November 12, 2002
Diagnosis and Symptoms
Question from St. Paul, Minnesota, USA:
My four year old daughter was having symptoms that I believed were due to a UTI [urinary tract infection] (bed-wetting, frequent urination, sleeping a ton, and a one-day fever), so but I took her to the doctor. Her urine showed no signs of an infection (they then did an overnight culture to confirm that there was no UTI), but she had some glucose and ketones, so she was immediately sent to an endocrinologist.
Her blood glucose was 144 mg/dl [8 mmol/L] by meter, over four hours after her last meal. While slightly higher than they would expect, they said they didn’t think she had diabetes. We followed up for several days with home blood glucose checks first thing in the morning and before bed, all of which were fine. They did the glycosylated hemoglobin check which was normal as was her antibody (for three antibodies) screen. We are quite relieved that she doesn’t have diabetes, but are looking for reassurance that sometimes kids who do not have just spill glucose into their urine like that. The lab is confident that there was not an error made in her urine check. What else could have caused the high urine glucose?
Answer:
The key to making a diagnosis of diabetes is laboratory confirmed high blood sugars typically in the presence of the common symptoms of diabetes. If your daughter doesn’t have the typical symptoms of diabetes and currently is not having high blood sugars, then I would suggest observing her for symptoms and increased blood sugars. Certainly, there are occasional lab errors — and very rarely, sugar in the urine not in the presence of high blood sugars.
MSB