Transient high blood sugars....

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elp Posted: Sat, Jun 13 2009 12:55 PM

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Hello everyone,  I hope you don't mind if I pick your brains over this.

First, my son has not been diagnosed with diabetes. 

Three weeks ago, he had an incredibly bad stomach bug (didn't eat lunch or dinner, steady vomiting for 5 hours).  He woke up the next morning (6am), and had a bowl of cereal & pedialyte, and when his blood sugar was taken at 10 am, it registered at 179.  He also had the acidic smell to his breath (I'm good at picking it out- my sister is a type 1 diabetic) that diabetics get when there are ketones in the urine.

A few hours later (4pm), we had it tested again and it was 186.

After this passed, his blood sugars returned to normal, and the doctor described it as an "extreme metabloic event".  The ketone smell was explained as the product of vomiting and fasting.

Flash forward three weeks, and he's sick with a cough (he had a moderately high fever 2 days ago) and his breath was smelling of ketones again this morning.  Completely different circumstances- no vomiting, eating more often than usual, and yes, he has been asking for water a lot (woke up last night at 3 am asking for it) BUT, that isn't too unusual to me....he's always been a big fan of water.

We tested his blood sugar this morning and it was 188. 

I know this is incredibly un-scientific, but I was hoping that someone can shed some light on what's going on here....and our doc is out of town.

I do understand the basics (fasting vs. non-fasting blood sugar levels, what is required for diagnosis, etc.)

Is it normal for non-diabetics to have transient high blood sugars?  Does anyone have a story that is similar to ours?  I would appreciate ANY and ALL input.

From a concerned mother.

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Ron AKA replied on Sat, Jun 13 2009 1:22 PM

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Is your son on any kind of medication, such as steroids? If not, those BG numbers seem high and not normal. While they do not appear to be high enough to be of any immediate danger -- requiring a visit to emergency, you do need to get a proper lab test done as soon as possible - Monday if at all possible. I would ask for an oral glucose tolerance test (OGTT) at minimum, and also if possible a c-peptide test which is an indicator of insulin level.

Ketone's in diabetics tend to be produced when blood sugar is high and insulin is low. Your observation of ketone odour would seem to suggest low insulin levels may be the cause of the high blood glucose. That is why you should ask for a c-peptide test.

When you get an OGTT ordered it is important to have your son eat normal to high amounts of carbohydrates the day before the test. Withholding carbohydrates can make the OGTT inaccurate.

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Debbie Butler replied on Mon, Jun 15 2009 4:31 PM

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I spoke to one of the pediatric endocrinologists at Joslin who suggested you speak to your son's pediatrician.  You may want to ask your son's pediatrician about obtaining an OGTT (oral glucose tolerance test) with insulin levels, an A1c, and a pancreatic autoantibody panel.  If there are any concerns with any of these labs then you may want to ask for a referral to see a pediatric endocrinologist.  Good luck!

-Debbie Butler, LICSW, CDE

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Sugar replied on Wed, Jul 15 2009 11:32 AM

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Elp,

I'm just reading this for the first time and I was wondering whatever happened?
I'm sure we'd all like to hear how your son is doing now.

Victoria

Mother to Logan who, at age three, was diagnosed with Type 1 Diabetes