October 27, 2004
Hyperglycemia and DKA, Other
Question from Ochelata, Oklahoma, USA:
For the last two years, my daughter has been in the hospital around 10 times. It’s always the same: she starts vomiting, can’t keep any thing down, dehydrates and then is in DKA. Topical phenergan and Zofran do not stop the vomiting ever. At the hospital, blood work shows a very high white blood count, which they say is sign of infection. They have not figured out what kind of infection or where the infection is. My daughter has been to four different hospitals and as many different doctors. Her blood sugars are normal before starting vomiting.
In June of this year, they discovered her gall bladder was diseased and it was removed. We thought the problem had been found. Two months later, she is back in hospital with same problem as before. Is it possible the infection and her being diabetic are connected somehow? What can she do to stop this cycle?
Answer:
Infection increases the stress hormones that antagonize insulin’s effects on blood sugars. Therefore, unchecked infection leads to the high sugars and recurrent DKA. I wonder if an additional problem may be a primary gut problem where the nausea and vomiting comes on and does not stop. This might be caused by gut-related complications from diabetes. I would make sure to have this discussion with your daughter’s physician to rule it out. Otherwise, your doctors will have to continue to look for occult sites of infection at areas such as the mouth and gums, skin, gut, perianal areas, and others.
JTL
