Blood sugar of 28 - OOH tonight or GP tomorrow?

[Poppetspinkpants]

My T2 diabetic Ddad is having problems with faints, has been to GP & hospital and had antidiabetic meds lowered, Tuesday's reading 2hrs post food was 15, tonight's 28.
No thirst or excessive weeing but doesn't feel strong enough to do much.
Dmum is going to GP to get appointment tomorrow for him, but can't help feeling that he should ring OOH tonight. Anyone else advise?

I would ring now as you are so worried, or NHS Direct.

28???!!!! Yes, definitely ring OOH!

That's dangerously high. My Mum frets if my Dad's goes up to 9/10.

A&E I'd say. Does his breath smell sweet at all? My mums sugars were atread at 15 once and the doctor said at 15 you can normally smell a pear drop scent on their breath.. Fortunately in my mum's case it was due to having sugar on her finger when it was pricked!! But 28 v high, I'd be off to A and E.

Out of hours GP, if not then A&E. I wouldn't leave it until tomorrow.

28?! I'd go to A&E with him

When did you test? Can you test again to see if it's staying high, going higher or coming down? Have you any urine strips?

Def A+E if it hasn't come down by now.

A&E immediately

Make sure his finger was really clean before taking the test then if it's still so high A&E. The pear drops thing is useful but not everyone can smell it, apparently it's a genetic thing.

Update-wouldn't go to A&E (stubborn old bugger) but he went to GP who wasn`t worriedand gave him more tablets.
He's giving me lots of grey hairs ATM.

Can recheck it

I am shocked by his GP to be honest.
Is his blood sugar normally so high?

Ripishere I agree, my DH was rushed to the ER with a blood sugar level of 29

You are all right. A blood sugar of 28 in a type 1 is very dangerous. If it wouldn't come down with insulin, you'd go to A&E.
But type 2s produce some of their own insulin. So in theory, won't go into ketoacidosis. It's still very high and should be sorted. But as far as I know, has no immediate danger.

Can you get some ketone strips from the pharmacy? Usually about a fiver. If its very high again, get your dad to test for ketones. If they are present then you need to seek medical help. I'm assuming her doesn't take insulin? If he does, can your dad not change his own doses and correct a high reading?

This forum has fantastic advice diabetes-support.org.uk/diabetesforum/index.php

I'm not shocked by his GPs reaction. A one of reading of 28mmols isn't dangerous, however a continued high blood sugar is more cause for concern. When was his last diabetic review? Has he has his HbA1C done recently? This would tell you a lot more.

NHS Direct is switched off in most areas now.

TBH, I agree that his surgery don't seem on the ball with this. When he was diagnosed two years ago with a FBG of 21 the doctor gave him a packet of Metformin and an appointment with the diabetic nurse.

A colleague of mine mentioned that her mother had been diagnosed with a FBG of 22 and had been admitted to hospital immediately- they're in a different area.
He's not on insulin and had to ask for a home monitor - the doctor didn't offer it. Anyway he's due to see the diabetic nurse this week for a foot infection (another diabetic problem).

The diabetic service in general is poor in his area. And he's spent most of his life having as little contact with doctors as possible, takes the pills the doctor gives and doesn't argue.

It sounds like his GP has so far dealt with your father correctly. If at diagnosis he was relatively well, with no immediately worrying signs of HONK then lifestyle advice and metformin sounds appropriate. Your friends mother could have had very different symptoms suggesting she was insulin deficient which could have been life threatening.
His foot infection is likely to have pushed his glucose levels up, and his GP increasing his medication dose, or adding new agents is reasonable as an increase in treatment.
Type 1 and 2 diabetes are very different things, and so sustained high glucose in a type 1 must be dealt with swiftly to avoid life threatening illness, whilst those with type 2 can generally function for a little while at relatively high levels without any major problems (other than needing to pee a lot and feeling thirsty).
It is important to get them back down to aid his wound healing, and reduce his risk of long term complications, but the new medication will need a chance to work.
Glucose monitors for people with type 2 diabetes is a contentious issue (unless on insulin) and GPs are pressured from up high to not routinely offer them out, unless there is good reason (tablets than can cause low readings, or if treatment is being changed for example).
If your dad is feeling generally well, and not exhibiting signs of his high glucose making him ill (confusion, weakness, severe lethargy, vomiting, visual impairment, leg cramps) there shouldn't be a need for him to be admitted. Your mum or dad should call OOH or a&e if any of these do occur though or they become worried.
On a separate note, if your dad has a foot wound, the gp or practice nurse should be referring him to your local podiatry service ASAP for review. You may be able to do this yourself, check your local community nhs website to check, some areas have this facility.

The podiatry service may be a good idea . DM is getting fed up cutting his toenails (there's love for you)

It is very important that any foot wounds are taken seriously. Accessing the podiatry service seems like a good idea as they can tell him if they are worried enough to consider he needs medical attention.