumption that are type 2. They are 2 very different but equally challenging diseases. Dh has been managing the disease for 50 plus years now and had a pump and and cgm as he now has site loss due to.it. He makes me laugh when he can count his carbs in an instant from my description of the food. It's years of practice and a dafne course will help. Expect dh to have alot of ups and downs , it's not easy , late diagnosed friends have found the diet control hard as have their wives! Focus on a day at a time for now. It does become second nature eventually