July 31, 2006
Diagnosis and Symptoms
Question from Ridgetown, Ontario, Canada:
I am concerned about my two year old daughter. She has all of the classic signs of diabetes. She drinks anywhere from two to four liters of apple juice a day. She awakes between four to seven times a night for her sippy cup. She soaks through a diaper in about an hour and I have to change her through the night about four times and she still wakes up completely soaked. She always has what seems to be a diaper rash that doesn’t go away and she always complains of being tired. I took her to the doctor and he took a urine sample that he said came back negative. Her urine that day was so dilute that it looked like water. He never investigated it any further with blood samples or anything. Do you think that I should push him into testing her more, or does this even sound like diabetes? I am very concerned about this since it has been going on for about seven or eight months. If you could please help me out as soon as possible with any suggestions that you may have for me, it will be greatly appreciated.
Answer:
The symptoms are very suspicious of “something not being right.” No doubt, diabetes mellitus would be a strong consideration, but a urine that had no glucose in it would suggest another issue. On the other hand, a urine test is not as specific as a blood glucose test.
The comment that the urine looked very dilute is also of interest. Another condition that is associated with major changes in urine and thirst patterns has the confusing name of “diabetes insipidus” (roughly translated as tasteless urination). This is a condition associated with a different hormonal disturbance related to ability to hold onto WATER by the kidneys.
The diaper rash could simply reflect her bottom being immersed in dampness all day. It could reflect something else.
In my view, your child needs a careful and complete and conscientious evaluation examination by her primary care doctor or a second opinion.
DS
