Is Blood-Sugar Equipment A Waste Of Time?

Discussions of the best (or worst) equipment to have on hand for use in the event of an injury during an emergency.

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Is Blood-Sugar Equipment A Waste Of Time?

Post by Hakamori-San » Sat Jan 15, 2011 12:25 pm

I was sitting an thinking about the Diabetic Equipment such as Blood-Sugar Meter, Grape-Sugar and those kind of stuff, could that be useful.
I need, as a Diabetic, this kind of equipment, but could you Non-Diabetics find it useful or would it just be a waste of room and weight.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by Krustofski » Sat Jan 15, 2011 12:57 pm

That depends on two things.

1) what is your level of training
2) do you expect to treat
a) diabetics
b) drunks

So, 1) is pretty self-explaining. If you know how to use a glucometer, standard values of blood sugar, and what to do in case of both hypo- and hyperglycemia, that's great.
As for 2), a) is also pretty self-explaining. Hyperglycemia in diabetics is kinda duh, and hypoglycemia... well, accidental intravascular injection of insuline, anyone?
That leaves us with the drunks. Consumption of larger quantities of alcohol can lead to dangerously low levels of blood sugar. Alcohol blocks gluconeogenesis in the liver. So, you find your friend Mike curled up on the bathroom floor. He stinks of vodka. He appears very drunk, but he's still responsive and all to well for you to call 911. I mean, he wakes up, and even tries to talk to you after a few slaps in the face. He has been worse and lived, so why bother? You drag him to his feet, stumble to his bedroom, and throw him in his bed to sleep it off. The next morning he's in critical condition and might end up in the ICU. What happened?
Typical symptons of hypoglycemia include sweating, nausea, vomiting, drowsiness, vertigo, tremor, cognitive disfunction, senseles babble... typical symptoms of milder forms of alcohol intoxication include... the same. You didn't realize Mike had a BGL of 20 mg/dl, and that's what fucked him up.

tl;dr: Under certain conditions, blood sugar equipment can make sense.



ETA: After reading my post again, I realized that I come of as a bit of a smartass douche. Sorry, I didn't mean to sound like that, I was angry while writing for something completely unrelated to this forum.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by Hakamori-San » Sat Jan 15, 2011 2:51 pm

Its Cool man, I'm not that easy to piss off. The funny thing is the fact that my real name is Mike and when i (The few times) drink i actually drink Vodka :lol:
Back to Topic; I haven't taken Insulin by a mistake but it happens that i take to much and i end up on my bed with Hypoglycemia, but that makes me think of, when you run/exercise your blood-sugar can drop fast to critical.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by J.C. » Sat Jan 15, 2011 4:31 pm

Hakamori-San wrote:I was sitting an thinking about the Diabetic Equipment such as Blood-Sugar Meter, Grape-Sugar and those kind of stuff, could that be useful.
I need, as a Diabetic, this kind of equipment, but could you Non-Diabetics find it useful or would it just be a waste of room and weight.
I have it in my FAK but only because my wife is type 1. She has her own supplies too and it would be the first thing she would grab but she has several meters and such so I keep one in the FAK that is attached to my BOB. I don't see the point for those that don't have the same condition.
squinty wrote: Birds gotta fly, fish gotta swim, zombies gotta shuffle around and eatcher brains. Why do sharks eat divers? Why not swim around and starve to death?
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by Apache » Sat Jan 15, 2011 6:14 pm

Depends on the context you are talking about. If you mean as a kit to use now then a glucometer is a very useful thing to have, especially if you have a family member who is diabetic. Make sure you have a means of raising blood sugar, otherwise it's pointless.

If you are talking end of the world scenario then no use at all. All diabetics would die once the insulin stocks had run out.
crypto wrote:So, yeah, well be fucked when theres no more antibiotics, but so will all the old people without boners.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by jmstevens2 » Sat Jan 15, 2011 9:00 pm

In a word, yes. Unless you have insulin, if they are altered, give them sugar. If they are low, it will bring them up, if they are too high, you can't fix that anyway. You don't really need to know if it is high or low. We did that for decades as Paramedics until the glucometers became small enough and reliable enough for us to test them. Decreased mental status, Narcan and D50.
If you have equipment, training, meds and a diagnosis that requires it, that might be different. How long will your insulin last without refrigeration?
Most people seem to forget that in a PAW, which is the context most use, without the follow up care most serious stuff will be fatal. We carry pressure dressings and such, but who is going to fix the underlying tissue damage? Where are the antibiotics going to come from?
Paw or massive Disaster, we need to think about down the road and not just right now. Most of the stuff I have been taught for disaster medicine flat out tells us that insulin dependent diabetics will not survive if it is more than a week beyond their med supply.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by Apache » Sun Jan 16, 2011 7:36 am

jmstevens2 wrote:Most of the stuff I have been taught for disaster medicine flat out tells us that insulin dependent diabetics will not survive if it is more than a week beyond their med supply.
Pah, much longer than that in most cases, especially if avoiding highly processed foods.

You'll pee a lot and drink a lot and lose weight. Might actually be a slow unpleasant death as you go blind, pick up infections and fingers and toes fall off!

I had a patient that was a cat diagnosed with diabetes, he wouldn't stand the injections. We left him until his quality of life was compromised - think he lived ~9months after diagnosis. Not a quick death by any means
crypto wrote:So, yeah, well be fucked when theres no more antibiotics, but so will all the old people without boners.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by KMAC179 » Sun Jan 16, 2011 5:21 pm

i wouldnt go out and buy one unless you have a more specific reason. i carry 1 of my spares, if nothing else just to determine what is wrong regardless of if i can treat it (hyper) anyone can treat (at least temporary) mild to moderate hypo.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by J.C. » Sun Jan 16, 2011 5:31 pm

Apache wrote:
If you are talking end of the world scenario then no use at all. All diabetics would die once the insulin stocks had run out.
I guess it depends on the sort of end of the world you are talking about. If there is still livestock, its actually possible to extract it without really sophisticated equipment. It was done for hundreds of people in Shanghai during World War II.
squinty wrote: Birds gotta fly, fish gotta swim, zombies gotta shuffle around and eatcher brains. Why do sharks eat divers? Why not swim around and starve to death?
Why do tornadoes zero in on trailer parks? Why not just blow around harmlessly? It's the way of the world, man.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by dallas » Mon Feb 21, 2011 9:31 pm

Hakamori-San ,
Are you type 1 or 2?

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by GP11 » Thu Feb 24, 2011 1:35 pm

jmstevens2 wrote:Most people seem to forget that in a PAW, which is the context most use, without the follow up care most serious stuff will be fatal. We carry pressure dressings and such, but who is going to fix the underlying tissue damage? Where are the antibiotics going to come from?
Paw or massive Disaster, we need to think about down the road and not just right now. Most of the stuff I have been taught for disaster medicine flat out tells us that insulin dependent diabetics will not survive if it is more than a week beyond their med supply.
Also in the PAW world context the glucometer is going to become useless pretty quickly. At least in my experience the test strips on are one of the places that the expiration dates really mean something--they become inaccurate pretty quickly after they expire, so it's not one of those things where you can lay in a lifetime supply.

If I were an insulin-dependent diabetic and were worried about never again having access to manufactured insulin in a PAW, I'd learn to extract insulin from pancreas using Paulescu's method or some variation.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by dallas » Thu Feb 24, 2011 3:20 pm

If you are type 2, get skinny with diet and excercise now.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by skukuza » Sat Feb 26, 2011 7:00 am

I work with a diabetic and he is totaly useless at keeping an eye on his blood sugar levels despite having the problem since birth.
Quite often his levels can be as high as 19 and as low as 1 or 2.
I have called an ambulance before and also had to get glucose down his throat, so I would reckon that having some glucose would be a life saver for such an event, of course you will need to know the symptoms first.
As I am aware of his condition and have had to deal with his Hypers and Hypos I am quite clear in seeing the early stages of the onset of either, here I will tell him to do a blood test and treat acordingly.
Rarely will I step in unless needed.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by dallas » Sat Feb 26, 2011 2:17 pm

skukuza wrote:I work with a diabetic and he is totaly useless at keeping an eye on his blood sugar levels despite having the problem since birth.
Quite often his levels can be as high as 19 and as low as 1 or 2.
I have called an ambulance before and also had to get glucose down his throat, so I would reckon that having some glucose would be a life saver for such an event, of course you will need to know the symptoms first.
As I am aware of his condition and have had to deal with his Hypers and Hypos I am quite clear in seeing the early stages of the onset of either, here I will tell him to do a blood test and treat acordingly.
Rarely will I step in unless needed.
Unfortunately, control like that leads to a short miserable life. I hate working on patients like that.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by skukuza » Sat Feb 26, 2011 2:36 pm

The bad thing about this Guy is when he is on a 'low' he can become nasty and while trying to get him to realise he is low ,has had a real go at me, verbaly and sometimes almost physically, its only a matter of time before those that try to help him stop and as you say, it can be a miserable life, and he is certainly having one of those, you can only sympathise with someone for so long.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by Medic Mentor » Mon Feb 28, 2011 2:26 pm

Very handy to have a glucometer for Heat Exhaustion/Stroke or Hypothermia patients.

But if the person is altered your treatment will be limited to your scope of practice and training.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by grand94jeep » Thu Mar 03, 2011 4:56 am

Not for me.

My father-in-law has dropped into two diabetic comas in the past week and a half. This was after almost 2 years of not having this happen. He's had a few stints put in and his new-found energy levels are causing his insulin dosage levels to be way off. He's on a pump. He's also on hemo-dialysis 3 (4hrs each) times a week, with his kidney function at 7%. He had a heart attack 7 years ago, and he's 58.

Both times we had difficulty locating his meter. When someone is unconscious and you suspect low blood sugar, minutes count. His first incident was at 38, this last one was 28. It took EMS 7mins to respond. My mother-in-law waited 5-10mins, before she called me to ask for help, as we live with them. That means 12-17mins from the time she discovered him till EMS is on scene. It then took EMS about another 5 mins (had difficulty hitting a vein) to run an IV to get him a glucose shot. Now we're up to 17-22mins. I wanted my own test kit that I could grab, as soon as I got word that he was unconscious. That and I now make sure I put my cell phone in my pocket and/or grab the house phone (portable) on the way to their room. I want to be able to shave off as much time as I can for response time, in anyway that I can. We have requested glucogen shots for us to keep at the house, and I'm going to make sure my wife and I have training. My MIL panics whenever this happens and goes into prayer mode, instead of getting training and learning how to respond. Trust me, it's infuriating that after 37 years married, she is like that. :x

I went out and picked up a CVS brand tester, with 10 sample strips for $15. Best of all, it comes with a mail in rebate, so it's basically free, if you submit the rebate. With a deal like that, why not get training and get one for your FAK? :idea:


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skukuza wrote:I work with a diabetic and he is totaly useless at keeping an eye on his blood sugar levels despite having the problem since birth.
Quite often his levels can be as high as 19 and as low as 1 or 2.
I have called an ambulance before and also had to get glucose down his throat, so I would reckon that having some glucose would be a life saver for such an event, of course you will need to know the symptoms first.
As I am aware of his condition and have had to deal with his Hypers and Hypos I am quite clear in seeing the early stages of the onset of either, here I will tell him to do a blood test and treat acordingly.
Rarely will I step in unless needed.
Either your "0" key doesn't work when pressed, or your numbers are wrong. :wink:

If he's dropping to 1-2 or 10-20 as I hope you're trying to say, he needs to get his shit sorted. :shock: It is seriously bad for his body to repeatedly drop into those ranges. :!: He'll be lucky to make it out of his 40's-50's, if he even makes it that long.

I do know what you're saying about being people being useless about keeping track of their sugar levels. It's been my experience that you just can't help those, that won't help themselves. Although, you're a good man for continuing to try. I know how infuriating it can be.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by dallas » Thu Mar 03, 2011 7:10 am

That is in mmol/l. The normal range is around 5. Multiply by 18 to get US values.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by grand94jeep » Thu Mar 03, 2011 6:58 pm

dallas wrote:That is in mmol/l. The normal range is around 5. Multiply by 18 to get US values.
Thank you for clearing that up. I'm still learning. :D

I still stand by my original comment, modified with newly calculated numbers, thanks to Dallas.
grand94jeep wrote: If he's dropping to 18-36, he needs to get his shit sorted. :shock: It is seriously bad for his body to repeatedly drop into those ranges. :!: He'll be lucky to make it out of his 40's-50's, if he even makes it that long.
skukuza wrote:The bad thing about this Guy is when he is on a 'low' he can become nasty and while trying to get him to realise he is low ,has had a real go at me, verbaly and sometimes almost physically, its only a matter of time before those that try to help him stop and as you say, it can be a miserable life, and he is certainly having one of those, you can only sympathise with someone for so long.
Also, I forgot to mention in my last post, my FIL is a relatively small man (around 5'7"), and has been in poor health the last few years. Even after all his poor health, I've seen him get aggressive and give my 6'6" 300+lb bro-in-law a run for his money. For a little guy, when he gets that way, he's incredibly strong. :shock:

Just keep in mind Skukuza, that while he should be helping himself keep from getting that way; he cannot control how he acts once he gets that low.

As I said before, you're a good dude for continuing to help, even if it's hard to sympathize with him. :)
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by doitnstyle1 » Thu Mar 03, 2011 7:15 pm

You have to consider that you could also check for Hypoglycemia. In a PAW situation where there is scarece food and a lot of nasties going around, it could become a useful tool to distinguish between HG and something else. It is not only used for diabetics.

I remember greying out once and stopped to get checked out. the EMT checked my BSL and found I was dangerously low. I had actually forgot to eat for three days because of work and the long hours I was pulling. They gave me some juice and and IV and let me go under protest. Once I knew what the problem was I was able to fix it. I ate steadily for the next three days.

it could be a useful diagnostic tool if the strips are not expired, it doesn't take up much space and when the strips expire you can toss it. I have one in my bag and have used it successfully several times. I found that three women were dangerously low beacuse of a stupid diet they were trying.
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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by J.C. » Thu Mar 03, 2011 7:49 pm

I'm sure everyone is different but highs and lows are very different symptoms - at least until they are unconscious. When my wife is low she acts like she is a little bit intoxicated. If she gets to this state she will not always be able to recognize and correct it on her own due to difficulty completing thoughts or actions without getting distracted. This begins to happen below 50 for her. She is on a pump and a continuous meter so it is relatively rare but they keep her baseline pretty close to normal so if she exercises without eating enough she can easily drop low. Before hand-held meters managed diabetics had to run high pretty much all the time and this creates a lot of long-term problems. Highs she will more readily notice herself due to classic symptoms like being thirsty all the time.
squinty wrote: Birds gotta fly, fish gotta swim, zombies gotta shuffle around and eatcher brains. Why do sharks eat divers? Why not swim around and starve to death?
Why do tornadoes zero in on trailer parks? Why not just blow around harmlessly? It's the way of the world, man.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by Entropy0311 » Fri Mar 11, 2011 7:26 pm

I wouldn't say it's a waste of time. BG is nice to know for all kinds of reasons. The obvious danger of hypoglycemia aside, hyperglycemia causes dehydration and hypercoagulability, among other things. But, a glucometer isn't always, or even often, needed to diagnose derangements in blood glucose. Someone who is irritable and lethargic and has had poor intake over the last 24 hours probably should eat. Someone who is pissing constantly, unable to get through a meal without drinking a gallon of water, and always hungry, while all the time just getting sicker, is very probably high. Give fluid, insulin, and K+ if you have it. In cases of suspected new onset diabetes, do what the Romans did: get someone to taste the piss. In hyperglycemia, sugar spills over into the urine and it (I'm told) tastes sweet. They'll need insulin.

In protracted SHTF scenarios, diabetics will eventually just die. Your continued existence is a luxury afforded you by advanced medical practice and wide availability of insulin. No offense.

Lest I forget the coolest thing to do with a glucometer: check the clear stuff coming out of their nose after they just smashed their head to see if it's snot or CSF leaking out.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by Krustofski » Fri Mar 11, 2011 9:09 pm

J.C. wrote:
Apache wrote:
If you are talking end of the world scenario then no use at all. All diabetics would die once the insulin stocks had run out.
I guess it depends on the sort of end of the world you are talking about. If there is still livestock, its actually possible to extract it without really sophisticated equipment. It was done for hundreds of people in Shanghai during World War II.
No. Yes. No.
Insulin produced this way is going to be a highly valuable luxury product. The process is simple enough, and given some time, literature, and low-tech equipment, I think I could do it. It would need some getting used to a more primitive approach ("What, no Western blot?!?!"), but the isolation alone is pretty straightforward. There are problems, some of them severe, concerning microbiological safety, hygiene, sanitation, purification, pirogen-free material etc. etc., but they all can be overcome with 19th century technology. THAT BEING SAID, the Saxls got incredibly lucky. They had well-meaning Chinese helpers, a complete laboratory and, above all, a CONSTANT SUPPLY OF SLAUGHTERHOUSE WASTE. A lot of people seem to forget, but without a highly industrialized meat production, livestock is a luxury. Sure, you can raise enough chicken, rabbits, pigs, goats, hell even cattle, to eat a little meat every now and then, without much infrastructure. But you can completely forget about ever getting your hands on a sufficient amount of pancreas to produce enough insulin for even a few diabetics without access to a slaughterhouse.
Isulin nowadays is mostly produced in genetically modiefied yeast, not only because it's easier and safer, but also because there simply isn't enough slaughterhouse waste to keep up with demand.

tl;dr: Safe for individual cases, I doubt that's a viable option.

Okay, so much for pointless rambling, BTT.
Off the internet until further notice.

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Re: Is Blood-Sugar Equipment A Waste Of Time?

Post by grand94jeep » Sat Mar 12, 2011 8:06 pm

Entropy0311 wrote:
Lest I forget the coolest thing to do with a glucometer: check the clear stuff coming out of their nose after they just smashed their head to see if it's snot or CSF leaking out.
I'm curious. Please explain. :?:
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