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September 11, 2007

Diagnosis and Symptoms

Question from Claymont, Delaware, USA:

My 10-year-old son has had foamy urine for four to six weeks. After learning that it was not normal, I took him to the doctor immediately. The pediatrician's office took a urine dipstick test in the afternoon. They found a trace of protein and sugar in his urine. A week before the test, my son had fevers at night for four days with the only other symptom being a headache. At first, the doctor wanted another morning urine sample in two weeks. In the meantime, my home glucose monitor reads 140 mg/dl [7.8 mmol/L] for his fasting almost every morning this week. I am pre-diabetic, and diabetes and kidney disease is in our family. Since his fasting blood sugar is high, the doctor wants him to go for a two hour post meal laboratory test. However, his blood glucose seems to be below 140 mg/dl [7.8 mmol/L] after two hours. Could he be diabetic? Is the protein related to the sugar? Why are his post meals normal, but yet his fastings high? He has gained a lot of weight over the past year and his BMI is "overweight." He has no other symptoms of frequent urination, thirst or hunger.

Answer:

I think that your son may not be fully diabetic, but to clarify the diagnosis, he might need a new fasting blood sugar test done in the laboratory with a urinalysis, an autoantibodies test (GAD, IA-2, IAA), an A1c test, and insulin levels done at fasting and post meal. He may eventually turn out to be pre-diabetic, but losing weight and promoting physical exercise can be the best way to prevent the full spectrum of clinical diabetes.

MS