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October 2, 2000

Diagnosis and Symptoms

Question from Laurel, Montana, USA:

I have suspected that my 16 year old daughter might be having diabetes symptoms for several months, but trying to get her to a doctor is almost impossible, she would rather eat nails. For the past few months, she has exhibited symptoms such as excessive thirst, excessive urination, incredible fatigue, dizziness, vision changes. In the past week, she has lost almost 10 pounds, but has been eating. She has been staying with grandma, who makes sure she eats. She also complains of being cold "all the time." I took her to her physician today. Urinalysis showed ketones 3+, glucose 2+, and proteins 2+. The doctor thought her blood glucose would be about 400 mg/dl [22.2 mmol/L] when it was done, but came out at 125 mg/dl [6.9 mmol/L]. This was a fasting blood glucose, because she hadn't eating all day. The test was at 3 pm. The doctor did an HbA1c, and test results will be back in the morning. He wants to see my daughter again tomorrow morning at 10 am for more tests. I should also note that I scanned her chart while waiting for the doctor, and I noted a urine test done eight months ago showed ketones 1+, glucose 3+, and protein 1+, but it was never mentioned to me! No charting was even done on the results. She was seeing her regular doctor at that time for severe cramps. The doctor who saw her today looked like he wanted to choke when I pointed out those results. I am a nervous wreck. What is your take on this? I feel so guilty for suspecting diabetes for so many months, but not getting her in. He diagnosed her today with ketoacidosis, glucosuria, and weight loss. I'm just looking for more info. As a nursing student, I should know all this stuff, but I'm so frazzled, as this is my kid, I'm feeling really stupid right now!

Answer:

I think that your daughter almost certainly does have diabetes, though I am not quite sure whether the albuminuria [protein in the urine] is part of that diagnosis. Her doctor seems to be doing all the right things and I imagine he/she has asked for an antibody� test which will decisively confirm Type�1A�or�autoimmune�diabetes and not some other form of diabetes. If this turns out to be the diagnosis, you might like to look in&nbsp�Books for Parents, Adults and Older Kids� for books to read.

DOB