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Post by Merge on Aug 12, 2025 22:55:00 GMT
So my 24-year old landed in the ER yesterday because she was vomiting continuously, lightheaded, shaky, and some other stuff. Her boyfriend took her and I didn't hear about it until afterward.
She had been at a party the night before and they diagnosed her with cyclical vomiting from cannabis use? I'd never heard of that but sure. People her age do stupid things. They got her stable, sent her home with a Zofran prescription and that was that.
She was looking at the paperwork they sent home, which included the results from her bloodwork and urinalysis. Her blood glucose was over 200 and marked as elevated though the doctor never mentioned it. She also had high anion gap, though I don't remember what she said that was. And she had ketones in her urine, which I recall from the bad old days of low carb dieting is something that a healthy person shouldn't see unless you are really following a low-carb diet.
The ER doc mentioned none of this. My kid started googling and now thinks she may have adult onset diabetes.
She has a long history of digestive issues like nausea with no explanation found. She also has, by coincidence, her yearly checkup with her PCP on Friday, so obviously she will bring this up. She's a little overweight but not obese, though of course she's now afraid that she's caused herself diabetes by being fat.
Can anyone tell us if the blood glucose and the ketones are definitive markers of diabetes? If so, is there anything she should do between now and Friday to make sure she doesn't land in the ER again? Could it be something else? Why wouldn't the ER doctors have mentioned these numbers?
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Post by littlemama on Aug 12, 2025 22:57:37 GMT
They didnt mention them because they decided cannabis was responsible and they didnt look any farther. They should have at least told her to follow up- or maybe she mentioned she had an appt and they felt that was enough of a follow up
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Post by Merge on Aug 12, 2025 23:02:24 GMT
They didnt mention them because they decided cannabis was responsible and they didnt look any farther. They should have at least told her to follow up- or maybe she mentioned she had an appt and they felt that was enough of a follow up Yes, that's what I'm afraid of. She had been using cannabis and has a lot of tattoos so they wrote her off. Lovely. (Hey Houston peeps, if your kids don't fit the perfect boy or girl scout mold, tell them to avoid Methodist ER in the med center.) |
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Post by Zee on Aug 12, 2025 23:04:55 GMT
Those things are not "definitive" as they're more a snapshot in time when her body was in some physical stress BUT all of those things together are certainly highly suggestive and should be investigated fully by her PCP. She needs an a1c.
As to why the ER doc didn't mention it, it's possible the two are not at all related and they're focusing on her chief complaint rather than incidentals, but it's also sloppy and unfortunately what happens often in the ER if that's not what she went in complaining of.
Didn't necessarily warrant a full workup at that time if the blood sugar was only 200, but should have been counseled to follow up promptly with her PCP.
She didn't make herself diabetic by being overweight at the age of 24. She could very well have insulin resistance/a metabolic syndrome that is contributing to being overweight. In any case, she should NOT beat herself up over it. Knowledge is power and what she didn't know, she didn't know. Now she will and can address it.
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Post by mom on Aug 12, 2025 23:24:55 GMT
Having a high blood glucose once may not be something to worry about. You can have hyperglycemia without having diabetes. In fact, weed will raise your blood glucose levels for some people, though in others, it can lower glucose levels. Obviously, if her levels are higher frequently, then I would be worried.
The amount of keynotes in her urine is whats important -- everyone has some, it's just when you have a high level that you need to get checked out. Vomiting, diarrhea, working out, alcohol use -- they all can cause keytones to spill into urine.
Having an elevated high anion gap after using weed is also not unheard of. Alcohol will do this as well. Does your daughter drink often? When my son was in his active alcoholism, we saw this anion gap + keynotes go high, yet he wasn't a diabetic.
While I completely understand worrying about adult onset diabetes, I am not sure you (or she) has enough information yet to really worry. Definitely watch her glucose levels and note when they go higher and how often. They have at home tests to test for keytones and she could track her results for a bit to see if they continue to be high or if they fluctuate.
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Post by Linda on Aug 12, 2025 23:33:36 GMT
She didn't make herself diabetic by being overweight at the age of 24. She could very well have insulin resistance/a metabolic syndrome that is contributing to being overweight. In any case, she should NOT beat herself up over it. Knowledge is power and what she didn't know, she didn't know. Now she will and can address it. this is SO important - thank you! @merge - I wouldn't panic but it would be worth having her checked out sooner vs later by a competent PCP - and for her to bring her discharge paperwork to that appointment. I would expect them to order an A1C at a minimum. |
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Post by Merge on Aug 12, 2025 23:51:01 GMT
Having a high blood glucose once may not be something to worry about. You can have hyperglycemia without having diabetes. In fact, weed will raise your blood glucose levels for some people, though in others, it can lower glucose levels. Obviously, if her levels are higher frequently, then I would be worried. The amount of keynotes in her urine is whats important -- everyone has some, it's just when you have a high level that you need to get checked out. Vomiting, diarrhea, working out, alcohol use -- they all can cause keytones to spill into urine. Having an elevated high anion gap after using weed is also not unheard of. Alcohol will do this as well. Does your daughter drink often? When my son was in his active alcoholism, we saw this anion gap + keynotes go high, yet he wasn't a diabetic. While I completely understand worrying about adult onset diabetes, I am not sure you (or she) has enough information yet to really worry. Definitely watch her glucose levels and note when they go higher and how often. They have at home tests to test for keytones and she could track her results for a bit to see if they continue to be high or if they fluctuate. She does drink but not excessively these days. There was a time in her life when it was definitely excessive - don't know if that would carry over to now. She also doesn't usually mix alcohol and weed. Her ketone level shows as 2+. Not sure what that means. |
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Post by Merge on Aug 12, 2025 23:52:02 GMT
Thanks for everyone's responses. I do appreciate them!
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Post by mom on Aug 13, 2025 0:02:28 GMT
Having a high blood glucose once may not be something to worry about. You can have hyperglycemia without having diabetes. In fact, weed will raise your blood glucose levels for some people, though in others, it can lower glucose levels. Obviously, if her levels are higher frequently, then I would be worried. The amount of keynotes in her urine is whats important -- everyone has some, it's just when you have a high level that you need to get checked out. Vomiting, diarrhea, working out, alcohol use -- they all can cause keytones to spill into urine. Having an elevated high anion gap after using weed is also not unheard of. Alcohol will do this as well. Does your daughter drink often? When my son was in his active alcoholism, we saw this anion gap + keynotes go high, yet he wasn't a diabetic. While I completely understand worrying about adult onset diabetes, I am not sure you (or she) has enough information yet to really worry. Definitely watch her glucose levels and note when they go higher and how often. They have at home tests to test for keytones and she could track her results for a bit to see if they continue to be high or if they fluctuate. She does drink but not excessively these days. There was a time in her life when it was definitely excessive - don't know if that would carry over to now. She also doesn't usually mix alcohol and weed. Her ketone level shows as 2+. Not sure what that means. 2+ is high - and it needs checked out. .5 to 1.5 is ketosis. So anything higher needs to be checked asap. When you add in the elevated glucose, then yeah - diabetes is on the short list. I would be really concerned about diabetic ketoacidosis (which could cause her to throw up). What’s her breath smell like? Fruity by any chance? |
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Post by Merge on Aug 13, 2025 0:06:49 GMT
She does drink but not excessively these days. There was a time in her life when it was definitely excessive - don't know if that would carry over to now. She also doesn't usually mix alcohol and weed. Her ketone level shows as 2+. Not sure what that means. 2+ is high - and it needs checked out. .5 to 1.5 is ketosis. So anything higher needs to be checked asap. When you add in the elevated glucose, then yeah - diabetes is on the short list. I would be really concerned about diabetic ketoacidosis (which could cause her to throw up). What’s her breath smell like? Fruity by any chance? I asked her about that. She said her breath was "sweet." What happens with ketoacidosis? Is she in imminent danger? She called her doctor about an earlier appointment this afternoon and they can't get her in until her scheduled appointment on Friday. She went out and bought a cheap glucose monitor and ketone test strips. |
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Post by mom on Aug 13, 2025 0:37:03 GMT
Merge  If this were my kid, we’d be taking his glucose levels and if they continue to be over 200 fasting, or if he continues to throw up, we’d go to the ER. Or really, if he had any of the signs in the photo. And here is a snapshot of what ketoacidosis does - it’s not something to mess around with especially if you think you could be a diabetic. 
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Post by Merge on Aug 13, 2025 0:44:17 GMT
Merge If this were my kid, we’d be taking his glucose levels and if they continue to be over 200 fasting, or if he continues to throw up, we’d go to the ER. Or really, if he had any of the signs in the photo. And here is a snapshot of what ketoacidosis does - it’s not something to mess around with especially if you think you could be a diabetic. Ok. So far today her glucose has either been a little low or in the normal range, and she’s not having those symptoms any more. She’s going to keep testing as you suggest and call me if she gets another high reading or starts feeling bad again so we can get her to the ER. And thank you. I do appreciate your advice. |
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Post by iamkristinl16 on Aug 13, 2025 1:22:45 GMT
I don’t know if this is relevant, but several months ago there was someone here who posted about her daughter having unexplained nausea, vomiting, etc. It turned out to be CHS (cannabinoid hyperemesis syndrome). So it is definitely possible for young people to have GI symptoms as a result of THC use. That being said, I’m glad she already has a physical coming up soon so she can talk to the Dr about the concerns/potential diabetes.
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Post by Merge on Aug 13, 2025 1:27:39 GMT
I don’t know if this is relevant, but several months ago there was someone here who posted about her daughter having unexplained nausea, vomiting, etc. It turned out to be CHS (cannabinoid hyperemesis syndrome). So it is definitely possible for young people to have GI symptoms as a result of THC use. That being said, I’m glad she already has a physical coming up soon so she can talk to the Dr about the concerns/potential diabetes. Yes, that's what they said she had. I must have missed that thread. I'm glad she has a physical, too, and that her job is very chill about people being out for medical appointments. |
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Post by iamkristinl16 on Aug 13, 2025 1:34:03 GMT
I don’t know if this is relevant, but several months ago there was someone here who posted about her daughter having unexplained nausea, vomiting, etc. It turned out to be CHS (cannabinoid hyperemesis syndrome). So it is definitely possible for young people to have GI symptoms as a result of THC use. That being said, I’m glad she already has a physical coming up soon so she can talk to the Dr about the concerns/potential diabetes. Yes, that's what they said she had. I must have missed that thread. I'm glad she has a physical, too, and that her job is very chill about people being out for medical appointments. Your dd may have something else going on, but I thought I would mention it in case you or anyone else reading missed the thread. Iirc that peas daughter had been having really bad symptoms for quite some time and had spent a lot of time doctoring before talking to the provider about her thc use. I hope your dd gets answers soon! |
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Post by scrapmaven on Aug 13, 2025 1:47:44 GMT
I was told that you need 2 high glucose readings to be considered diabetic. Bear in mind that I'm not a medical professional. Has your dd ever had a motility workup?
Gastroparesis can accompany diabetes. That is slow emptying and could explain the nausea. The nausea could also be explained by a zillion other things. So, take my words with a grain of salt. Might be worth asking her PCP about motility if the PCP thinks that your dd is diabetic. Again, don't worry about motility. It's just an idea and I don't know medical stuff from Adam.
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Post by voltagain on Aug 13, 2025 3:20:02 GMT
So my 24-year old landed in the ER yesterday because she was vomiting continuously, lightheaded, shaky, and some other stuff. Her boyfriend took her and I didn't hear about it until afterward. She had been at a party the night before and they diagnosed her with cyclical vomiting from cannabis use? I'd never heard of that but sure. People her age do stupid things. They got her stable, sent her home with a Zofran prescription and that was that. She was looking at the paperwork they sent home, which included the results from her bloodwork and urinalysis. Her blood glucose was over 200 and marked as elevated though the doctor never mentioned it. She also had high anion gap, though I don't remember what she said that was. And she had ketones in her urine, which I recall from the bad old days of low carb dieting is something that a healthy person shouldn't see unless you are really following a low-carb diet. The ER doc mentioned none of this. My kid started googling and now thinks she may have adult onset diabetes. She has a long history of digestive issues like nausea with no explanation found. She also has, by coincidence, her yearly checkup with her PCP on Friday, so obviously she will bring this up. She's a little overweight but not obese, though of course she's now afraid that she's caused herself diabetes by being fat. Can anyone tell us if the blood glucose and the ketones are definitive markers of diabetes? If so, is there anything she should do between now and Friday to make sure she doesn't land in the ER again? Could it be something else? Why wouldn't the ER doctors have mentioned these numbers?
One time "snap shot" such as she got, they absolutely are NOT markers of diabetes. What she had to eat/drink during the two or three hours prior to the blood work can show those without there being an issue. The most definitive test for diabetes is an A1C test and/or a fasting glucose challenge. Where you only have water for 8+ hours before the test starts, get a measured glucose drink to chug down and they watch how fast your blood sugar rises and returns to the baseline. 200 also is not a worrisome elevation by itself without context of when/what she last ate/drank. She is fine until she sees her doc. Also, we know now that being fat is not the only cause of diabetes. Having elevated blood sugar can cause you to gain weight. It can be a vicious cycle where the easy out is to blame the person as being morally degenerate. Diabetes is also caused by autoimmune disfunction. Good luck. Hope her primary care doc is more helpful. If her PCP does find she is diabetic or pre-diabetic see if you can locate a community health nurse who specializes in diabetic care. Mine has extremely helpful education information, how to cook foods, eat out, manage my meds... and most importantly she has long enough appointment times to not make me feel hurried. eta: They didn't mention it because by itself those numbers are meaningless. If she had been admitted for a hospital stay they would have recorded and monitored them. I've been a diagnosed T2 (now also insulin dependent) since 2008 or 9. |
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Post by librarylady on Aug 13, 2025 15:22:18 GMT
As others mentioned, one test does not qualify for a diagnosis.
A blood test after 8 hours of fasting is used to indicate diabetes. If that points to diabetes, then the test will be given where she consumes something high in sugar and then she is tested 2 hours later to see how her body has handled this high glucose. Then a proper diagnosis can be made.
Diabetes is an awful disease to handle because what works today may or may not work the next day.
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smartypants71
Drama Llama
Posts: 5,992 
Location: Houston, TX
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Post by smartypants71 on Aug 13, 2025 16:36:02 GMT
I can only speak to Type 1 diabetes, but *I* wouldn't be vomiting with a bg of 200. Mine would have to be over 300 for the nausea to kick in, but that may be bc I've had it for a while. At my initial dx, I was rapidly losing weight, yet had overwhelming hunger and excessive urination, but symptoms are maybe less noticeable in adult-onset cases.
I've only been in severe DKA twice and needed a hospital admission to ICU both times.
My advice is to follow up with a specialist. I don't really have faith in medical professionals who don't specialize in diabetes. I have so many nightmare stories of doctors lecturing me on my care when they were absolutely wrong. If she IS dx'd with diabetes, I would make sure they include an antibody test to determine which type.
If she needs a good endocrinologist, I have an awesome one in Bellaire. PM me if you'd like the info.
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Post by librarylady on Aug 13, 2025 17:20:54 GMT
Echo smartypants71 recommendation to consult a physician who specializes in diabetes. As she said, there is lots of bad information swirling around diabetes. DH visited with on such doctor. That doctor boldly told the patient "I will only treat your diabetes, do not try to bring up any other issue or concerns with me." That doctor got DH on the right track and then DH returned to having his internist handle things. |
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smartypants71
Drama Llama
Posts: 5,992
Location: Houston, TX
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Post by smartypants71 on Aug 13, 2025 19:46:12 GMT
Echo smartypants71 recommendation to consult a physician who specializes in diabetes. As she said, there is lots of bad information swirling around diabetes. DH visited with on such doctor. That doctor boldly told the patient "I will only treat your diabetes, do not try to bring up any other issue or concerns with me." That doctor got DH on the right track and then DH returned to having his internist handle things. OMG - I was getting my retina exam with an MD eye dr. He tried to change my chart to say I had T2D instead of T1D because he said I was too old to have Type 1. I argued with him, and he YELLS at me asking me "did you go to med school?". So I yelled back "did YOU?  ". Needless to say we don't see that guy anymore! |
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Post by Zee on Aug 13, 2025 20:37:44 GMT
Echo smartypants71 recommendation to consult a physician who specializes in diabetes. As she said, there is lots of bad information swirling around diabetes. DH visited with on such doctor. That doctor boldly told the patient "I will only treat your diabetes, do not try to bring up any other issue or concerns with me." That doctor got DH on the right track and then DH returned to having his internist handle things. OMG - I was getting my retina exam with an MD eye dr. He tried to change my chart to say I had T2D instead of T1D because he said I was too old to have Type 1. I argued with him, and he YELLS at me asking me "did you go to med school?". So I yelled back "did YOU? ". Needless to say we don't see that guy anymore! 😳😳😳 That's frightening! |
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". Needless to say we don't see that guy anymore!