Diabetic help required

[BAKERS DOZEN]

Mr BD was diagnosed as being diabetic four weeks ago and is on insulin twice a day - 34 units am and 30 units pm. He has just admitted to me that for the past couple of days he has had trouble with his hands shaking when he tries to do something. When sitting or standing he is OK but it has just taken him over ten minutes to write the figures "7.4" in his log book because his hands were shaking that much. Last night he had difficulty holding his knife and fork. He has been on Metformin 500mg tablets for the past week as well as his insulin. Any ideas please about what could be causing this or should I get him to the docs tomorrow? Thanks in advance for any advice.

[Sqad]

That 7.4 is a one off..........what are his other blood sugar levels?

It sounds as though he is taking too much insulin.......I would give him a drink of fruit juice and see if that stops the shaking.........i either case, record his blood sugar levels first thing in the morning mid afternoon and last thing at night.

It sounds as though his blood sugar sometime during the day is low.

[BAKERS DOZEN]

The last few days have been 8.7/7.5 then 8.9/10.7 then 11.3/9.4 then 7.6/10.4. Yesterday 5.7/6.3 and today 7.4/5.2. He was told by the diabetic nurse just to record it before breakfast and before his evening meal.

[Sqad]

BD.....those figures would not suggest that he was hypoglycaemic.....try the 6fluid ozs of fruit juice and see if that affects the shaking and get back to us.

[BAKERS DOZEN]

Thanks for your help Sqad. What I don't understand is that his hands are not shaking at all normally but only when he picks up a fork or a pen. He has had one Metformim tablet a day for a week and three days ago moved up to two tablets a day (one morning and one evening) and has since had diarrhoea. Could it be his body is adjusting to the new dosage?

[Sqad]

My guess would be that the diarrhea is caused by the Metformin and I must day that 500mgms of Metformin and his insulin is quite a high dose, but presumably his Metformin was increased because of high blood sugar readings.

No need to panic at this stage.

[BAKERS DOZEN]

You are a star. Many thanks. Will keep my eye on him.