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May 20, 2002

Diagnosis and Symptoms

Question from Kingman, Arizona, USA:

My four year old son lost 12 pounds in a month, drinks a lot and goes to the bathroom frequently. He also will sleep more than four hours in the afternoon and go to bed on time. He complains of stomachaches and leg pain.His father has family members with both type 1 and 2 diabetes, and there is a history of diabetes on my family's side. Due to the symptoms, the doctor had him checked for diabetes. He did three fasting blood sugars and his numbers were 96-117 mg/dl [5.3-6.5 mmol/L], we have continued to monitor him at home, and his numbers have remained elevated (196-370 mg/dl [10.9-20.1 mmol/L]) for about the last five days. His pediatrician does not see a problem, but we will be getting a second opinion. What are the ranges that he should be? How high should his numbers be to possibly visit the ER since we are getting no where with his physician? One physician told me he was just going through his terrible twos late.

Answer:

It sounds like your son may be developing diabetes and needs to consult with a pediatric diabetologist or pediatric endocrinologist right away assuming that the technique you are using for blood glucose testing is giving accurate results, hands are washed, etc. The fasting values are high-normal, but the other values are definitely abnormal. Twelve pound weight loss in a preschool child is definitely abnormal unless he started out rather obese.

SB

[Editor’s comment: If he is able to drink enough fluids, he should be able to wait to see the specialist (soon!). However, if he develops nausea and is unable to drink enough fluids to match what he’s losing, then it’s a medical emergency, and a trip to the ER would be required.

WWQ]