April 4, 2003
Sick Days
Question from Redmond, Washington, USA:
Since his diagnosis with type 1 diabetes two years ago, my 12 year old son has been sick frequently, and we are very concerned with how often he seems to get sick. He misses a lot of school with viral illnesses, mainly sore throats, congestion and headache, but also with vomiting and just generally not feeling well. He also has had three cases of otitis externa in the last eight months, one requiring a visit to an ear nose and throat specialist to drain the ear.
His diabetes is in moderate control with A1cs of 7.4-8.4%, and we are working hard to control his sugars, but he has wide variability in sugars which makes him difficult to control. He is currently using Lantus (insulin glargine) with Humalog, is very good at carb counting, and we are waiting for his pump to arrive. Does having diabetes make him more susceptible to viral illnesses than if he did not have diabetes?
Answer:
I understand your concern regarding the possibility that your son’s viral illnesses might be related to diabetes mellitus. If he is in moderate control (as it can be judged from his hemoglobin A1c), there is no reason why diabetes might make him more prone to infections. On the other hand, blood sugar control should be kept as normal as possible especially during infections, and I think an insulin pump will help him quite a lot.
Your son’s infections have surely contributed to the sudden increase/decrease of his blood sugar, and provided these highs/lows are confined to few weeks (as they generally last), they are not dangerous. Nevertheless our advice is to try always to adapt someone’s insulin regimen (intensified insulin scheme) to these new needs in order to keep blood sugar under the best control, but I must admit this is not always easy.
MS
