October 23, 2003
Diagnosis and Symptoms
Question from Lambertville, Michigan, USA:
There many relatives with diabetes on both sides of our family, and I am concerned about my daughter who has been drinking more, constantly hungry, and recently she has been wetting the bed at night. I took her to the doctor two weeks ago who checked her urine and said that she is fine. There was no sugar in her urine at all, and no infection. However, she continues to wet herself, acts like she is starving all the time, and she has gained about 10 pounds in the past month.
Can you have a normal urine test and still have diabetes? Should she be tested further?
Answer:
It sounds like your child would benefit from additional testing for diabetes. I would suggest you review your continued concerns with your daughter’s pediatrician who can arrange for additional testing over time. A single negative urine test does not rule out diabetes.
MSB
[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 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]
