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Question:

From Miami, Florida, USA:

Recently, after a night of very high fever (105), my son (17 months old) woke up with no fever, I decided to take him to the doctor to have him checked out and before I left he drank a small bottle of baby apple juice. When the doctor checked his urine he decided to send him to the hospital because this doctor felt my son was a diabetic (this was not my son's regular doctor). After arriving at the hospital and many blood and urine tests, I was informed that my son probably had "Stress Hyperglycemia" but he should be checked after a few days to confirm the diagnosis, which later was confirmed, but I was told that children with this condition later turn out to become diabetics.

I would like to know what "Stress Hyperglycemia" is, if it is true that children do develop diabetes after being diagnosed with this condition, and if there is anything I should be doing or can do to avoid this or any problems in the future.

Answer:

I receive many phone calls and several hospital consults a year about this diagnosis. Since I have worked with the same group of pediatricians for many years, I expect I don't hear about the vast majority.

Stress hyperglycemia is very common in children. I cannot give the actual percentage of ill children with the diagnosis. The episode ends as it did with your son: without diabetes. I have seen glucoses of several hundred; worrisome, but fortunately, all turns out well.

The real question is the risk for diabetes. I rarely see a child that had stress hyperglycemia and then diabetes. That isn't real science, but it's my experience.

I expect you have been told the symptoms of diabetes. You and every other parent need to watch for these signs and report to your physician if they occur. A simple blood glucose answer the question of diabetes.

P.S.:

I wrote the above reply and then felt guilty and went to Medline and looked. Last year a good paper in Archives of Diseases of Children looked at all children seen in a pediatric ER for a year. 36 had hyperglycemia and were matched to controls. Bottom line: 36 months of followup and no diabetes.

This confirms my non-science.

LD

Original posting 4 Oct 1998
Posted to Hyperglycemia and DKA

  
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Last Updated: Tuesday April 06, 2010 15:09:00
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