My 15-year-old daughter has had many symptoms of diabetes–extreme hunger, extreme thirst, frequent urination, blurred vision, weight loss, fatigue, and irritability. We took her to an endocrinologist who tested her blood sugar and A1c which were both normal. She has had some higher blood sugar readings, but they are still somewhat normal. Her symptoms are getting worse. Should she still be developing diabetes or could this be something else?

Some of the symptoms you describe are common with diabetes – high sugar levels – but all have a huge list of possible explanations. I assume that a detailed history and physical exam were also done and also normal at your pediatrician’s office as well a diabetes team office. Sometimes early pancreas failure is not consistent and shows with only intermittent abnormalities. Antibody testing, if negative, will not help; if positive, it will let you know there is some underlying autoimmune problem that could lead to diabetes. But, none of these tests are 100%. So, I would keep her under watchful surveillance, periodically checking blood glucose levels before and one to two hours after eating and staying in contact with the diabetes team to give you guidance, particularly if there are still intermittently abnormal blood sugar values (fasting levels and pre-meal levels over 100 mg/dl [5.6 mmol/L] and post-meal (post-prandial) blood sugar levels over 140 mg/dl [7.8 mmol/L]).

SB