High bg levels coming off viral infection

[tc3]

Hello,
My 3-1/2 yr old son was recently hospitalized because of vomiting due to a gastrointestinal virus of some kind.  He's ok now and at home and past all the virus symptoms.  We've been slowly increasing his insulin dosages while his body gets used to properly digesting food, but, now that we're back to normal insulin dosages, he's still exhibiting very high levels after breakfast and into lunch (approx 24-27 mmol/L or 430-480 mg/dL).  The rest of the day, he's well within range (4-10 mmol/L or 70-180 mg/dL).  Before getting sick, his bg levels were pretty well balanced and in range all the time, but now we're still getting this peak in the morning.  He's in excellent spirits and not uncomfortable, so we don't think he's producing excess ketones (we're checking thoughout the day).  Our diabetes team is aware of the situation and suggesting we wait a couple more days before trying to modify anything, like changing the injection regimen, etc.  Right now he's on NPH (intermediate) & Novorapid (rapid).

Has anyone had a similar experience and/or suggestions?

Thanks,
Tony

[tc3]

Thanks,
His bg levels are much better now, even after only a couple of days after my original post.  He seems to be back to normal, with the exception that we're up a 1/2 unit of Novorapid in the morning, and at dinner.
As for switching to Lantus, it won't be until he's old enough to give himself a lunchtime injection, as I'm sure that would have to be added.  Plus, that would have to be part of the decision to go to a pump, when the time comes...
Thanks again for the help,
Tony

[JDRF-Team-ES]

It sounds like you are doing all the right things.  Your physicians are aware of the situation and their recommendation to wait a few days is the usual response to situations like this. Kids are very resilient and he may not be experiencing any syptoms that slow him down, even though there may still be a little virus running through his body.  So, give it a few days to let the virus fully work its way through his system.

I am not a doctor, but I do have diabetes and I do notice that those blood sugars tend to creep up and behave erratically when I am sick, especially with viral type illness.  If his morning blood sugars don't improve after several days, you may want to ask your doctor about switching to a longer acting insulin like lantus. It doesn't have the peaks that NPH does and it can give you a litle smoother coverage through the night.

It is very tough to have a young child with diabetes, but it sounds like you are doing a great job!  The good news is that there is a lot of support out there for families dealing with diabetes and there is a lot of research going on that will hopefully bring us a cure in your son's lifetime. For more information, contact your local JDRF Chapeter.  Best of luck to you and your family!