There is a family history of diabetes on both sides of our family, and I am concerned that my son possibly has diabetes. He has shown possible signs of the disease. He always complains of being thirsty, drinks several glasses of liquid, and complains a lot of being hungry shortly after a full meal. Often if he goes too long without food, he begins to look pale and ill. He is unusually tired in the mid-afternoon to early evening, will lay down often to nap, and is very moody for his age.

The school nurse and the daycare providers are concerned that I need to have him checked for diabetes, and I feel I should have him tested, but I am not sure what type of test to request. His previous doctor checked his urine only, said he found no signs and that was enough. Should I get a second opinion to be sure? What type of test do I ask for?

A reasonable test to screen for diabetes is a urine test. If that is negative and there are still strong suspicions of diabetes, an oral glucose tolerance test and continued observation may be appropriate. I would discuss these options with your son’s physician.

MSB

[Editor’s comment: Formal 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 A1c, might be used to help confirm a suspected diagnosis of diabetes, but the A1c (also called HbA1c or glycosylated hemoglobin) is not usually considered as appropriate to make an initial diagnosis. Antibody testing is occasionally done as a screening test in high-risk situations, or as confirmatory of type 1A (autoimmune) diabetes, but is not part of routine testing.

Urine sugar tests or 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, urine or home glucose testing, if negative, would not conclusively exclude diabetes.

WWQ]