From England, United Kingdom:
Now almost four years old, my son was born with transposition of the great arteries. He had his first lot of surgery at 7 hours old and a full arterial switch at 13 days old. He does have a leaky aorta, but is doing well and leads a normal lifestyle for his age and is on no medication. In the last few months, we noticed a change in his behaviour - lack of focus or concentration, not particularly wanting to play with one thing in particular, he is just on the go the whole time. Trying to talk to him or getting him to listen is proving difficult, also, and we find it difficult to take him places that he can't really be running around in, i.e., supermarkets, our daughter's school plays, etc. It's almost as if he has no understanding of what you are saying to him. The main things that are making me think it could be diabetes are his constant drinking, that he can be on the go one minute and then completely lethargic the next. He is potty trained, but the last week or so, we've gone to check on him and he's soaked the bed despite having urinated before going to sleep. His eating habits can be quite poor at times. He eats his breakfast well but will mainly pick at his lunch and tea. His preschool recently took me to one side to tell me that they were getting concerned with him in regards to his concentration and that his behaviour had changed quite a bit in the last couple of months. We have all agreed that we will have someone come in to preschool to monitor him for a few hours to see whether he would benefit with some help in regards to his concentration/behaviour. Should I be concerned about diabetes? I am borderline. My dad has type 2, my maternal grandmother had type 1, my paternal grandmother had type 2, and my paternal aunt and cousin have types 1 and 2 respectively
The excess urination and enuresis, especially when new behaviors, are worrisome but the other behavioral changes don't quite go along with diabetes. However, it's pretty easy to check his urine or blood glucose values to see if there is sugar. Urine should be free of glucose and your family doctor can get this done quite easily if you bring in a sample. Blood glucose can be checked if someone with diabetes in the family has a blood glucose meter, with a simple fingerstick prick, or the family doctor can get this done as well. Before food, he should be less than 5.5 mmolL [99 mg/dl] and 1 to 2 hours after food, he should be less than 7.7 mmol/L [140 mg/dl]. Anything higher than that fasting or before eating and anything higher than that after eating is suspect and then you need more formal blood glucose testing to be done at your doctor's office or in consultation with a pediatric diabetes specialist. Any change in urinary patterns, thirst patterns, unexplained weight loss and/or enuresis demands a blood glucose test a few times to be certain that these are not signs of diabetes developing. There is no relationship at all with his cardiac transposition of the great vessels or its repair.
Usually, high sugars do not cause the type of behavioral changes you are describing but sometimes there is extreme lethargy. Wearing my pediatrician's cap and not my pediatric diabetology cap, they are certainly not normal and somewhat worrisome - so I agree with trying to figure out causes.
Original posting 8 Aug 2012
Posted to Diagnosis and Symptoms
Last Updated: Wednesday August 08, 2012 11:11:30
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