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My son, age 7, was hospitalized 3 months ago for asthma, a month later for a broken arm and last month for pneumonia and ketoacidosis. His blood sugar was 250 and ketones were in his blood and urine. He was given insulin for a short time in hospital. Since then blood sugar has been normal without insulin. His A1c was normal, microalbumin was normal, liver function normal. Are we missing something? Could this be a reaction to prior health problems? How do we determine whether or not he is diabetic? Could this be attributed to anything else?


It sounds like your child's doctor may think that your child has "transient" high blood sugar which can be seen in individuals during an acute illness (especially if they are on medications for asthma which increase the blood sugar along with IV glucose). Although ketones with an elevated blood sugar almost always signal that a child is developing true Type 1 diabetes, ketones can also be produced when a child is stressed with illness, dehydrated, and on asthma medications in a child without diabetes.

True Type 1 (insulin dependent) diabetes may develop over months or years with gradual loss of insulin production. The blood sugar may be normal when the child is well, but may go up transiently when the child is sick and on asthma medications because the pancreas can't make extra insulin which is needed. A good way to help decide if your child had transient high blood sugars or is developing true insulin dependent diabetes is to have his blood tested for antibodies against the pancreas which are usually positive in children before their blood sugars become abnormal. I would discuss this with a pediatric endocrinologist in your area if possible.


Original posting 28 Feb 1998
Posted to Diagnosis and Symptoms


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