My five and a half year old daughter has lost weight, dropping from the 75th percentile to the 30th. This happened gradually over a five to six month period. Obvious causes were ruled out with a physical exam (no abdominal mass, no swollen lymph nodes, a normal neurological exam). She had a simple blood draw that checked her glucose, no fasting test or glucose drink. She has no excessive thirst or urination. Could she have diabetes that isn’t showing up on a test? Should she have a more detailed test? She was not anemic. Her thyroid was normal, CBC was normal, and liver enzymes were normal. I’m perplexed because she has no warning signs of any disease other than weight loss and looking like she lost muscle definition.

By definition (and please see What is Type 1 Diabetes?), one could not establish a diagnosis of diabetes on your child given that she does NOT have symptoms or an elevated glucose. So, no, she would not have diabetes that would not show up on a proper blood test.

Your concerns for your daughter’s unexplained weight loss is well deserved. Her pediatrician will likely want to perform serial assessments to learn of changes in eating habits, use of medications, changes or exaggerations of bowel habits and stool consistency plus serial examinations with height determinations, and then possibly expand diagnostic testing to look for more subtle intestinal disorders that can interfere with food absorption or issues.

A detailed, accurate diet history might be helpful to review with a registered dietician.

But, at that this time, I think you can comfortably exclude diabetes mellitus today.

DS