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June 24, 2003

Diagnosis and Symptoms

Question from Aurora, Illinois, USA:

My mother, sister, and I all have type 1 diabetes, and my 12 year old son seems to drink and urinate a lot at times. He had the flu a few months ago, and was going to the bathroom a lot. (I counted five times in an hour.) I was pushing fluids but when I checked his cups he had drank less than a cup. He had small ketones (I only checked once), and his blood sugar (using my meter) was 90 mg/dl [5mmol/L]. This was the worse episode. In the morning he urinates for a long time. When I have mentioned to his previous pediatrician, she wasn't concerned and no lab tests have ever been drawn. We changed doctors, and the new one he did a urinalysis once, and since I was never called, I assumed it was normal. Would it be reasonable to check my son's antibodies? When I asked his doctor at his last sports physical, he said he hadn't heard about them and did not know what to order, but he did agree to do the test. Am I being reasonable?

Answer:

I’m not sure that checking his antibodies (ICA 512 and GAD 65) will be beneficial. These tests may be done on newly diagnosed children if there is a question about whether they have type 1 or type 2 diabetes. They are not typically helpful prior to a diagnosis of diabetes in my practice.

I would suggest careful screening for diabetes over the next few months, especially if your son has had a lab-documented episode of a high blood sugar. See Classification and Diagnosis of Diabetes Guidelines.

MSB