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February 4, 2008

Diagnosis and Symptoms

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Question from Bernville, Pennsylvania, USA:

I found this site in my endless search to find more info on juvenile diabetes. I have a six-year-old son that we are currently in the midst of testing for diabetes and heavens knows what else. I have been charting his symptoms over the past year and he’s had endless trips to the pediatrician with lots of questions. He recently had another decline in his weight that I feel it is significant, 2 pounds in five weeks, giving a total loss of 6 pounds in six months. In September, he weighed 60 pounds. As of Monday, January 28, 2008, he weighs 55 pounds.

With respect to his history, he wets the bed about three times a month, which is much better than a year ago when he was wetting the bed three times a week. He is active, but not a lot. He does enjoy down time as much and seems a bit less active over the past six months. His appetite is ravenous. For breakfast, he will have two waffles, one peanut butter and jelly sandwich, and water to drink. Twenty minutes later, he needs a snack, a banana or crackers. For lunch, he will have a sandwich, a banana, peanut butter crackers, a granola bar, and water to drink. Again, 20 minutes later, he is looking for a snack. For dinner, he will have two servings, wait 20 minutes, then ask for a snack. I do not buy chips, cakes, etc. It is all pretty much healthy food. Sometimes before bed, as a snack, he will ask for another little helping of dinner. He does not drink juice, only water, with milk occasionally. He has constant belly pain in the morning, with productive bowel movements. He has belly pain in the afternoons and in the evening, but no diarrhea. Sometimes afternoons and evenings are not productive, but the pain is there. He drinks constantly, and urinates as well, frequently.

We did visit the doctor on Monday, and after realizing the weight loss yet again, I pushed for testing, though the doctor was fine to sit with it all. However, I am a bit more aggressive in my search for answers at this point. They did a series of blood work via the arm, urinalysis, and stool cultures. I did get one test back on the from the laboratory technician that his sugar was 110 mg/dl [6.1 mmol/L]. It was not a fasting test, though, and no other tests were back. The testing was done at 3 p.m., hours after his last meal. I am waiting patiently for results.

My dad is type 1 diabetic and has been for many years. He takes very good care of himself, so he has no real “issues” with it. He takes his medications, etc. Two of my second cousins, on my mom’s side, also have type 1 My maternal grandmother and most of her seven siblings had diabetes as well. Any insight on what I need to ask for as far as testing would be greatly appreciated.

Answer:

From: DTeam Staff

You have asked some very thoughtful questions. This presentation is quite complex and will be best handled by a board certified pediatrician who can do a thorough history and physical examination — and follow your child for some time. There may be additional testing that may need to happen and your pediatrician may wish to involve other pediatric subspecialists such as a pediatric gastroenterologist (for the tummy pain). The blood sugar testing does not look overly worrisome (a normal blood sugar is usually 65 mg/dl [3.6 mmol/L] to 110 mg/dl [6.1 mmol/L]) although there may be need for some future testing. I would encourage you to discuss your concerns thoroughly with your pediatrician. The decisions on what tests would be appropriate are best made by the physician that is examining your son.

MSB