January 7, 2003
Sick Days
Question from Adelaide, South Australia, Australia:
My 11 year old son, who has type 1 diabetes, has been feeling unwell due to an ear infection. He has a loss of appetite and so had not consumed his regular amount of carbohydrates, but his blood sugars are slightly elevated compared to when he is feeling well. My understanding of diabetes tells me that if he is not eating, his blood sugar levels should be low rather than high, but my wife assures me that his endocrinologist has indicated that if he is unwell his levels will be slightly higher. How is this so?
Answer:
During an infection, the body secretes increased amount of blood glucose raising hormones (the stress hormones — mostly cortisone and glucagon) effectively increasing insulin requirements because of insulin resistance and the increased endogenous sugar produced by the liver). The increased insulin requirements during illness usually last for a few days, but sometimes they can last up to a week after recovery. During these days, higher insulin doses are needed to achieve the same blood sugar lowering effect.
MS
