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My 3 year old daughter was diagnosed with Type 1 in November, 1995 (2 weeks ago). She had pneumonia at the time and her blood sugar was 240, with high ketones. Since she has recovered from the pneumonia, her blood sugar has stabilized. Is this normal? Is this just a honeymoon? Could the high blood sugar and ketones be explained by anything else?

Kids who develop a severe illness such as pneumonia may have a transient problem with high blood sugar due to the combination of dehydration and inadequate food intake, and their blood sugar and ketone levels may be elevated.

In little kids with severe illnesses, the onset of Type 1 Diabetes usually looks even more dramatic than seems the case for your daughter: the sugar is frequently much higher than 240, and there's an increase in the blood acid level (a condition that's called diabetic ketoacidosis or DKA). We don't have enough information in your daughter's case to be sure about the diagnosis: she'll need assistance from a pediatric endocrinologist to be sure.

Does your daughter actually have Type 1 Diabetes? Assuming that the sugar levels stayed consistently high after resolution of the acute illness, the diagnosis of diabetes seems reasonable. Of course, several weeks after the acute illness is gone, the blood sugar levels will probably be much better, and indeed, making the diagnosis of diabetes now would be nearly impossible based on the blood sugar levels now. More lab tests (for islet cell antibodies and C-peptide levels) would be very helpful to make the diagnosis.

If indeed she has Type 1 diabetes, you can expect continuing improvement in blood sugar control in the near future, even on lower and lower doses of insulin. This period of time where everything is going very well is called the "honeymoon" period, and will last for a while, like any honeymoon, then come to an end.

But if the diagnosis of diabetes can't really be established cleanly at this time, we'd still be very concerned. We'd call the diagnosis "Impaired Glucose Tolerance" and advise very close followup for the possibility of developing diabetes later in life.

Original posting 14 Dec 95


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Last Updated: Tuesday April 06, 2010 15:08:52
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