Short but not very sweet!
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A 17-year-old high school senior presented with diabetic ketoacidosis (glucose 720, pH 7.13) after feeling progressively unwell and tired for about three months. When I saw him the morning after his admission, he had recovered well and was alert enough to begin a discussion about diabetes including types 1, 2 and 1.5.
He reported that his father had diabetes as did an older sister and an aunt. I quickly picked up on that and suggested that learning how to check his blood sugar would be easy since he must have seen his father do so many times.
The father, who was in the room, looked stunned. He had absolutely no idea what I was talking about. He had carried the diagnosis for 18 months, took his metformin and glipizide regularly and felt fine. He had never been advised to check his blood glucose and had no knowledge of his HbA1c nor what I was talking about.
The FDA is appropriately concerned about the accuracy and reliability of some of the available glucose meters and is considering new standards. They can insist on the best technology possible, but it goes for naught if there are clinicians who either dont have the time or take the time to instruct the patient about the importance of checking capillary blood glucose.
Will someone please assure me that this father was an isolated case?!
PS: The young man is doing well and father and son are enjoying the closeness of learning about diabetes together. They are both competitive but have avoided playing the game of my sugar level is better than yours!