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Are my son's sugar levels high due to type 1 diabetes?

Q: A few days ago my 4 month old son started crying and didn't stop for a long time. I got scared and took him to the hospital. The paediatrician checked his blood sugar, which was over 400. They did a whole bunch of tests including x-rays and said that there is a small lung infection as well. He stayed in the hospital for 3 days. The whole time his sugar levels varied between 180-350. An endocrinologist said that he has type 1 diabetes. But they were not sure until the blood report came from the lab. After getting discharged, we took him to an endocrinologist. The lady start explaining about insulin and said that he has type 1 diabetes. She diagnosed him without the result and said that we need to give him lantus 1 unit everyday. We did accordingly. After a few days he had high fever and we again took him to the hospital. The paediatrician said that the lung infection has increased and he has pneumonia. We gave him insulin and antibiotics. The next day his sugars were 120-180. We decided to wait and see if his sugar would rise if we did not give him insulin. But it stayed under 200. The next day his sugar levels went down, so we didn't give him a shot. And now it was 86 early morning and 116 a few hours later. Could the blood sugars be high due to his infection? Or is it normal during diabetes. Do we have to give him an insulin shot if his sugar levels are not too high?

A:It is very difficult to comment based on the limited information whether your child has Type 1 diabetes or transient diabetes since the blood sugar has normalised so rapidly. It is possible to develop transiently high blood sugars during infections especially if a child is receiving glucose in the intravenous fluids (I don't know if your child received fluids and what kind of iv fluids) It is also possible that the child was developing diabetes and the infection precipitated it. More tests would be needed to make a final diagnosis. Glycosylated Haemoglobin (HbA1C) is a test which gives an average of the blood sugar levels over the last 3 months and that would give us an idea about the baby's blood sugar levels over the last 3 months. There are other tests too which would need to be done under the guidance of a paediatric endocrinologist to decide about this. Meanwhile, stay in touch with your doctor, continue to monitor the baby's blood sugar and give insulin if the blood glucose exceeds 160 mg/dl. If the baby does need insulin, the type of insulin should also be changed.


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