
February 9, 2004
Other Illnesses
Question from Calgary, Alberta, Canada:
I am going to start from the very beginning so that you can get an idea of the whole picture. When my seven year old daughter was born two weeks early, the hospital told me that it looked more like she was three or four weeks early, because of her weight of 5.5 pounds and her other measurements (head circumference, etc), plus the fact that she was still covered all over with the white waxy substance. She was also whisked away from me right away because she was making little gasping noises that the doctor did not like. She ended up being in the special care nursery for seven days; they wanted to make sure she was gaining weight. They had started her on antibiotics because my waters were broken for 26 hours before she was born, in case of chest infection. During her first week of life in the hospital I was nursing her; she was my first child, so getting the hang of doing this “properly” didn’t really happen. When I took her home we continued nursing, but at the age of two months I switched her to formula (it just hurt too much and it seemed like she was nursing for five hours at a time).
Since she was my first child, I was unaware that having two 8 oz bottles of formula was more that the usual baby ate. The doctor told me that babies stop eating when they are full and not to worry about her eating too much. She started gaining weight rapidly. At 10 months she was 28 pounds and at the age of one year she was 31 pounds. We were referred to a pediatrician. This was the start of many years of being told that my daughter has “something, ” but no one could ever put their finger on it. My daughter was put on a strict diet, at the age of one year she was switched from whole milk to skim milk and she would only eat healthy foods (lunch, for example would be one slice of bread and two slices of turkey roll, as well as fat-free and sugar-free yogurt). She also started having some pretty wicked tantrums, one of which was so bad that her nose started bleeding. At one of our pediatrician appointments, the doctor asked me if her tantrums were worse than that of a typical child. At the time, I had no one to compare to, so I was certain that they weren’t. She was admitted to the hospital for one week at the age of three years because they wanted to monitor her diet strictly to see if she would lose any weight. I think they thought I was secretly feeding her high fat and high sugar foods. Needless to say, she did not lose any weight, in fact, she gained 1/2 a pound. Over the years, the tantrums got worse and every few months we were called into the lab to give blood and urine so that one thing or another could be ruled out. She wets the bed on a regular basis and this is still ongoing. When we moved to Alberta, she started Kindergarten; her teacher told me she was globally delayed and asked my permission to have the school psychologist observe her. We were told that she is autistic and that is the reason for all of her tantrums; I was shocked. She is very high functioning (speaks, can show emotion).
At around this time, I noticed that her wet bed smelled very sweet, which concerned me because, on her father’s side (her grandfather and all of his brothers and sisters), there is type 2 diabetes. Now, since we are in a new city, I have brought this up with our new pediatrician. A very simple test came back negative. A couple of years later, I brought up my concerns again. We went into a lab after fasting for 10 hours and they took her blood. The level at that time was 4.7 mmol/L [85 mg/dl]. She had a sweet drink and had to wait in a room for two hours where we could not move very much as this will cause an inaccurate reading. They took some blood again at the two hour mark and the level was 4.3 mmol/L [78 mg/dl]. My doctor told me that it was very odd that the level came back lower after the sweet drink, but, because she still falls within the normal range she is OK. A couple of other things that I should mention is that her teacher (now she is grade two) told me that she drink three times that amount of water during the day that the other children; she was concerned with this because she is diabetic and she was aware of my previous concerns and her wild tantrums. Also, she has to go pee all the time (every hour). I am now contemplating going back to the pediatrician to see if there is a better more definitive test that can be done to see if she is hypoglycemic. What do you think?
Answer:
I’m afraid that this complex story doesn’t make a diagnosis easier. However, I am certain, from what you have told me that your daughter does not have diabetes at this time. If she is very overweight and continues to be, then there is a higher risk of type 2 diabetes in later years.
There are a number of ‘syndromes’ which have a combination of physical and mental characteristics. I expect that your daughter’s pediatrician has already considered these.
KJR