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Hyperglycemia and DKA

We have two children in our elementary schools with diabetes who both have labile blood sugar readings which sometimes are well over 450 mg/dl [25 mmol/L]. We call the parents who don’t seem to be alarmed and direct us to give the insulin per the prescribed sliding scale. How should we as school health individuals handle this?

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In type 2 diabetes, do you usually develop ketosis prior to initial diagnosis? Is there any danger of someone with type 2 diabetes going into DKA?

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When I talked to this child’s endocrinologist for follow-up, he replied that the DKA was the reason her HbA1c was elevated so high. Is that so? I thought it was a test of average glucose. Can you find any supporting documentation for his answer?

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My 13 year old daughter has always had pretty good control, but she has been hospitalized with ketoacidosis twice in the last two months. They tell me her hormones are causing this, but do not offer me a solution as to how to avoid this again.

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My son had a “hi” on his meter, and about an hour after insulin and going to bed, he got up and complained of a stomachache, headache and being thirsty. He was also confused and had trouble expressing his thoughts. Can short term very high blood sugars cause confusion?

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My 16 year old daughter has lost more than 20 pounds in the past few months. She did go to a bunch of camps but shouldn’t have that much weight loss. I’m starting to see some of the same signs I did before she was diagnosed, and her recent A1c was above 14%. I think she is afraid to take all her insulin because of weight gain, but I don’t ask her because it’ s kind of touchy for her.

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My son started showing signs of fluctuating blood sugars which I addressed with his doctor who didn’t feel that a change was needed, but now he has been passing ketones. The doctors can’t seem to give me any answers other than this is a sign of no insulin, but I know he is getting his shots. I don’t know the proper questions to ask to get results.

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My four year old daughter’s recent readings have been very high. Should I be concerned about these high readings? Does the lack of ketones reduce the risks of letting her run high?

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My 21 month old son has been waking up with high blood sugars and on some occasions with moderate or large ketones. Can rebounding cause large amounts of ketones? Is this from being high all night?

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My son has frequent episodes of migraines and DKA. He also has delayed gastric emptying along with a paralytic ileus. Medications have helped to stabilize his blood sugars but not helped with the episodes of migraines and DKA. Do you have any suggestions to help with these episodes?

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