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September 25, 2000

Diagnosis and Symptoms

Question from Arkadelphia, Arkansas, USA:

My little girl has cerebral palsy and gastrostomy tube feedings. One night, when I went in to check on her, she was gagging so I picked her up and put her in bed with dad while I finished the laundry. when I came back down to my room, dad was out of bed in the hallway with her because he could not wake her up. She was cold and clammy and very weak. We rushed to the hospital. They said that she was a little low on her fluids, so they started an IV. Her respiratory rate was were 8 and heart rate was 180. They put on oxygen and took blood work. Her blood sugar was 300 mg/dl [16.7 mmol/L]. We have no idea what got it that high. After two hours, she finally woke up and was back to her old self. Her blood sugar went back down on its own. They still don't know what happened. She is home now and back to her happy, jolly self. Yesterday, her blood sugars were 79 mg/dl [4.4 mmol/L], 138 mg/dl [7.7 mmol/l], and 78 mg/dl [4.3 mmol/L]. Can she have diabetes? Will her blood sugar go back to 78 mg/dl [4.3 mmol/L] without insulin? I know they used insulin on her in the neonatal intensive care unit. She was 1 pound 10 ounces at birth.

Answer:

I do not think that your little girl has diabetes. I imagine that the high blood sugar of 300mg/dl (16.7mmol) was likely due to the stress of whatever event made her lose consciousness. All the other blood sugars at the time were within normal limits.

Just what happened? I really can’t tell, but I wonder if the gastric tube came out or got misplaced into the trachea or if she somehow aspirated through it.

DOB