My three year old granddaughter who weighs 25 pounds has always been a unhealthy child, and for no reason she gets sick. She has no energy, is lifeless, has fever, vomiting, and a craving for chocolate. The problem is the doctors are not really addressing my questions nor my daughter’s.

My daughter took her to the hospital where they told her she needed to get a second opinion and suggested she take her to another hospital. When my daughter ask what they thought was wrong, they said they found sugar in her urine. Could that mean she has diabetes? They did not explain anything to my daughter. How do we find a doctor to take the time to answer our questions in layman’s terms? We are very dissatisfied with most doctors we have met.

I regret that you haven’t gotten satisfactory responses from the various doctors that you have talked with. I can address some ideas to help you and your granddaughter’s doctors to better communicate, and then I will address your specific question about your granddaughter having sugar in the urine.

First of all, despite our efforts and hopes, doctors are not magicians and don’t always know what is wrong. Sometimes, unfortunately, it takes several visits to look and study a patient, ask for a few special blood tests or x-rays to see if we can come up with an answer. And sometimes we just don’t know. From the doctor’s perspective, we often feel that there is a lot of good that comes from that because we can tell you what it’s not, although we may not be able to tell you what it is. So, we can help by trying to exclude bad things that might be immediately life threatening.

Another hurdle for families is that for a variety of reasons, people can’t or don’t make a relationship with the same doctor — someone who learns to know you and the child. Far too often, people go the emergency room for a non-emergency issue or they go to the local walk-in clinic and see a new person each time. Not all doctors are trained to understand all things. Emergency room doctors have the perspective of emergencies, and they don’t have the time or facilities to establish long-term relationships and follow up. Certainly, some family practice and pediatrician offices are busy, too. However, if you call in for a “sick visit” appointment (with, for example, a complaint of stomachache), your doctor’s office will devote a relatively fixed time for that issue. If you think you will need more time, let them know, when you make the appointment, that you have lots of questions and would like to have the doctor reserve more time for you. This may delay the appointment, or you may have to schedule a couple of visits, but most primary care doctors have many folks, just like you, who have questions and concerns. By all means, I want you to have your questions answered, and I would hope that your granddaughter’s doctor will take as much time as he or she can, but then you can’t really complain the next time you are at the doctor’s office that you have to wait, and wait.

So to your question — yes, sugar in the urine can be a signal of diabetes, But several other things can cause the kidneys to spill sugar. The best way to define if your granddaughter has diabetes is with blood tests, some of which may be done first thing in the morning before a meal, others may be done at other times, and some may have to go to special laboratories and won’t give an answer for several days. I would still encourage you and her mom to have on-going discussions with the doctors.

DS