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January 10, 2005

Hyperglycemia and DKA, Thyroid

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Question from Guildford, United Kingdom:

My son has type 1 diabetes, celiac disease and hypothyroidism. He is seven years old. He has a gluten free diet, take 75 mg of thyroxine and three or four units of Lantus in the evening, and an average of eight or nine units of NovoRapid during the day before meals. His 14 day average blood sugar level is 13.7 mmol/L [247 mg/dl]. His blood sugars are erratic, bouncing high and low. At night time, the Lantus injection makes him hypoglycemic in the night (unless he goes to bed at a level of 20 mmol/L [360 mg/dl] then he would wake up at about 4.0 mmol/L [72 mg/dl]).

Nobody seems to be able to help explain what is going on in his body. We are currently waiting for Addison’s disease test results. He has had diabetes for three and a half years. We have recently be told, by a consultant, that he may still be in his honeymoon period and this would explain the small doses he required and the erratic readings. We had previously been told that he could not possibly still be in a honeymoon period. We don’t know what to believe and would be grateful for your opinion.

Answer: