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hepatitis C with diabetes

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Posted 3/20/2013 2:34 AM (GMT 0)
My father diagnosed with hepatitis-C 4 years ago. Now suffering with liver cirrhosis like complicity and high blood sugar level. Last night he became very sick and showing unwillingness to talk, drink, eat as well as stubbornness like mad. What to do? Any suggestion will be highly appreciable.
Posted 3/20/2013 3:10 AM (GMT 0)
Does he have a doctor? Have you called them, or taken him into an ER? It sounds as if he needs immediate medical attention.
Posted 3/20/2013 3:33 AM (GMT 0)
He just taken to local clinic. Dr. yet to come!!! We failed to give him regular medication and insulin because of vomiting.
Posted 3/20/2013 5:06 AM (GMT 0)
Hello, umhafiz, and welcome to the forum. Is your dad on Lactulose? It sounds like he is having an episode of hepatic encephalopathy (HE), which is ammonia that has gone to the brain. The liver is unable to filter toxins well, so they end up in the brain. Due to his diabetes, he might not be able to take this med. Another med that is used for HE is Xifaxan. It is costly, but can be obtained for nearly free...just a small co-pay...if you go to the manufacturer's site (see a link in the Hepatitis Resources thread, near the end.)

Is your dad seeing a hepatologist (liver specialist?) If not, he should be. Where are you located? Would it be difficult to get a referral to a hepatologist?

Is his blood sugar under control with meds and diet?

Hugs,
Connie
Posted 3/20/2013 6:12 AM (GMT 0)
Dear connie,
Thank you for an informative response. Duty doctor visited him and suggested laxative. A hepatologist will visit him later. After vomiting he became more weak and sleeping now. We are trying to feed him by tube.
His diabetes measured 19 mmol/L last night (not under control for weeks). Right now should we inject insulin or not?

We will ask Dr. about Xifaxan.

Thank you once again.

umhafiz
Posted 3/20/2013 1:58 PM (GMT 0)
Umhafiz, Can you translate his diabetes being measured at 19 mmol/L ? My boyfriend has Hep C, Cirrhosis and very bad diabetic. He takes both lactulose and Xifixan for his ammonia levels. The only time he doesn't get his insulin is if his sugar levels go under 100. And that is because once he goes under that he drops very fast.

Robin
Posted 3/20/2013 2:25 PM (GMT 0)
Just to butt in on the measurement side.

19mmol/L translates to 342mg/dL which is the measure used normally in the US I think.

Calculator/converter is here:

http://www.diabetes.co.uk/blood-sugar-converter.html

Hope that helps someone to give advice to umhafiz.

Ann
Posted 3/20/2013 3:11 PM (GMT 0)
His U.S. blood sugar would be 342, which is high. I would guess he should have insulin with tube feed and test again later.

Needs to stay hydrated so as not to damage kidneys with the laxatives. Other than that, the hepatologist will know more after he sees him

Mae
Posted 3/20/2013 5:05 PM (GMT 0)
Thanks, Ann and Mae, for your input.

Umhafiz, are you in the UK?

Hugs,
Connie
Posted 3/21/2013 4:07 AM (GMT 0)
Dear Connie,
My father in Bangladesh.
Dr. gave insulin by injection. Liquid food and laxative given using nasal tube. Catheter placed for urine collection. Little urine collected but no defecation occurred, yet. He is still semiconscious for more than 24 hours.
Last level sugar level was 16. Any suggestion is highly appreciable.
Thank you.
Posted 3/21/2013 6:06 AM (GMT 0)
Thanks to Robin, Ann and Mae.

@Connie,
What to do to avoid coma in this situation?
Posted 3/21/2013 10:46 AM (GMT 0)
UMH, all I can say is the doctors gave more lactulose EVERYTIME my brother was in that condition. They started out giving it every hour! Must get that ammonia level down in order for him to come out of the semi-conscious state. It sure sounds like hepatic encephalopathy. Been through this a zillion times with my brother.

I think most doctors don't realize that. The doctor always told us lactulose, lactulose, lactulose. Don't worry about overdosing, you can't overdose on lactulose but make sure he gets fluids as well, whether thru IV or otherwise.

Have they checked his ammonia level?
Posted 3/21/2013 5:39 PM (GMT 0)
Umh, I would say exactly what Mae did. It sounds like he's in a near-coma due to hepatic encephalopathy. The treatment for that is Lactulose, though it might be under a different name in Bangladesh. Lactulose removes ammonia from the brain via frequent bowel movements, so it acts as a laxative in that way. You say they gave him a laxative via NG tube. Could that have been Lactulose?

Hugs,
Connie
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