Dr. Zulfiqar Ahmed
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
A 19-year-old relative is experiencing severe stomach pain and diarrhea. A Friday CT scan (computed tomography) revealed substantial fluid and inflammation around the appendix, obstructing the view. The surgeon was uncertain about the extent of the inflammation. Additionally, the patient had a very high sugar level of 400, which was brought down to 200 using insulin. The appendix was subsequently removed the following morning, revealing a micro rupture that affected only the appendix. Post-surgery, the patient was prescribed antibiotics and insulin. However, his sugar level remains in the 200-300 range in the hospital setting. Despite visible improvement in the patient's condition, including eating and talking, he still complains of stomach pain. He is a 19-year-old individual with mild autism and, until now, no apparent chronic health issues. The family is seeking to understand the cause of this insulin-resistant high glucose and whether an infection or damage to the pancreas could be the contributing factor. The family desires clear communication and information about the ongoing treatment. Currently, they feel left in the dark and are contemplating discussing the situation with someone and exploring the possibility of transferring the patient to another facility.
Thank you.
Hi,
Welcome to icliniq.com.
I am glad you chose icliniq for your medical-related queries.
I understand your concern and will try to help you with it.
There could be multiple causes, with one possibility being related to the pancreas. Currently, he may require insulin to manage his sugar levels. It is plausible that his diabetes was brought to light due to the stress he experienced and possible infections.
I appreciate your trust in icliniq.com and for giving me the chance to serve you.
Our goal is to prioritize your health and help you according to your preferences and needs.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
Is not there an antibody test for diabetes? Why have not they confirmed it definitively yet? Additionally, what is the current strategy for controlling it, and why does it seem that insulin is not proving effective?
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
Yes, there is a blood test, known as the GAD (glutamic acid decarboxylase) antibodies test, to determine if it is type 1 diabetes. In acute situations, insulin is the standard treatment for elevated sugar levels, regardless of the underlying cause. Typically, it should not take more than a few days to bring sugar levels under control. Initially, we initiate insulin and continue it for a few weeks. Once the actual diagnosis is known, oral medication may be considered if necessary. Individuals with pancreatic issues might require long-term insulin for managing diabetes. In critical illnesses, high sugars can sometimes be transient, and they may normalize as the underlying condition is treated because elevated sugars can be the body's response to fighting disease. Have they conducted an HbA1c test, which provides an average sugar level over the previous three months? Another consideration is that during acute illnesses, insulin is occasionally administered as an infusion, adjusting the dosage hourly to swiftly and effectively control sugar levels.
Looking forward to your response in order to help you.
Thank you.
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Diabetology
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