July 16, 2005
Diagnosis and Symptoms
Question from Lakewood, Colorado, USA:
Yesterday, I took my four year old son to the doctor’s because he has had increased urination. Over the past few weeks, he has needed to go to bathroom about every five minutes or so. Sometimes, he urinates a “regular” amount, other times small amounts. He does not complain of pain or burning. I haven’t notice a huge difference in the amount he drinks, maybe a slight increase, i.e. he actually finishes his milk/water or may ask for seconds when he never did before. A similar episode like this happened back in January for several weeks and then went away.
The physician’s assistant (P.A.) who saw him took a urine sample and screened it. He said it was “clean” and did not show any evidence of bacteria. It did not show any glucose but his ketone level was 5 mg/dl, his protein level was 10 mg/dl and bilirubin was “small”. The P.A. then did a quick check of his blood sugar with a device that I believe diabetics use to monitor. It read 113 mg/dl [6.3 mmol/L]. He had eaten lunch about two and a half hours beforehand.
The P.A. sent the urine to be cultured, which he said would take a few days. My son is otherwise pretty healthy although may be a little underweight for his age at 34 pounds. How worried should I be and how far should I push for further testing to rule out diabetes? I know knowledge is power, but I don’t want to freak out unnecessarily by getting on the Internet and searching for information that may not be appropriate.
Answer:
You may wish to read What is Type 1 Diabetes? and Classification and Diagnosis of Diabetes.
Based on what you have described, it would appear that your son does not have diabetes. Can it be excluded? No, but it would seem very unlikely at present. Further testing in the future, which might include repeat fasting SERUM blood tests (not just with a little bedside glucometer but a through a needle stick from a vein and run in the laboratory) plus follow up testing after meals might be helpful.
For the time being, I’d simply put diabetes back to the recesses of your mind and try to reassure you.
However, if you told me that you or his father or other first degree relative already has been diagnosed with type 1 diabetes, that might prompt me to do some other specialized testing.
DS
