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Grandma in the ER

My grandmother's new primary care physician does not believe she has diabetes. She was diagnosed with diabetes by a doctor in another state. She was taken off of diabetes medication due to concerns of kidney damage. Her nephrologist said her kidneys were fine a month or two ago. He requested blood work prior to her followup appointment. Her glucose levels were at 480. He thought it was strange that her primary care physician wasn't doing anything to control her glucose levels. He told her to contact her doctor immediately in regards to high blood glucose. This was on Monday. She had an appointment with her primary care physician on Tuesday anyways for an unrelated issue. She said she told her primary care physician about the blood work, but her doctor didn't take it seriously or did not believe her. This is where my sister intervened. She received a call from the nephrologist's office nurse with her concerns about the blood glucose. I guess she was just following up. My sister called the primary care physician and was told that there were no available appointments until May 10th. The office worker was rude and stated that she wasn't a doctor and did not know anything about diabetes. I guess the office worker got upset when my sister was trying to explain to her that a 480 reading is cause for concern. At this point, I got involved and checked her blood glucose levels. The meter was reading Hi, which indicates a reading of above 600. This was this afternoon. I called her primary care physician's office and explained what was happening. She didn't seem to care much and stated that there were no available appointments. It finally got her attention when I told her that the meter was reading above its maximum level. She then spoke with a physician and advised us to go to the emergency room immediately. My grandmother was admitted and had a 576 blood glucose reading. I was giving her water to hydrate her to try and lower it. I feel horrible that I didn't do more to understand exactly what range her blood glucose should be at. She has to stay overnight. They inserted an IV and are slowly bringing her blood glucose levels down. They also said she has some type of infection that could cause organ failure. I'm pretty upset with how her primary care physician handled the situation. She knew about the elevated levels on Tuesday. She could have prevented my grandmother from going to the ER. I don't know what exactly my question is. I'm just trying to figure out if I'm just overacting or was it our responsibility to do more than notify her doctor. I always just assumed that the doctor would recommend what steps should be taken. With a 480 level, should I have taken her to the ER on Monday?
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Avatar universal
No, in my opinion you have done everything right. Your family relied naturally on her doctor's expertise. It is hard to resist a doctor, a medical expert saying "it's nothing, don't worry", let alone if he implies you are overreacting. What would I do? Fire the doctor immediately after letting him know how displeased you are with his criminal negligence. Then find another doctor, or perhaps an endo, who will take your grandmother's situation in hand.

As for "knowing what to do at certain numbers" it generally works out best if the person with diabetes monitors their own numbers and knows what to do if there is a problem. I'm not sure how old your grandmother is or her degree of responsibility. I belong to a website where people exchange information and monitor their own diabets and there are some 80 year olds on that website! My guess is her numbers have been running too high for awhile. Does she have a meter? Does she know what her blood sugar should be?I wouldn't run to the ER if I had a 480 (though I haven't seen numbers like that since I first got diagnosed) unless I was also feeling quite ill or couldn't get the blood sugar down with corrections. She can also buy test strips that test for ketones which are what make high numbers dangerous. You did the right thing by trying to hydrate her. Without her being on insulin, it is very hard to treat numbers like that, and the doctor should have seen her right away.

I hope she recovers from her infection and when she is home the best support you can be is find her a good endo and then encourage her to learn to manage her diabetes on her own by educating herself and frequent testing.
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Avatar universal
I found out a little more information. The ER physician said that the infection was likely the cause of the glucose levels being high. I guess my grandmother's primary care physician didn't believe my grandmother had diabetes based on prior tests. For some reason, she disregarded the lab results sent to the nephrologist.
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yes rite away
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