All of my son’s tests have come up negative for diabetes. His fasting glucose was 86 mg/dl [4.8 mmol/L] and his after meal test was 125 mg/dl [7.0 mmol/L]. His urine was also clear. However, for a month now, he has been urinating frequently, excessively thirsty, excessively hungry and has lost weight. He gets very irritable, especially at night. All of his symptoms worsen during the day, especially right before bed. His tests were all done in the morning. Is it possible that his blood sugar would go up in the evening? Should I ask for a GTT? My doctor insists that he would be very ill if he had diabetes and he acts like I am overreacting. Am I?

I don’t know if you are overreacting or not, but I often maintain that no one will/should be a stronger advocate for a child than their parent.

If you will refer to the web page we have on the Classification and Diagnosis of Diabetes, you will find that diabetes is currently defined based on serum glucose levels:

if the fasting serum level is confirmed over 125 mg/dL [7.0 mmol/L] (“greater than or equal to 126 mg/dL [7.0 mmol/L]”);

if the patient has symptoms AND a random serum glucose greater or equal to 200 mg/dL [11.1 mmol/L]; or

if during a properly performed oral glucose tolerance test, the serum glucose at two hours is greater than or equal to 200 mg/dL [11.1 mmol/L].

So, based on the limited information that you have given, I wouldn’t diagnose diabetes in your son either!

There are certainly other things that can cause urinary symptoms as seen in diabetes; the combination of change in urinary and thirst habits with weight loss and irritability brings to mind an overactive thyroid, but there certainly are other possibilities.

Is your child obese? Is his school performance good? Is he on other medications?

Keep an open dialogue with your pediatrician.

DS