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June 1, 2008

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Question from Waller, Texas, USA:

Diagnosed with type 1 about seven months ago, my four-year-old son has been urinating much more for the last two weeks. He soaks a pull-up through every night and has several accidents throughout the day. I thought this was just a sign for the onset of diabetes or high blood sugars. Is there something else that could be causing this problem? His blood sugar has been well maintained and his last A1c was 6.9.

Answer:

A couple of thoughts.

Seven months is just about enough time for a four-year-old to emerge from the honeymoon stage. He may be having higher than you think blood sugars between meals and that causes increased urine. Check. Controlling that is hard because too much mealtime insulin might make him low later, so be careful. Likewise, the overnight glucose might be higher at bedtime and right afterwards but okay by the morning…again be careful that he does not go low in the night.
The doctor can check and make sure he can concentrate his urine. Diabetes mellitus is sugar. Diabetes insipidus is the lack of ability to concentrate urine because of another hormone from the pituitary.

LD