July 17, 2003
Hyperglycemia and DKA
Question from Rockford, Illinois, USA:
My son uses nighttime Lantus and Humalog with meals, and this week after a swim meet he attended an unplanned pizza party. Naturally, I expected his blood sugar to be high when he returned home, but his meter read “hi” (greater than 600 mg/dl [33.3 mmol/L]). About an hour after his insulin and going to bed, he got up and complained of a stomachache, headache and being thirsty which I expected with high numbers. He was also confused and had trouble expressing his thoughts. It almost seemed like a scary hypoglycemic episode. I did check his blood sugar, and he was not low.
We do not have a lot of experience with very high numbers, he is rarely over 400 mg/dl [22.2 mmol/L], and a high for him is usually in the 300s mg/dl [16.7 mmol/L]. Can short term very high blood sugars cause confusion? He has been fine since then. Is there need for concern?
Answer:
Those sound like typical symptoms of highs. Your goal should be to avoid those as much as possible. I would encourage you to send insulin along with your son so he will be prepared for all of his “unplanned pizza parties” in the future. Eating at unscheduled times is typical for all adolescents and being prepared to take insulin to avoid unnecessary highs is important not only for his current level of control but also for avoiding complications of high blood sugars such as the miserable symptoms that some feel. See hyperglycemia for more useful information about high blood sugars.
MSB
