April 7, 2008
Diagnosis and Symptoms
Question from Missouri, USA:
My two and a half-year old daughter had been sick over the weekend with fever, frequent urination, abdominal pain and a few episodes of vomiting. After taking her to her primary care physician for what I thought was maybe a urinary tract infection, her urine test showed a large amount of glucose. A second test run at the laboratory confirmed the results. We were sent to the Emergency Room for more laboratory work and the Accu-Chek and BMP (basic metabolic panel) were 80 mg/dl [4.4 mmol/L] and 110. They didn’t have an answer for what caused the glucose in her urine. So, after that scare, should we be concerned that she may develop type 1 in the future or was it just one of those things that can’t be explained?
It likely is pretty easy to explain. You very likely will see glucose in her urine every test in the future. There are families with renal glycosuria, that is, the threshold for spilling glucose into the urine is lower than the general population. This is well described and even has some genes attributed to it. This is not diabetes. Now, I cannot say she will never get diabetes. There are other genes and antibody tests for that, but with a normal blood glucose, she doesn’t have diabetes now.
You did a good job. Every parent should be observant for new frequent urination as a symptom of diabetes. It isn’t always the diagnosis, but had it been that, your daughter sounds like she would have been diagnosed early before she became really ill.