A child on my case load exhibits constant craving for juices, and fruits, and is very overweight. The child gets very angry and tantrums when not given the food. He is exhibiting behaviors of cruelty to animals in the home and siblings around him. He goes up to the animals and the sibs, attempting to choke them when he doesn’t get the food he wants. He is obsessed with eating. We were wondering if this could be indicative of early diabetes. Can a child as young as 18 months old have diabetes?

A child at age 18 months certainly can develop diabetes, but most children this age have type 1 diabetes and are quite often quite ill with dehydration from the increased urination. They also are often rather thin and not overweight. The behavior issues you describe are not classic for diabetes.

Is this child developmentally on target? On any medications? There are various forms of hypothalamic obesity — some of which may be associated with developmental issues, hypogenitalism, and visual or hearing issues. It is easy to screen him for diabetes with a fasting glucose and, if necessary, a two-hour glucose after breakfast glucose reading. The developmental issues should be assessed by a developmental pediatrician or general pediatrician with an interest in behavioral issues.

DS