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February 10, 2003

Daily Care, Diagnosis and Symptoms

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Question from Hopkinsville, Kentucky, USA:

My four year old son recently began getting ill every time he eats. It started out with vomiting about once or twice a week, and now he is sick to his stomach first thing in the morning and throughout the day (after he eats). He drinks a lot, goes to the bathroom frequently, and also has dry skin. His pediatrician finally scheduled a blood glucose test which was high (they didn’t tell me the levels) and said we needed to go to hospital.

We are going to the pediatric diabetes center and possibly to the endocrinologist there, but his doctor didn’t do anything for him except set up this appointment which isn’t until next week and my son is still sick. What other tests are involved in diagnosing someone with diabetes? What is the first plan of treatment? When will his nausea go away after starting treatment? Do you think diabetes is causing his nausea? I am a very concerned mother, and I’m not getting any answers at home.

Answer:

From: DTeam Staff

It would be extremely helpful to know just “how high” the glucose value was. If it was done fasting and was over 126 mg/dl [7 mmol/L], then the diagnosis of diabetes is almost certainly established. If it was high, but not done fasting, then, depending upon how high, other testing may be warranted, which really means periodic blood draws. Rarely is a glucose tolerance test needed these days. If your child is still nauseated or vomiting, and if he really has diabetes, this could be the sign of a serious complication of diabetes called DKA [diabetic ketoacidosis].

Please speak with your regular pediatrician for clarification. I am not certain that I would routinely “wait” for a week to have a newly diagnosed four year old seen. You may even wish to call ahead today to the diabetes specialists where the appointment is scheduled to see if they can shed some light.

Remember, not all blood sugar elevations equate with diabetes.”Stress” can cause minimal increases in blood sugar, and many things can cause tummy aches, but the combination of increased urination, increased thirst, effects of dehydration that you describe in light of the “high” glucose warrant an appropriate explanation if it is not diabetes.

DS