What are the complications of high blood sugar levels?

Question

Hi doctor,

My father is 73 years old, 5 feet 8 inches in height, and weighs 264 pounds. He has type 2 diabetes, high blood pressure, gout, mild renal failure, and had a heart attack nearly 10 years ago, for which he had two stents placed in his heart. He also has high cholesterol and takes medication for these conditions. His blood sugar levels are usually between 20 to 30 mmol/L. He uses Lantus Solostar (62 units) and NovoRapid (60 units, 2 to 3 times a day) to manage his diabetes.

What complications could he face in the future if his blood sugar levels remain high?

Answer 1

Hi,

Welcome to icliniq.com.

Such high blood sugar levels may cause acute complications like dehydration, hyperosmolar hyperglycemic state (HHS), or diabetic ketoacidosis (DKA), which can be life-threatening. He should drink plenty of water to reduce the risk of dehydration. In the long term, consistently high blood sugar can lead to heart disease, worsening kidney disease, neuropathy, blindness, diabetic foot, or gangrene. Therefore, it is crucial to prioritize bringing his blood sugar under control.

As mentioned, his diet should be optimized, and his insulin doses should be adjusted. Both his Insulin glargine and Insulin aspart may need to be increased, but recent blood sugar readings are essential to determine the right adjustments. To do this, either use a glucometer to measure his blood sugar levels at home or have them tested at a nearby laboratory. Initially, it is important to get his blood sugar levels before breakfast and after lunch, with more frequent readings later for tighter control. The insulin dose adjustments will depend on these recent blood sugar levels.

Regards.

Answer 2

Hi,

Welcome back to icliniq.com.

The main risk of increasing insulin is low blood sugar. It can also cause skin changes at the injection site and may lead to weight gain, but if his diet is controlled, this risk is reduced. Compared to the risks of consistently high blood sugar, these side effects are less serious and should not prevent the use of higher insulin doses if needed. Has he tried other medications along with insulin to help keep his insulin dose lower?

Thanks and regards.