Summary: Recently I shared a section of the book about hypoglycemia (low blood sugar). Today I am sharing a bit about high blood sugar. For us, Q has had quite a few growth spurts this past year that have caused some unmanageable high blood sugars, particularly overnight when no amount of insulin seems to bring her back into range.
Hyperglycemia (High Blood Sugar)
Hyperglycemia, or high blood sugar, occurs when blood sugar is elevated above the normal range as set by your endocrinologist. Causes of high blood sugar include: eating food without the proper amount of corresponding insulin; eating high-sugar-content foods that aren’t matched by the insulin; hormones such as growth hormone, glucagon, and adrenaline; steroids, which are sometimes prescribed for other medical conditions; illness; growth spurts; menstruation; and anger. The condition can also occur as a rebound after treating low blood sugar. High blood sugar can result from bad insulin. And for those using an insulin pump, pump failures such as a bubble or kink in the tubing, an empty insulin reservoir, a bent cannula or cannula that has come out, or a leak in the infusion set can cause a high.
Some symptoms of high blood sugar include lethargy, an overall crummy feeling, extreme thirst, and frequent urination. Your child may have had these symptoms at diagnosis. For Q both at diagnosis and to this day, emotional swings are a symptom. If her blood sugar is very high, she is easily upset and cries quickly. Some children experience aggressive behavior or behavior that is not normal for them.
I remember that during Q’s kindergarten year I met her on the school steps and saw her head hung low. She told me she was so bad that day that the teacher had to write a note home. It seems that Q lashed out several times, including throwing a toy and shoving a boy. I had a long talk with her about her behavior. Later that night, as I logged her numbers from the day, I noticed they were all in the very high 200’s. The teacher and I discussed how, while Q needs to be held accountable for her actions, her blood sugar had been high all day, which can make her volatile. She hasn’t had a day at school like that since.
The obvious treatment for high blood sugar is to give a correction of insulin. Your child may need extra fluids and lots of trips to the bathroom until the blood sugar comes back down. For blood sugar above 250 or 300, as suggested by your endocrinologist, ketones should be checked. If the child uses an insulin pump, you should troubleshoot to see if the issue is with the pump.
If a high blood sugar is a single occurrence, it might be chalked up to a missed bolus, incorrect carb counting, or a high-carb or sugary meal. I know there are certain foods that make Q’s blood sugar spike high, and I have to develop a strategy to deal with them either preemptively or after the fact. But if you see a pattern emerging, it might be time to look at insulin-to-carb ratios and/or basal rates. I always reread relevant sections of Think Like a Pancreas, written by Gary Scheiner, when I’m dealing with carb-ratio and basal-rate issues. I also fax my blood sugar logs to the diabetes educator to discuss possible causes and changes.
Just recently, we had a weekend when I couldn’t keep Q’s blood sugar in range, and she spent three days in the low 200s. Correction after correction didn’t bring her down. Opening a fresh bottle of insulin didn’t work. I was at my wit’s end thinking we needed a complete overhaul of her basal rates or that the high blood sugar readings were an indication of oncoming illness. After we discussed it with our diabetes educator, her blood sugar returned to normal, and we decided that the spike was related to her recent growth spurt.
(For more information on illness and high blood sugar, see chapter 9.)
If you’d like to learn more about the book, you can read more on the Kids First, Diabetes Second book page. It’s available widely in print and as an eBook from book sellers such as Barnes & Noble, Amazon.com, and IndieBound. And if you do read it and find it to be a valuable resource, I would greatly appreciate if you could write a review on any of the online retail sites. Thanks!
Disclosure: This post contains affiliate links to booksellers.
Please remember that I never give medical advice. Ask your endocrinologist or pediatrician for advice about your own child. Make your own informed decisions for your own child.