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Question:

From St. Louis, Missouri, USA:

My 26 month old son has had on and off symptoms of diabetes for the past two to three months but has not been diagnosed. He has excessive thirst and was in diapers until one week ago, when we began potty training, but I've noticed he urinates almost every 30 minutes, then he occasionally wakes up dry from his nap or even overnight. My son, the greatest sleeper in the world (usually 11-12 hours continuous), has begun waking occasionally. He also begs to eat before bedtime.

I tested his glucose levels a total of 22 times within four days, and five times his readings were over 120 mg/dl [6.7 mmol/L] (including levels of 168 mg/dl [9.3 mmol/L] and 200 mg/dl [11.1 mmol/L]). After doing this, I called our pediatrician and stated my concern. They had us come in the next morning with a "clean catch" urine sample, performed a glucose meter test, and drew blood for a fasting blood sugar and hemoglobin A1c which were all normal.

I have dipped a reagent strip in his urine four or five times, and it has never shown a sign of glucose or ketones. Two days ago, he vomited before getting out of bed in the morning. Since we are potty training, I decided to dip a reagent strip into the urine in his potty chair. This was about his third or fourth urination of the morning. It quickly showed glucose levels (250+) and ketones (80-160).

DKA [diabetic ketoacidosis] and two other things (I can not remember what they were called), and everything was normal. The requested another urine sample which showed only glucose. Two hours later, another urine sample showed no glucose and no ketones. That day, and the following days, my son ate like crazy! He is still very thirsty and still urinating a lot.

I've been told by a friend he may have pre-diabetes, but he also may be growing which could result in high blood sugar. I've read that this could be true, but why would he show ketones on a urine strip and high sugar if he is growing and eating? We have been referred to an endocrinologist and will be there next week.

Answer:

This could be prediabetes and is unlikely related to growth. Occasionally, with a variety of hypoglycemia syndromes, there can be some intermittent hyperglycemia along with urine ketones.

I would do what you are doing with close observation and, if any doubt, head for the emergency room or the pediatrician's office for more detailed testing. There are some special blood antibody tests available that also may be of some help but they are not 100% sensitive. Time may help figure this out. Unexplained change in symptoms, weight loss or vomiting are all signals to get medical assistance without delay.

SB

DTQ-20030826172256
Original posting 16 Sep 2003
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:50
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