From Virginia, USA:
My son, 3, was seen by his pediatrician last week for severe abdominal pain and vomiting. All physical exams and x-rays were benign, and he had no fever. During lab testing, he showed ketones, but no sugar, in his urine and was treated for dehydration. While looking for the source of his abdominal pain a day later, blood tests showed a glucose level of 233, then 260 two hours later. The urine tests done at the same time were both negative for sugar, still positive for ketones. Six hours later, the glucose had returned to normal, 89, but his urine sugar was +4. The next morning a fasting glucose was 79 and he was negative for sugar in the urine. Could a stomach virus cause an increase in blood sugar to 260 in a child without diabetes? The doctor said a slight rise was normal.
Our medical group will see him again, but should I push for any special tests? Should I ask to be allowed to take his sugar levels at home? Does he sound like a child with the onset of Type 1?
P.S. We never identified the cause of the vomiting and he never developed a fever.
Very clearly your son had a high blood glucose on two occasions and this spilled into his urine. However, without symptoms of diabetes, I would be inclined to think that this was a stress response to having his blood tested and perhaps this was exacerbated by a virus which disrupted blood sugar control (e.g., an enterovirus such as Coxsackie). One off high sugars are actually quite common in sick children. You should, however, ask for a haemoglobin A1c check and he should be followed up for a short while to make sure he stays well. If there is any doubt I would recommend a glucose tolerance test and antibody testing.
Original posting 12 Oct 1998
Posted to Hyperglycemia and DKA
Last Updated: Tuesday April 06, 2010 15:09:00
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