October 6, 2000
Diagnosis and Symptoms
Question from Wellington, New Zealand:
My nine year old son seems to have so many of the symptoms of diabetes, except that he is overweight. He is 50 kilos which is I think about 110 pounds and he’s about 1 meter 35 centimeters tall, about four and one-half feet. Three years ago, he was a normal weight for his age and a good runner. The weight was gained suddenly it seemed, and now he is self-conscious of it and gets tired even walking with the family,when the four-year-old is okay. His other symptoms include: extreme thirst, excessive urination (urinates every two to three hours, wet the bed three times a week until recently. He is now on medication and has stopped, no problems with kidneys, etc.), blurred eyesight at times (eye specialist saw nothing two years ago, but an optician says it’s developmental and gave him glasses), gets “drunk”/silly/giggly/red in the face/dizzy/feels unwell when doing excessive physical activity or when hungry, craves sweet things, but doesn’t eat a lot of food (when he does, he crams it in and can over-eat when “starving”), and he gets viruses that don’t clear up very quickly. Other symptoms he has, which may not be relevant, are: he gets an “itchy anus”, has problems concentrating in class and remembering things, despite being a bright boy in school tests; he can also have a lot of phlegm that causes night-time coughing and appears to have begun puberty (hormone spots and pubic hairs).
My doctor says my son is hypoglycaemic and needs to watch his diet, needs regular two-hourly snacks and should have glucose with him when doing sports. He dismisses talk of the boy having diabetes, but has agreed to test his blood sugar levels over a day. I feel my son is not a well boy. Is my doctor right? Could the child have diabetes? Maybe type 2?
Answer:
I rather doubt if your son’s main problem is hypoglycemia. I think it is much more likely that he is either in the earliest stages of Type�2 diabetes, something that has become increasingly common in childhood, or that he has become insulin resistant, primarily because of obesity (he is about 15 kilograms over the 95th percentile for weight for a nine year old. In any case, he needs to have the initial diagnosis of diabetes made with elevated blood sugar, and, for further confirmation, an antibody test (in type 1 diabetes, several different autoantibodies against normal tissues are found. These antibodies seem to attack the beta cells of the pancreas, or do other destruction. Some of the autoantibodies which are found in diabetes patients include: islet cell antibodies (ICAs), anti-insulin antibodies (AIAs) and anti-GAD�antibodies) and a serum insulin or C-peptide test.
I think, in any case, that your son needs to be seen by a paediatric diabetes specialist.
DOB
