June 26, 2002
Diagnosis and Symptoms
Question from Joplin, Missouri, USA:
For a few weeks, my 11 year old daughter has been showing the typical symptoms of diabetes (excessive thirst and urination; failure to gain weight). Several urine dips at her doctors office have all been negative for sugar, her fasting blood sugar was 98 mg/dl [5.4 mmol/L], and two-hour post meal blood sugars in the doctors office were 132 mg/dl [7.3 mmol/L] and 144 mg/dl [8 mmol/L].
Her pediatrician has ruled out diabetes and also did extensive testing for diabetes insipidus (water deprivation test, etc.), which has been ruled out. Is it possible that she has type 1 diabetes based on the continued symptoms and the slightly elevated two-hour after meal blood sugars? Is it possible to have the thirst/urination symptoms without showing sugar in the urine? I am worried that the doctor has dismissed this possibility too soon. What do you recommend as a next step?
Answer:
I appreciate your concerns. Your daughter’s results are mostly normal with the exception of the blood sugar of 144 mg/dl [8 mmol/L] in the two-hour post-meal test which is only very slightly above the normal limit. I would suggest continued close monitoring for possible diabetes in the future.
It doesn’t sound like your daughter has diabetes based on the test results you’ve shared with me, although continued close follow-up with her physician is likely necessary to rule out other causes of her symptoms. Thirst and urination are symptoms that are present with diabetes — but can also be present with a variety of other conditions.
It sounds like you have a pediatrician who is diligent already with testing and follow-up. I would follow your doctor’s advice regarding any future testing that may be necessary.
MSB
[Editor’s comment: See Classification and Diagnosis of Diabetes Guidelines.
SS]
