My five-year-old daughter has always been tiny. When I was pregnant with her, I had gestational diabetes and preeclampsia. She was born a week early by C-section and was 7 pounds, 8 ounces. We took her to the doctor Monday for a weight check. For the third month in a row, she lost weight instead of gaining. She is now down to 34 pounds, even though she eats more than I do. The doctor ordered a bunch of blood work, one of which was a random glucose test. Her blood sugar came back at 298 mg/dl [16.6 mmol/L]! This was all the doctor has told me so far. He wants to run some more tests on the blood they drew Monday before he tells me more. My question is, what other tests could he be running? Is she diabetic? What does this all mean for us as a family? In the last week, she has also started urinating in her pants, but she ONLY does it at pre-school, not at home, or at Head Start. She has always been a thirsty child, and the last two weeks, she has been extremely tired.

Based on the symptoms of fatigue, weight loss, increased urination, increased thirst, and elevated blood glucose, I think you should be prepared for a diagnosis of Diabetes Mellitus. It MIGHT it be something else, maybe, but the other considerations are rarer and diabetes mellitus is common.

IF this is diabetes mellitus, it would likely be type 1, which requires insulin. If she is shown to have diabetes mellitus, it would be hard to tell exactly when it started, but there are blood tests, such as a test called “Hemoglobin A1c” that can gauge how long the blood glucose has been elevated.

I am not sure what additional tests your doctor wishes to do or when those are scheduled, but I would not delay in any way to get the diagnosis confirmed. If your child begins to have vomiting or diminished consciousness, take her to the nearest Emergency Department immediately!

Tests that should be done now include basic blood chemistries and urinalysis (especially looking for “ketones”). I would also strongly consider a Hemoglobin A1c and pancreatic antibody tests.

DS