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Question:

My 21 year old niece had several infections about two months ago: a yeast infection, urinary tract infection, and kidney infection. In the emergency room she was tested and her blood sugar was 280; they gave her an insulin shot and told her to go to her doctor the next day. Her doctor tested her again and her blood sugar was 216. He put her on glyburide [a diabetes pill for Type 2 diabetes].

After taking the medication for about a month and a half he told her that her blood sugar was too low and to stop taking the medication. She has tested her blood every day and her levels have never been higher than 120, it is usually below 100 at any given time of the day. She is wondering if she is really diabetic at all. She has been experimenting for a couple of days eating all the wrong things just to see if her blood sugar will rise and it hasn't. I told her to be very careful doing that, but she is so confused as to why her levels were high only twice and on that basis she was diagnosed as diabetic. By the way while she was taking the glyburide her blood sugars were dropping down to 40 at times.

My main question is: if a person had a severe infection, could that cause the blood sugar to rise that much and would that constitute a diagnosis of diabetes? She has actually had only one post-prandial blood sugar. Her blood sugar was actually lower after eating than before. Is there a possibility of misdiagnosis: could those infections have triggered the rise in her glucose without the presence of diabetes? Should she get a second opinion?

Answer:

Assuming that the two high blood sugars were taken fasting then a likely explanation of your niece's experience is that she has a latent form of one of the two main types of diabetes and that the stress of the infections temporarily reduced her ability to make enough insulin. It is probable that these events will recur with further infections or with pregnancy; but not necessarily with any permanent need for medication.

The high blood sugars might also have been due to stress alone and perhaps they were not taken fasting. There are a number of laboratory tests that can be done to work all this out and from what you have said I think that it would be wise to seek advice from an endocrinologist even though blood sugars are now normal. A definitive answer would, I am sure, relieve anxiety in the family, even if it did mean facing the prospect of clinical diabetes at some later date.

DO'B

Original posting 25 Jan 97

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