My six year old grandson has a big thirst, has a problem with wetting, is skinny as possible, has a big appetite, and has horrible teeth cavities. Both my mother and I have type 2 diabetes. His doctor did one test and said he is does not have diabetes, but I disagree. What test does he need ? How old for diagnosis?

A urine examination done in your pediatrician’s office is an excellent screening test for diabetes. Diabetes can be diagnosed at any age. Your grandson’s symptoms are disturbing and very well may represent diabetes. If he has a negative urine test, he should be followed for the possibility of diabetes with some serial urine tests over the next few months.

MSB
Additional comments from Dr. David Schwartz:

There are other possibilities, some worrisome and some not, that can lead to big appetite and poor weight gain that have nothing to do with blood glucose control. For example, various intestinal disorders that lead to poor absorption of nutrients. Usually, these are associated with frequent bowel movements or diarrhea. Another possibility includes an overactive thyroid gland. This can sometimes also lead to increase in thirst and urination and can mimic diabetes. Your grandson’s pediatrician can screen for these.

DS

[Editor’s comment: Another approach would be to have a fasting blood sugar done, then let your grandson eat a big breakfast and do another blood sugar about two hours later. Since he has symptoms, if either of these is elevated, he probably has diabetes. See: Classification and Diagnosis of Diabetes Guidelines.

SS]