April 25, 2011
Hyperglycemia and DKA, Hypoglycemia
Question from Franklin, North Carolina, USA:
My 16-year-old daughter, who has had type 1 diabetes since September 2005, was involved in a car accident. Her sugar was fine, had nothing to do with the wreck, and she wasn’t seriously hurt. She had a CAT scan to make sure. She only had muscle aches. This was a week ago and her sugars are bouncing. She will wake in the night with low sugar, usually around 30 to 40 mg/dl [1.7 to 2.3 mmol/L], then she wakes up in range but, by afternoon, she is high, around 280 to 300 mg/dl [15.6 to 16.7 mmol/L]. She doesn’t have ketones, but I was wondering if the muscle aches have anything to do with it. I expected to effect her for a few days, but she isn’t sore any more, and I thought her blood sugars would have evened out by now. Her sugars before the wreck were pretty steady. Should I be concerned?
Answer:
Assuming that you are getting accurate information from your ketone check strips, then these higher glucoses are not too worrisome, as long as they are temporary. I would have you simply correct them as you have been instructed by your primary endocrinology team.
As to the cause of these higher readings, I suppose they could reflect a “stress response” (residual pain/soreness) or reflect that with the discomfort, your daughter is not as active. The lower readings might reflect your corrections that may not be taking into account changes in other overall activities. I do suspect that matters will even themselves out, but if not, please discuss this with your child’s diabetes team.
DS
