My daughter’s blood sugar tests were normal, but she still has all the symptoms of diabetes (dizziness, excessive thirst, frequent urination). She has lost over 10 pounds in less than two weeks, she is always hungry but yet can’t always eat, and she is always very tired and has no energy. She almost always has nausea, vomiting, and severe stomach pain. Could she still have diabetes, even though her blood sugar is testing normal? Her father and grandparents on both sides have diabetes. I would appreciate any help you can give me.

I really understand your concern regarding your daughter’s risk of developing diabetes, especially with a family history for it. Besides current symptomatology interpretation, I’d check her again as soon as you can, with a serum determination of a fasting and random glucose concentration and concurrent urinalysis. Ask her pediatrician for a rapid referral then to a pediatric endocrinologist.

MS

[Editor’s comment: 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 Guidelines. for further information.

Occasionally, lab blood sugar testing might be normal in an early case of diabetes, repeat blood sugar testing at the same or a different time, or performing a glucose tolerance test, might be appropriate if there is a high suspicion of diabetes despite normal initial testing. Another test, the glycosylated hemoglobin, might be used to help confirm a suspected diagnosis of diabetes, but the GHB (also called HbA1c or A1c) is not usually considered as appropriate to make an initial diagnosis. Antibody testing is occasionally done as a screening test in high-risk situations, or as confirmatory of type 1A (autoimmune) diabetes, but is not part of routine testing. Urine sugar tests or home glucose testing, if done, might be positive, which would make the situation more urgent to get lab testing done to confirm the abnormal results. However, urine or home glucose testing, if negative, would not exclude diabetes.

SS]