A Hidden Tick-Borne Infection That Disrupted Blood Sugar Control

A 36-year-old man with Type 1 diabetes and frequent exposure to wooded areas developed fever, headache, muscle pain, and a rash. His initial test results—including standard Lyme disease screening, Babesia smear, and Anaplasma and Ehrlichia PCR—all came back negative. Blood cultures were also clear. Yet something was clearly wrong. It took a specialized blood PCR test to reveal the culprit: Borrelia miyamotoi, a spiral-shaped bacterium spread by tick bites that conventional tick-borne disease testing often fails to detect.

As the infection progressed, this patient's blood sugar climbed above 500 mg/dL—unusually high, yet without the blood acid buildup (ketoacidosis) that often accompanies severe hyperglycemia in Type 1 diabetes. His doctors traced the spike to two factors: the infection itself, which increased his body's insulin resistance, and a failure in his insulin pump delivery. The combination meant his insulin therapy wasn't working effectively at a time when his body needed more of it, not less.

Lab work also showed elevated creatine kinase levels (1464 U/L), a sign of muscle breakdown that researchers attributed to exercise, dehydration, and the infection's effects on muscle tissue.

This patient recovered fully after 17 days of doxycycline treatment, with both his blood sugar levels and lab abnormalities returning to normal. His case highlights an important lesson: when someone with Type 1 diabetes has unexplained fever, headache, muscle pain, and rash after being outdoors or in wooded areas, tick-borne illness should be considered—even if standard Lyme tests come back negative.

It also underscores how infection itself, separate from diabetes management, can dramatically increase insulin requirements. Insulin pump failures during illness can make this worse. Close blood sugar monitoring and consideration of a specialized blood PCR test for Borrelia miyamotoi may help catch this infection earlier and guide appropriate treatment before complications develop.

Source: IDCases. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.