
February 19, 2002
Diagnosis and Symptoms
Question from Kingsport, Tennessee, USA:
I took my 10 year old son (who is overweight) to the doctor for his yearly physical and also said I wanted him tested for diabetes. The doctor proceeded to tell me that type�1 diabetes is seen in children and that since his urine test looked fine, he didn’t want to test my son. He then proceeded to ask what his symptoms were and I told that my son has frequent thirst, frequent urination, tummy aches, mood swings, headaches when he doesn’t eat something every one to three hours and a problem with his eyes. Should I take him back and insist that he be tested for type 2 diabetes or not?
Answer:
Diabetes is diabetes: fasting blood glucose over 126 mg/dl [7 mmol/L] on two occasions at the lab is diabetes. Type�1 diabetes usually presents dramatically and type�2 slowly, but both can have dramatically elevated glucoses, and both can cause severe illness. Both can be “caught” at the time of a physical exam if there is glucose in the urine. It is not likely he has very high blood glucose now, if the urine glucose is negative.
There are additionally lab tests that could be done. Some, myself included, do look for “risk” for the metabolic syndrome by measuring insulin levels, cholesterol, etc. We know that 20% of Americans have this.
If your son is overweight he may be at risk for diabetes later. As to the symptoms, I cannot tell you the cause.
LD
[Editor’s comment: Urine glucose testing, if negative, does not exclude diabetes.
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.
WWQ]