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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Do Blood Sugar Levels Just Above 500 Need ER Treatment?

My friend is staying with me and is insulin dependant diabetic. Her blood sugar at 10:30 EST was over 600, she adjusted her pump and retested 30 min later and it was down to 563. She plans to check again in 30 min. Should she still seek emergency treatment if over 500 but lower?
Tue, 26 Aug 2014
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General & Family Physician 's  Response
Brief answer : Yes , she should

DETAILED ANSWER :
Blood sugar above 500 is a medical emergency and shoudl be taken seriously as it can lead to 2 acute medical complications
1) Diabetic keto acidosis (DKA)
2) Hyperosmoler hyperglycemic state (HHS)

Not everyone whose blood sugar goes over 500 mg/dl develops either condition , but to be on save side one should go to emergency.

It is also likely that your insulin is denatured , if that is the case take insulin from new voil and new needle.

But if blood sugar does not come down swiftly in response to your usual techniques, or if your blood sugar is over 300 mg/dl and you are vomiting and cannot keep down liquids, or having a lot of diarrhea, you do need to head to the ER. Other alarming symptoms include drowsiness and lethargy, delirium, coma, seizures, visual changes or disturbances, hemiparesis (one sided paralysis), and sensory deficits.

In the ER you will undergo several tests like
repeated RBS levels
urine r/e
urine for ketone bodies
ABGs
S.electrolytes

Kindly rate my answer if i was of any help

Regards
Dr.Shah
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Diabetologist Dr. Riyaz Sheriff's  Response
Dear Sir/Madam,
Welcome to HCM,
Your friend seems to be quite familiar with dose adjustments in insulin pump which is a very good thing. I think the only thing we need to worry about is the ketone bodies. If the sugars come down successfully well i dont think she will need a ER treatment if Ketones are negative. She will need to take plenty of fluids to flush out the excess by products formed during hyperglycemic states. Ask her to monitor and if sugars are not coming down you can take her to ER.
Hope i have answered your query
Dr.Riyaz Sheriff
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Do Blood Sugar Levels Just Above 500 Need ER Treatment?

Brief answer : Yes , she should DETAILED ANSWER : Blood sugar above 500 is a medical emergency and shoudl be taken seriously as it can lead to 2 acute medical complications 1) Diabetic keto acidosis (DKA) 2) Hyperosmoler hyperglycemic state (HHS) Not everyone whose blood sugar goes over 500 mg/dl develops either condition , but to be on save side one should go to emergency. It is also likely that your insulin is denatured , if that is the case take insulin from new voil and new needle. But if blood sugar does not come down swiftly in response to your usual techniques, or if your blood sugar is over 300 mg/dl and you are vomiting and cannot keep down liquids, or having a lot of diarrhea, you do need to head to the ER. Other alarming symptoms include drowsiness and lethargy, delirium, coma, seizures, visual changes or disturbances, hemiparesis (one sided paralysis), and sensory deficits. In the ER you will undergo several tests like repeated RBS levels urine r/e urine for ketone bodies ABGs S.electrolytes Kindly rate my answer if i was of any help Regards Dr.Shah