My four year old daughter is in the process of being monitored/tested for diabetes. The doctor is going on the basis of her being overweight (98% above normal weight for girls her age), shortness (10% shorter than girls her age), extreme hunger and problems holding her bladder. But, I have read in other reports that extreme weight loss, vomiting and nausea are signs of this disease, which she does not have. Also, I do have a family history of diabetes and had my son tested at the age of four (now eight), and they just did a simple blood test for him. For my daughter, they have put her on a special diet for one month to see if that helps her lose some of the weight before they give her a blood test. Why would they not just give her a blood test so that we can treat the disease from the beginning?

Your question cannot be answered in this format. In general, obesity may be related to type 2 diabetes in children and it sounds like they may be more worried about obesity related problems than diabetes per se. You should go back and ask your physician what they’re worried about and what they are testing so that you can better understand the process. The classical type 1 diabetes can also happen in obese children and it is the classical type 1 diabetes that is an autoimmune problem and associated with more severe initial insulin deficiency, weight loss, excess thirst, excess urination etc. Type 2 diabetes in children, as well as adults, can be more subtle, slower onset and with fewer symptoms than type 1, but there may also be some obese children who have both types of diabetes. Dr Peter Chase’s manual, Understanding Insulin-Dependent Diabetes, has a good, short explanation of these differences. There is a more detailed scientific chapter is in my own textbook, Pediatric and Adolescent Diabetes.

SB