February 23, 2010
Diagnosis and Symptoms, Hyperglycemia and DKA
Question from Shelbyville, Tennessee, USA:
After surgery, I hemorrhaged because my spleen had ruptured. When in the ambulance, they had asked if I was diabetic because my blood sugar was 425 mg/dl [23.6 mmol/L]. Later, I was told this was due to the amount of blood loss. Could this cause me to be diabetic in the future? I was told trauma can cause you to become diabetic.
Trauma leads to increased stress hormones that antagonize insulin’s effects. Stress from hemorrhage or any other cause can raise blood sugars in the short term. They do not cause diabetes in the long run. In fact, you cannot diagnose diabetes in the presence of an intercurrent illness. On the other hand, I would say a blood sugar of over 400 mg/dl [22.2 mmol/L] is a red flag that should be followed up. Sometimes, the fluids that are given at the time of the resuscitation have glucose in them. If the glucose were measured from a vein directly near the I.V. infusion site, the glucose could seem very high. This goes away when the glucose is sampled in the absence of the glucose infusion in the I.V. In conclusion, if you had a glucose over 400 mg/dl [22.2 mmol/L] with an illness, you should have follow-up for the detection of diabetes after the acute illness has been treated.