Jennifer over at In Jennifer’s Head has a short post about her recent physical exam. In Did You Know she says,
That when you go in for that annual health screening so generously provided by your employer and they read your blood glucose at 54* that the nice little nurse lady will escort you to the fruit stand and make you eat a banana?
I think I would have told that nurse where to stick the banana. I’m always amazed at the number of people, including medical people who don’t get the concept here.
First, if Jennifer is not a diabetic, and she isn’t, why are they checking her blood glucose unless they suspect that she has developed Type II diabetes? If her mental status is normal, and having met and talked with her, I can assure you that it’s above normal, there isn’t any reason to check this. Well other than being “thorough” which more and more means seems to mean “Covering our asses.”
If you are screening for Type II Diabetes, that’s fine. However, Type II Diabetes typically has very high blood glucose readings, not low readings. Assuming that Jennifer was fasting and is not a Type I Diabetic, then a blood glucose of 54 is nothing to worry about because her body can release and use stored glucose in various forms to produce energy.
There no need for the nice little nurse lady to panic and insist that Jennifer eat a banana, drink orange juice, or do anything else to boost her glucose level. All Jennifer has to do is finish being examined and go out for breakfast (or lunch) like any other person would do when they get hungry.
Still this confusion persists at all levels of medicine. I wrote about it back in 2011. Neither medicine nor my opinions have changed since then, so I think it’s a good reference point.
I don’t know why people don’t get this. Maybe the answer is to do some “rebranding”. I know that both are caused with Insulin regulation problems, but how they are seen, evaluated, and treated are different, especially in the pre hospital setting. Rarely, well never, did I see a Type I Diabetic call because their blood glucose is too high. Rarely, but occasionally, I did see a Type II Diabetic who was hypoglycemic. The ones I did very sick, but still it was pretty rare. In no case did I ever find it necessary to provide ALS treatment to a person with a Diabetes history who was conscious and alert. At least not for the Diabetes.
It’s probably just me not having enough important subjects to write about, but it really does annoy me.