Over the past week, my son has had increased complaints. I’m not sure what is going on, but the school nurse has mentioned diabetes. These complaints have come on rather suddenly and are varied. He complains of being very thirsty and, if he doesn’t drink water right away, he vomits (mainly clear with some bile). This has happened three times this week at school and he has had to leave. He does not run a fever, have a cold, etc. After he vomits, he says that he feels fine. He is urinating frequently, but is that because he’s always drinking? I don’t know. He is more tired than usual and he seems to always be hungry. Again, could this just be a coincidence because he’s a growing child? I don’t know.

I did call his pediatrician today and took him in for a urine test and preliminary results were negative for both sugar and a urinary tract infection. I requested blood work to be done and I’m waiting on the results. I’m curious what the sugar levels are in his blood. Will these levels tell me if he has diabetes? Should he have a fasting test drawn? I’m not sure what is going on and it may not be diabetes related at all. However, I do know that something is “just not right” (call it mother’s intuition) and the doctor was not able to see him at today’s appointment. So, I’m not sure where to go from here. If all tests come back normal and symptoms still persist, what should I do? What tests should be done? Are there other tests to diagnose his illness?

First of all, good for you and the school nurse to recognize that your child is off his usual pattern.

Is there “something wrong”? I don’t know that there is anything serious wrong but certainly your description sounds suspicious.

You raise a VERY COMMON problem, which I call it the “chicken-and- the-egg” problem. Did the increased thirst then lead to (appropriate) increased urination (to prevent “over-hydration”) OR did the increase thirst occur (appropriately) AFTER the increased urination to prevent dehydration. In diabetes, the increased thirst is an appropriate, compensatory mechanism.

Not all issues that relate to fluid balance relate to diabetes mellitus (“sugar-diabetes”). If that’s not confusing enough, there are other medical conditions that have “diabetes” in the description that has NOTHING to do with sugar (one example is called diabetes insipidus). Other things can cause primary thirst or primary urination.

Your son deserves a very good and thorough history and physical examination reviewing many aspects of his physical and emotional health. Some specific laboratory tests, including possibly blood and urine tests, would not be unreasonable and, yes, I think they would optimally be done first thing in the morning before he has eaten, had a drink, gone to the bathroom, etc. Depending on what is learned, maybe other tests would be warranted.

See other links on this site about type 1 diabetes (What is Type 1 Diabetes?). Vomiting and, then, relief of symptoms after vomiting are not typical, primary symptoms of diabetes mellitus.

DS