September 19, 2012
Diagnosis and Symptoms
Question from Atlantic, North Carolina, USA:
Since the first of July, my daughter has had excessive thirst and excessive urination. She had an 11-year-old check-up on July 23 when I talked to the doctor about the problem. My daughter gets up every hour to hour and half at night to urinate and get water and goes about the same amount during the day. They did a urine sample and said that was fine. About two to three weeks later, the problem was still occurring. They had her go in for blood work, not fasting, or glucose test. This test came back fine. The doctor said she may have a small bladder that has not yet stretched for her age and that also this could be the body’s way of preparing her for diabetes, which may show up later on. So, when school resumed, I told the teachers about her problem. Things went fine the first week, but during the second week, the teacher asked me if my child was using this as an excuse to get out of doing school work. This teacher is not one of my favorite people after this statement was made. I took my daughter back to the doctor last week and she did have blood in her urine but nothing else. She had to go yesterday for an ultrasound of her bladder and kidneys. I have not yet heard from these results. I was wondering if a urine sample would not detect diabetes and if a glucose tolerance test should be done. Her symptoms fit everything for diabetes. Any help or information you could give would be greatly appreciated.
Answer:
Diabetes mellitus presents with excess urination and excess thirst but urine would have glucose/sugar present on urinalysis. Her blood glucose would also be elevated with so many symptoms. Glucose tolerance testing usually is not needed except in very early and mild cases, but not with so many symptoms.
There are other causes for excessive urination and excessive thirst. One, called diabetes insipidus, involves problems in and around the pituitary gland where a hormone called ADH is insufficient. This presents the same symptoms but with something called urine specific gravity very diluted. This should have been checked on the urinalysis that was done once or twice so you should ask your primary care physician for these results.
Small bladder, bladder infections or kidney infections all can present the same. Excessive fluid intake also will do the same thing. But, a detailed history and physical exam will usually point to such problems. If there is still some question, then a consultation either with a urologist or with an endocrinologist would be reasonable.
SB
