I have two kids with type 1 diabetes, an eight year old diagnosed at four and a four year old diagnosed at two. My four year old urinates frequently, as many as 10 times per day. My first thought was that her sugars must be high all the time, but it just isn’t so. Her last A1c was 7.6 and every time I checked post-bathroom, she was in target range, 80 to 180 mg/dl [4.4 to 10.0 mmol/L]. At night, she wears pull-ups but has awakened dry for the last month or so. Is this a developmental issue rather than a diabetes issue? Or, is there another condition that I should be aware of? She does not indicate that she is in any pain.

Her being dry at night is strong evidence that this is not a “medical” or “pathologic” issue. You have wisely looked for daytime higher glucose readings to explain the urinary frequency. The lack of pain upon urination suggests, but does not exclude, the possibility of a bladder or other urinary tract infection.

When she goes the 10 times during the day, is she also making large volumes? If normal or teeny volumes, I’d consider some issue, developmental, psychological, or perhaps maybe physical in terms of complete bladder emptying or what is sometimes referred to as spasmodic bladder (“detrusor muscle dysfunction”), although that is sometimes associated with sudden bladder emptying.

So, I’d start with your general pediatrician with a routine, carefully collected urinalysis and go from there.

DS