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August 13, 2002

Diagnosis and Symptoms

Question from Australia:

Ten days ago, my 12 year old son had a fainting spell after playing basketball, fell and chipped his tooth. He is also having nighttime sweats, waking through the night to urinate and increased frequency through the day. He has lost 3.5 kilograms over two weeks and says his mouth feels like sandpaper. This evening (at 1:45 am), he awoke with toileting, came to me was totally irrational and cold, said he had a headache and couldn't sleep, so I made him a sweet hot tea, he came right straight away and went to sleep. He is a slight child, and I have always said he gets hypoglycemic (not diagnosed). He goes pale and clammy if or when he runs out of fuel, but we feed him and he comes right or we give him sugar and he is fine. We have a family history of type 2 diabetes on both sides and one grandparent has type 1. Is there a possibility my child could have diabetes? What test should I request? Am I being neurotic?

Answer:

Some of the symptoms you describe may be due to diabetes. The simple test is to check his urine for glucose (glycosuria). It is a very simple test. In any case you should get him along to your doctor to get him checked out. No, you are not a neurotic mother, you simply caring for your child and a concerned parent.

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]