February 8, 2005
Honeymoon, Hyperglycemia and DKA
Question from Princeton, New Jersey, USA:
My daughter’s blood sugar levels seem to rise dramatically when she is ill. When she was diagnosed with type 2 in April 2004, she had shingles, and a 600+ mg/dl [33.3+ mmol/L] blood sugar level. Once those shingles went dormant, her levels reduced to 70 to 120 mg/dl [3.9 to 6.7 mmol/L]. She maintained that range with metformin for seven months and then she became ill again. This time, she had a sinus infection and she had one or two readings in the 300+ mg/dl [16.7+ mmol/L] range. Her endocrinologist increased her metformin, and she dropped back down to 80 to 180 mg/dl [4.4 to 10.0 mmol/L] readings for over two months. Now, she is sick again, and her levels have again increased. She peaked at 467 mg/dl [25.9 mmol/L] last night. We are so worried. Are illnesses really capable of creating that much havoc on diabetics? Or, is there a chance that she is really a type 1 and she is experiencing a “honeymoon phase?” She just had her three month check-up and blood work.
Answer:
If you really want to know if there are type 1 antigens, you should ask your endocrinologist ask to test, but it might be expensive. Illness is a real stress to any diabetes. I don’t usually see type 2s with 80s mg/dl [4.4 to 4.9 mmol/L] on metformin alone do that, but what is the A1c? What are some two hour post prandial blood sugars? That, too, might help you know how often the glucose is going up every day.
LD
