From Harbor City, California, USA:
My 4 1/2 year old daughter exhibits signs of diabetes. She had a routine urine test during a physical that resulted in an amount of sugar in her urine. Her blood test showed slightly elevated level of ketones. My doctor told me not to worry about it. She does urinate very often and drinks and eats constantly. Her hair falls out very easily. She craves sugar all the time. She is only 31 pounds but can out-eat her 8 year old brother. She also complains about being tired all the time. Her father has Type 2 diabetes and both of her grandfathers on her maternal side had diabetes. She was a premature baby that was delivered at 31 weeks. Should I be concerned and demand further testing?
I would strongly suggest further testing for your daughter. In early diabetes, an elevated blood sugar may be intermittent, but the pancreas may fail quickly and your daughter could get quite sick with diabetic ketoacidosis if untreated. I would suggest checking the blood sugar and urine sugar about 1 hour after a meal high in sugar (a formal glucose tolerance test is rarely necessary in a young child). If the blood sugar is over 200, and she has symptoms of diabetes (thirst, excessive drinking), no further testing is necessary and she needs insulin. If the blood sugar is normal, I would recommend testing her thyroid as an overactive thyroid can cause excessive appetite (usually with weight loss), hair loss, fatigue, and excessive urination (usually without sugar in the urine if the blood sugar is normal, but sometimes an overactive thyroid may cause the blood sugar to go slightly high and sugar may appear in the urine). Also a child with an overactive thyroid is more likely to have ketones in the urine (from weight loss) even if the blood sugar is normal. Ketones and sugar in the urine, however, make one worry that the blood sugar is high.
Additional Comment by Heather Valdes Speer, DPT-1 Research CoordinatorThis child can also be tested for Islet Cell Antibodies and hemoglobin A1c. As Dr. Lebinger reported, diabetes has a long preclinical period in which there are transient hyperglycemias. Full blown diabetes does not develop until 80% to 90% of the islet cells are destroyed.
As an aside: Half my child's hair fell out 10 months before she was diagnosed with diabetes. A specialist told us the hair loss "might have been the result of a high temperature," possibly an immune response to a viral assault.
Original posting 4 Oct 1998
Additional comment added 26 Oct 1998
Posted to Diagnosis and Symptoms
Last Updated: Tuesday April 06, 2010 15:09:00
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