
June 11, 2003
Diagnosis and Symptoms
Question from Weyers Cave, Virginia, USA:
My almost eight year old daughter has had multiple problems that I think “could” be related to diabetes, but her doctors have ruled it out. First of all, my sister and two cousins have type 1 diabetes and numerous adults in the family have type 2. I had gestational diabetes with this child in question as well as one other pregnancy.
About a year ago, my daughter started complaining about constant stomach aches. For the first week, they were accompanied by a fever, and her doctor said it was just a virus. The fever went away, but for the next three months, she complained on and off that her stomach hurt. She developed pink eye which affected the whole side of her face, and, while at the doctor’s visit for this, I asked when I as a parent should be concerned about my child constantly complaining about her stomach (there was no other symptoms), and he said when other symptoms started along with the stomach pains.
Less than a month later, she started losing weight, vomiting, and having diarrhea. She was diagnosed with giardia. She was seven years old at the time and only weighed 37 pounds. Antibiotics cleared this up and she gained back the five pounds she lost.
During this time, as they did numerous blood work to find out what was wrong, she had a glucose level of 162 mg/dl [9 mmol/L]. One urine test also showed some ketones, but they said the ketones could have been an early sign of dehydration. For the next three months, they did more blood work to test her levels which were fine. They said the elevated blood sugar could have been from stress, or a possible warning sign of developing diabetes later. Also during this time, she also started having night terrors which only lasted two weeks and ended as quickly as they started. She continued to complain about her stomach as well as difficulty with swallowing, so our doctors sent us to the university medical center.
There the doctors were a little concerned about her size, being small for her age, but ran tests as well and they all were okay. (I know one had to do with whether she was allergic to wheat). At one point I was told her liver enzymes were elevated, pancreas levels were elevated, blood glucose levels were elevated, and one other I cant remember, but none were elevated enough to be concerned about. They diagnosed irritable bowel syndrome related to stress, and did find a lot of air on her belly.
She continues to seem to catch colds and viruses, and more recently, I’ve noticed more changes in her. We have tested her blood sugar at home and most of the time its normal, but there are times when it has been back up in the 160s mg/dl [8.9 mmol/L]. For the past couple of weeks, she has complained of being thirsty all the time, tired at school, and she has even wet the bed, (only once, but still very unlike her). Also when she does need to use the bathroom, she has to go right now! It’s like she cant hold it. I have also noticed a little bit of a personality change. Usually this child is not in trouble, but I have had to get on her more, and then she’ll go from that behavior to just sitting quietly by herself. Finally, I have just noticed blisters on one of her hands. There are one to two on each finger except her thumb all around her knuckles which. look exactly like burn blisters, but they are not. She says they don’t itch or hurt.
I don’t want to keep going to my doctors insisting there is something wrong with my daughter when they have done lots of tests. I don’t want to be one of those parents who run to the doctor every time my child complains or gets bruised, but should I be concerned? Does this sound like diabetes? Is there something else the doctors should look for?
Answer:
Either go back to your daughter’s pediatrician, or better, go back to the university doctors. They both need to know these facts since some of the original tests may need to be repeated. It sounds like they tested for celiac disease originally (the wheat test).
It is unclear if this is diabetes, but the symptoms are not so consistent except that the blood glucose levels you report are certainly not normal. Occasionally there are many weeks or months of vague symptoms like you describe that predate frank diabetes. If you discuss this with the university doctors, they will know how to proceed and what to test.
SB