Recently I’ve been getting a strong smell of urine from my four year old son’s breath, on and off, and each time I try to find out more about this on the internet, diabetes keeps coming up. Except for having eczema since he was six months old, he’s an otherwise healthy boy. Do you think he should be tested for diabetes?

It is not likely that he has diabetes if this is the only symptom he has. Unusual smell on the breath can be caused by many different things. If you are worried he may have diabetes, a simple urine check can give you the answer.

JS

[Editor’s comment: Testing for diabetes should include blood sugar levels performed by a medical laboratory. The timing of the sample (fasting, random, or postprandial) would influence how high a level is considered abnormal. See Classification and Diagnosis of Diabetes for further information.

Occasionally, lab blood sugar testing might be normal in an early case of diabetes, repeat blood sugar testing at the same or a different time, or performing a glucose tolerance test, might be appropriate if there is a high suspicion of diabetes despite normal initial testing. Another test, the glycosylated hemoglobin, might be used to help confirm a suspected diagnosis of diabetes, but the GHB (also called HbA1c or A1c) is not usually considered as appropriate to make an initial diagnosis. Antibody testing is occasionally done as a screening test in high-risk situations, or as confirmatory of type 1A (autoimmune) diabetes, but is not part of routine testing.

Urine sugar tests or home glucose testing, if done, might be positive, which would make the situation more urgent to get lab testing done to confirm the abnormal results. However, urine or home glucose testing, if negative, would not exclude diabetes.

WWQ]