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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Has Diabetic Ketoacidosis. Taken Ursocol And Golbi For Pancreatitis And Fatty Liver. Cause For Diabetes?

Hi Doc, 2 years before my son was admitted for acute pancreatitis and he was stayed only 4 days at hospital and become normal. After one year he had a stomach pain and admitted with the suspesion of same pancreatitis but it was not the same and he discharged within 2 days due to stomach upset. on Gastroenterologist advised him to take URSOCOL and GOLBI 300 continusly to avoid recurrence of pancreatittis and fatty liver . After six months have continous intake of ursodeoxylic acid suddenly he had a symptom of vomitting, nausea, frequent urination and we thought it s a normal symptom of stomach upset and local doctor given him injection for 2 days. 3rd we had a doubt and admitted him in ICU and found DKA ( diabetic ketoacidosis ) and for the past 3 months he is taking insulin injection 4 times a day. Please advise this diabetic has happend due to the above medication (ursocol and golbi) or other reason. My son age is 13 years. Please advise
Tue, 7 Aug 2012
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Endocrinologist,  's  Response
Dear Ms Ahv999



Thanks a lot for your question.



There are different types of diabetes namely type1 , type 2 and secondary diabetes. Secondary diabetes as the name indicates is secondary to "something" and it causes 1-2% of all diabetes. Pancreatitis is the most common cause for secondary diabetes. It is important to know the reason for his pancreatitis to see the course of his pancreatitis. Further if he is over weight he could have insulin resistance and that could cause type 2 diabetes. Lot of times type 2 diabetes and secondary diabetes overlap and it is hard to distinguish the latter.



So at this point he should continue with his insulin and his insulin requirements has to be titrated based on his blood sugar. Goal BG is 80-120 ( before food) and 140-160 2 hr after he eats. So accordingly insulin can be adjusted. He should continue healthy diet and exercise ( if he is overweight). Insulin antibodies can help differentiate type 1 and 2 diabetes and the same can be done.



Please follow up with your endocrinologist regularaly.



Thanks for your question



Dr Sruti Chandrasekaran
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Diabetologist,  Dr. Vikrant Tari's  Response
dear ahv999,
your son is suffering from diabetes caused due to acte pancreatitis which is insulin dependent.
this has most likely not happened due to the medications you have mentioned.
continue him with insulin 4 times daily...
you can consider him to be put on insulin pump...
dr vikrant tari
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Child Has Diabetic Ketoacidosis. Taken Ursocol And Golbi For Pancreatitis And Fatty Liver. Cause For Diabetes?

Dear Ms Ahv999 Thanks a lot for your question. There are different types of diabetes namely type1 , type 2 and secondary diabetes. Secondary diabetes as the name indicates is secondary to something and it causes 1-2% of all diabetes. Pancreatitis is the most common cause for secondary diabetes. It is important to know the reason for his pancreatitis to see the course of his pancreatitis. Further if he is over weight he could have insulin resistance and that could cause type 2 diabetes. Lot of times type 2 diabetes and secondary diabetes overlap and it is hard to distinguish the latter. So at this point he should continue with his insulin and his insulin requirements has to be titrated based on his blood sugar. Goal BG is 80-120 ( before food) and 140-160 2 hr after he eats. So accordingly insulin can be adjusted. He should continue healthy diet and exercise ( if he is overweight). Insulin antibodies can help differentiate type 1 and 2 diabetes and the same can be done. Please follow up with your endocrinologist regularaly. Thanks for your question Dr Sruti Chandrasekaran