### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My pal who has been diagnosed w/ diabetes & the 40 something yr old fellow also is a regular (sometimes daily) user (a shooter) of methamphedamine . Well he is new to this an hasn t as of yet been regular w/ doing his insulin .He saw the dr yesterday an was given his perscription (they increased his from 10 to 14 units & increased his oral med dose to 1000 also) & was informed that if he sees readings above 500 to go to the ER. Many times he runs above 500 I hear. Well he has done meth tonight an has just done a reading an it is 565 an was gonna do his insulin (though his girlfriend suggests to hold off an do it at 7am instead of now @ 1am so to start doing it at the same time each day) but now w this high blood sugar reading what should we do ? He didn t wanna go to the E.R. an said it (his high reading) is probably cause he has recently just shot meth . So is he in need of the E.R.?

### output:

Hello, Thanks for the query. It is clear that your friend has highly uncontrolled diabetes. Plus taking methamphetamine can further aggravate and cause severe hyperglycemia as you have now mentioned. This can also lead to a severe complication of diabetes called as diabetic ketoacidosis. Which can be a serious emergency condition needing hospitalization and blood glucose control to be achieved through IV Insulin and other supplements (electrolytes). At 565 mg it is essential that he goes to ER. Taking Insulin at home may still not correct the situation. If he wants to control his blood glucose effectively, event possible long term complications of diabetes then should refrain from methamphetamine. Otherwise, he will face more serious consequences. Ideally blood glucose should be maintained as : FBG <100 mg, PP 150 to 160 mg & HbA1c%<6.8. He is no where close to these recommended levels. It essential to convey these things to him. Thanks.