From Richmond, Virginia, USA:
In the past two months, our two and a half year old daughter has been admitted to the emergency room for blood sugar issues. Both were affiliated with illness. The first episode was for dehydration due to a stomach virus. When she got to the emergency room, her blood glucose was 41 mg/dl [2.2 mmol/L]. Within two to three hours and an apple juice, her blood glucose was 495 mg/dl [27.5 mmol/L]. After the first episode, she was diagnosed with type 1 diabetes, but it was retracted after she maintained good levels on her own with minimal insulin intervention. The second episode was from vomiting attributed to strep throat. She was very lethargic after vomiting, so I tested her blood glucose and it was 370 mg/dl [20.5 mmol/L] within minutes after vomiting. In the emergency room, she pepped up, and her blood glucose was 98 mg/dl [.5 mmol/L] when tested.
The pediatric endocrinologist is attributing both incidences to stress-hyperglycemia. Do you think she will "outgrow" this or, if she is destined to have dramatic blood glucose fluctuations with every illness, or if she is likely pre-onset type 1? Could you please give me some background on the diagnosis of stress hyperglycemia and why it seems to be repeating?
"Stress" certainly is a normal stimulus to lead to higher glucose readings. When stressed, we need energy, for instance, as fuel to run away if frightened. We make increased amounts of various hormones, such as cortisol and adrenaline, when stressed and these hormones, along with other mechanisms, help us to release stored glucose into the blood.
Glucose levels into the 300s (mg/dl) [over 16.7 mmol/L] seem a little high to me for simple "stress." It may be that the child does have glucose intolerance and has diminished insulin producing capacity and may indeed have risk of type 1 diabetes.
Please talk with your doctor and the pediatric endocrinologist about consideration of pancreatic antibody testing for type 1 diabetes. I do not usually advocate formal glucose tolerance testing, but a properly prepared and performed glucose tolerance test may be warranted here, based on your description.
Last Updated: Tuesday April 06, 2010 15:09:56
This Internet site provides information of a general nature and is designed for educational purposes only. If you have any concerns about your own health or the health of your child, you should always consult with a physician or other health care professional.
This site is published by T-1 Today, Inc. (d/b/a Children with Diabetes), a 501c3 not-for-profit organization, which is responsible for its contents. Our mission is to provide education and support to families living with type 1 diabetes.
© Children with Diabetes, Inc. 1995-2017. Comments and Feedback.