Tuesday, April 24, 2012

Diabetes?


For two days leading up to her admittance to the hospital, while Shaina was still quite foggy from a mental standpoint, she started craving sugar. Anyone who knows Shaina knows that she has quite a Dr. Pepper addiction. But it was way beyond that. She no longer wanted any food or drinks other than really sweet stuff – fruit, soda, sweet sports drinks. And she couldn’t get enough; she was gulping the liquids down faster than we could bring them to her. We gave her what she wanted, because we didn’t want her to get dehydrated. I asked her liver doctor if the cravings could be associated with encephalopathy, but he was not aware of any such correlation.

The night after she was admitted, her labs came back showing a blood glucose level of 1,031. Normal levels range from 70 – 145. When her nurse came into the room, she was visibly concerned - they had never seen glucose levels that high before on the transplant floor. They tested her blood sugar with a handheld monitor, hoping that the lab result was incorrect. But the meter, which only registers levels up to 500, read 500+.  The nurse immediately called the doctor on-call, who ordered an insulin drip and electrolytes, and her sugar was checked every 30 minutes throughout the night. The kidney doctor arrived the next morning, surprised that we weren’t in the ICU. He said he had never seen a patient with glucose levels that high who wasn’t in a coma.

The kidney doctors ran a test to see if Shaina’s sugars had been high over the last 3 months. It turned out they had. First they thought that she might have another autoimmune disease affecting her pancreas, but the next day they found that her body was producing some insulin on it’s own. So they have diagnosed her with Type 2 Diabetes and put her on long-acting and short-acting insulin shots. She has to check her blood sugar four times a day and change her diet. Her sugars seem to be stabilizing. We are hoping that the sugars were affected by the high Prograf levels, the infections, and the other imbalances in her body and that they will go back to normal once everything settles down.  

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