My six month old nephew, who has had numerous medical problems from birth, was taken to the hospital due to a mental status change, and they found he had a blood sugar of 500 mg/dl [27.8 mmol/L]. What could cause an infant to have a blood sugar of 500 mg/dl [37.8 mmol/L]? Could this be a temporary condition that could go away on its own? If it can, will it come back? What are the short term and long term complications?

The most likely explanation for your nephew’s high blood sugar is that he has type 1A (autoimmune) diabetes. The change in his mental state could have been due to cerebral edema (brain swelling). Whilst this is serious there should be no long term complications other than the diabetes itself, if he was treated promptly.

A transient form of neonatal diabetes is described, but an onset at the age of six months makes this rather unlikely. In view of the other medical issues, particularly if they include eye problems, deafness, other episodes of changed mental status or lactic acidosis, it would be important to talk to the doctor about the possibility that he has of one of the so called ‘mitochondrial’ forms of diabetes such as MELAS or Wolfram’s Syndrome as this might involve a somewhat different approach to treatment.

Hyperglycemia over a long period can certainly cause coagulation problems, but it is very unlikely that this would occur in your nephew’s case.

DOB