January 8, 2001
Daily Care
Question from Memphis,Tennessee, USA:
My 14 year old daughter has had diabetes for nine and one-half years and on the insulin pump for six months. Her last HbA1c was 7.8%. She was recently rushed to hospital. Her blood sugar was 124 mg/dl [6.9 mmol/L], but she large ketones and was vomiting. No infection or virus was detected. Her white blood count was okay. The doctor had no explanation. she Have you ever heard of this? After seven hours in the emergency room, a low grade fever of 101 degrees appeared. Around 2 am the next morning her fever went away, her blood sugars were normal and the ketones were gone. Any reasons as to why this happened?
Answer:
Sounds like a vomiting virus. We see this all the time up here in the Boston area, generally in mini-epidemics and just exactly as you describe. Pepto Bismol seems to help often to stop the vomiting. Occasionally, people get so dehydrated that they need a few hours of intravenous saline in the emergency room or with an overnight hospital stay. Usually we can treat this at home with temporary decrease in insulin dosage, frequent blood glucose readings to guide fluid and insulin adjustments and some Pepto Bismol. Not much of a puzzle to me except that this particular virus did not cause insulin resistance and hyperglycemia.
SB
