May 5, 2004
Hyperglycemia and DKA
Question from Los Angeles, California, USA:
I’m 30 years old and have had type 1 diabetes for six years. I recently visited my best friend in Colorado and her kids were very curious about my diabetes. They asked me to test their blood sugar on my meter. When I tested my friend’s 11 year old son, I was surprised to see that his glucose reading was 160 mg/dl [8.9 mmol/L]. I thought that seemed slightly high. I asked him when the last time he ate was, and he told me that he had some Cheetos about two to three hours earlier. I told my friend that I felt somewhat concerned about his glucose level and that I wanted to test it again later.
That night, we went out to dinner and ate a very high carbohydrate Italian meal, including dessert. I thought to myself that I would test my friend’s son’s blood sugar again after dinner to see what his blood glucose was after eating a high carbohydrate meal. When we got home, I tested him. His blood glucose reading was 572 mg/dl [31.7 mmol/L]. I made my friend go out to the pharmacy to get keto sticks and glucose urinalysis sticks. When we got back and tested his urine, his ketones were minimally elevated, but his glucose was negative. We tested him one more time, about 30 minutes after the previous reading. His blood glucose level was 105 mg/dl [5.8 mmol/L]. My friend thinks that the high reading was just because he had a big piece of chocolate cake at the end of the meal, but I still feel a little concerned. I tested him the next morning, after fasting, and his blood sugar was 101 mg/dl [5.6 mmol/L].
Should my friend be concerned about her son? Could a high carbohydrate meal really push a non-diabetic up into the 500’s (mg/dl) [over 27.7 mmol/L] even temporarily? That doesn’t seem normal to me.
Answer:
The only possible and most logical explanation is that 572 mg/dl [31.7 mmol/L] wasn’t really correct due to some technical mistakes that are difficult to pinpoint now, especially if you consider the post high urine analysis was negative, while all the others blood sugar measurements seem to be fine. I think you can relax and not to be concerned.
MS
Additional comments from Brenda Hitchcock:
One factor to consider with the high reading is the cleanliness of the child’s hands. It is possible that the child had food particles on the finger from which you took the drop of blood. Children often say they have washed their hands, but sometimes you have to witness it yourself! You may wish to read our page on Classification and Diagnosis of Diabetes and keep in mind that the diagnosis of diabetes is based on blood sugar readings taken by a qualified laboratory, not a home glucometer. Please see a similar question at Ask the Diabetes Team.
BH
