Both my husband and I have very strong family histories of type 1 diabetes, and our seven year old daughter has been showing all the classic signs along with vomiting and diarrhea. Her doctor says since she has diarrhea, it not diabetes and will only do a urine test, which was negative. Since the urine test is negative, should I still push for additional testing for diabetes?

Urine testing is a good screening test for diabetes. In a child with “classic” symptoms of diabetes (excessive thirst and hunger, frequent urination, and weight loss), blood testing may be appropriate. Your physician should be able to confidently give you advice regarding testing for diabetes.

MSB

[Editor’s comment: Testing for diabetes should include blood sugar levels performed by a medical laboratory. The timing of the sample (fasting, random, or postprandial) would influence how high a level is considered abnormal. See Classification and Diagnosis of Diabetes for further information.

Occasionally, lab blood sugar testing might be normal in an early case of diabetes, repeat blood sugar testing at the same or a different time, or performing a glucose tolerance test, might be appropriate if there is a high suspicion of diabetes despite normal initial testing. Another test, the glycosylated hemoglobin, might be used to help confirm a suspected diagnosis of diabetes, but the GHB (also called HbA1c or A1c) is not usually considered as appropriate to make an initial diagnosis.

Home glucose testing, if done, might be positive, which would make the situation more urgent to get lab testing done to confirm the abnormal results. However, home glucose testing, if normal, would not exclude diabetes.

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