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February 5, 2007

Other Illnesses

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Question from Atlanta, Georgia, USA:

My daughter has strep throat for the fifth time since November. We just had the strep confirmed again today even though she is still on antibiotics. It looks like she cannot get rid of the strep throat. Is this because she is a diabetic and it is harder for diabetics to get over infections or is this unrelated to the diabetes? We will be going to see an ENT at the end of February. If they decide to remove the tonsils, what should I expect with respect to her diabetes during and after the surgery? Should this surgery be avoided, if at all possible? Currently, her blood sugars are fairly normal and her last A1C was 6.2. We did have elevated blood sugars when she first started to get the infections, but now it does not seem to effect her blood sugars anymore. I have herd that even though the removal of the tonsils is fairly easy, there is a lot more involved with diabetic patients.

Answer:

From: DTeam Staff

Some children and adults can be strep carriers and they require different treatment than just a course of the typical antibiotics for strep. When a child is getting recurrent strep throat, they sometimes are candidates for surgical removal of the tonsils and sometimes adenoids. Your pediatrician will best be able to determine whether your child should have that surgery. The surgery is typically well tolerated even among children with diabetes.

MSB

[Editor’s comment: Should your daughter require surgery, be sure to consult with your diabetes team about dealing with blood sugars just before, during and after the procedure. Most surgeries require fasting beforehand, which may warrant an adjustment to your daughter’s diabetes regimen. You might also need to educate the physician/nurses involved about your daughter’s diabetes and insulin pump. It is often better if YOU test your daughter’s blood sugars at the hospital, which may or may not have the most up-to-date glucose meter. And, if she’s on an I.V., be sure you know exactly what’s in it as it may contain dextrose, which could cause elevated blood sugars.

BH]