July 17, 2008
Hyperglycemia and DKA, Other Illnesses
Question from Bogota, Colombia:
For a week, I have an unidentified bacterial pneumonia. This has caused me to have elevated blood sugars, higher than 140 mg/dl [7.8 mmol/l] before meals. The endocrinologist says that this is normal, but I want to know how long it will be until my blood sugars are normal?
My latest A1c was 5.3. I take 18 units of Lantus at night, six units of Humalog before meals, and two units of Regular before lunch.
You have a very good blood sugar as reflected by the A1c. This is clearly a good target for you, as long as you are not having a great deal of low blood sugars. It is true that any illness, including a pneumonia, will cause blood sugars to go higher. The reason for this is that the body makes more of the stress hormones, including cortisol and adrenaline, during illness. These hormones help you through the illness, but they also work against the ability of insulin to lower blood sugars. It may take two to three weeks before blood sugars come back down to pre-illness levels.