My nine year old son failed his school eye exam last year, so I took him to the eye doctor who said he needed glasses. His vision at the time was 20/40. At the six month eye checkup, his prescription was increased, and at the one year eye checkup, the doctor told me that his vision was twice as bad as when he was first seen. She said that this could be due to growing and recommended that he wear contacts. A coworker recommended I have him tested for diabetes. My son is small for his age, he will be 10 soon and is only 48 inches tall and weighs 50 pounds. He eats a lot and he is very energetic, but he has never fallen on the growth curve. He also wets the bed regularly. Should I have my nine year old son tested for diabetes?

You have asked some very good questions. This situation may need to be sorted out by having a fasting blood glucose test performed at least for reassurance. I would tell you that myopia and myopic progression is much more common than type�1 diabetes, the type suspected at his age and weight.

You did not say what type of vision condition your child had. I would guess that he is myopic which is seen commonly to develop at that age. There may also be a family history of a parent being myopic, although not necessarily. If your son is myopic, myopia tends to be progressive and progresses more rapidly if onset is at a younger age, as in your son’s case. Myopia is related to growth, hereditary and environmental factors such as a classroom student versus an outdoor farm worker.

With myopia, it is very common to see changes in glasses to double in a years time which would be more the rule then the exception. While double may seem like a very large change, this is not so. A vision of 20/40 is approximately related to glasses with a strength of about 0.75 power units called diopters. If his glasses have now become twice as strong his glasses may be about 1.50 diopters and this may relate to a vision of approximately 20/100. This may “sound” like a big change to be concerned about, but in fact it is considered a low value of myopia and is almost predictable in the “natural” progression of myopia to change by that amount.

Vision changes with rising glucose levels that one would see with developing type 1 diabetes could typically cause greater vision changes as much as values greater than 3.00 diopters, almost quadruple the original.

Bed wetting may not be necessarily excessive urination that is seen with diabetes. Other symptoms of diabetes may include excessive hunger and thirst and night leg cramps which were not mentioned and weakness as opposed to being “energetic”.

As a parent, I understand your concern. I would discuss this with your son’s doctor and perhaps have him tested for diabetes for reassurance.

CAG