Help- my 8 yo healthy son has been very ill with influenza B with fevers 103-104 for several days last week, slowly slowly coming down. We brought him to Dr who checked urinalysis; urine glucose =1000, finger stick was 200'ish. Went to ER, iv fluid hydration brought finger sticks down to normal. HgA1c was 6.1. He was 4 days into high fevers and dehydration at this point. He developed viral myositis for 2 days, have CPK = 2000. Endocrinology has asked us to check fasting BG in mornings and 2-3 hr post-prandial every night. He is still a little sick with poor appetite and low grade fever. It has been a total of 10 days of illness now. Morning fasting BG's ranging 60-70, but 2-3 hr post-prandials are running 160's every night since we started checking. I would love someone's input on this. No family hx of IDDM and the blood work for autoantibodies is pending.
Caveat: 3 years ago he had a significant viral infection during which an ER also measured his urine gluc =1000 and blood gluc 130. On follow-up it resolved.
Question: is this stress hyperglycemia or insulin resistance secondary to illness, or could this be IDDM? Everything I've read is that children with stress hyperglycemia do not appear to have longterm higher risk of developing IDDM. Thanks.
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