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June 22, 2006

Diagnosis and Symptoms

Question from Pembroke, Georgia, USA:

I took my son in earlier this week for his five year check up. He is 41 inches tall and 33 pounds. For the first time, they did a urine test. It came back positive for sugar in his urine. They then pricked his finger and did a blood glucose test and the result was 111 mg/dl [6.2 mmol/L]. The doctor said that it wasn't much higher than normal and it wasn't much to be concerned about. However, they wanted to run another test the next morning after fasting. I just got the results back and his blood sugar was 83 mg/dl [4.6 mmol/L], well within what she said was a normal result. When I asked her about what could have caused sugar to be present in his urine, she said that she wasn't sure, maybe he had eaten to many sweets. On the day of the urine test, he did have a sugary cereal for breakfast and then two peanut butter and jelly sandwiches for lunch. She said that she couldn't see that as a reason for sugar to be present. I am so confused. Do you think this is an early sign of diabetes? He doesn't have any of the symptoms other than being hungry all the time. I figured that was normal for a five year old boy. I've read on the Internet that constipation could be an early detector for diabetes. Is this true? My son has always had problems having a bowel movements, even as a newborn. Some days he cries trying to use the bathroom. I have tried everything the doctor has suggested and nothing seems to help. He always has hard stools. Am I just being a paranoid parent reading more into this than there is? Or, is the doctor not telling me everything?

Answer:

Having sugar in the urine is clearly abnormal. I would suggest watching your son closely for signs/symptoms of diabetes including excessive thirst and hunger, frequent urination and weight loss or gain. He likely would also benefit from further testing for diabetes that can be done through your physician’s office. Having a normal blood sugar does not rule out diabetes as diabetes can be a slowly developing disease. He needs to be closely monitored by a pediatrician with repeat testing of his urine and blood.

Constipation is not a symptom of diabetes.

MSB
Additional comments from Dr. David Schwartz:
One of my favorite dictums is that “A common cause of an abnormal laboratory test is an abnormal laboratory.” In other words, laboratory tests are certainly 100% accurate all the time. That is why I echo Dr. Brown that the test(s) should be followed up and confirmed positive or negative.

Rarely, depending upon the method in how the urine “sugar” was detected, some other substance led to the “positive” test. Not all sugar in urine is glucose sugar.

DS