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Question:

From Brownsburg, Indiana, USA:

I have been concerned about my two and a half-year-old daughter. The last month or so she has been extremely thirsty and is urinating way above what her normal had been. It's gotten to the point where we are having to change her five or six times a night and changing her sheets at least once a night, if not more. Her eating habits have also changed. She used to eat meals and snacks at regular times but, lately, she wants to eat all the time, but never very much. I looked online for anything that may be the cause of these problems and the only thing I could find was type 1 diabetes. In light of this, I purchased a home glucose monitor and have been tracking her blood sugars for the last week or so. Most of the time when she wakes up in the morning, her sugars are in the 50s mg/dl [2.8 to 3.2 mmol/L] and range during the day from about 160 mg/dl [8.9 mmol/L] to 280 mg/dl [15.6 mmol/L]. We did have one evening where it was up to 360 mg/dl [20.0 mmol/L]. I called our local hospital's nurse line about this and she advised me to take her in to the Emergency Room (ER). Well, when we got there, her sugar was normal so the doctor said that there was nothing that he could do. We also checked the machine against the laboratory results to make sure that it was giving accurate readings and it was. I'm just not sure at this point what else I should do, if anything. His recommendation was to wait until she was lethargic and obviously sick and then bring her back. I don't want to wait until she is in DKA before something is done. I made an appointment with a pediatrician, but as the appointment is almost a month away, I am concerned about what I should be doing right now. Should I be limiting her sugars and continuing with the home monitoring? The doctor at the ER made me feel rather stupid so now I feel like I am just going crazy. Is there some other reason that all this could be happening? Is it possible to diagnose this disease before she is really sick?

Answer:

In retrospect, going to the ER was probably not necessary, as from your letter, the she was not life-threateningly ill. But, of course, we can only say that now. Keep in mind that adult ER doctors are not always most up-to-date on pediatric concerns, especially diabetes.

I don't know if your child has diabetes or not. The glucose readings obtained during the day are VERY abnormal, assuming the meter is coded and calibrated correctly and the child's finger was adequately clean and dry before the blood poke.

I think you are absolutely correct to note the changes in her urinary, thirst, and eating habits as potentially serious. I suggest you call her general pediatrician right away and speak with him/her or the chief nurse. CALMLY explain the changes you've noted. I am certain that they will want to bring her in. They should check blood and urine. This may not be diabetes mellitus, but it certainly may."It" may be something else. Whatever "it" is, this is the time to find out!

DS

DTQ-20071004084927
Original posting 6 Oct 2007
Posted to Diagnosis and Symptoms and Hyperglycemia and DKA

  
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Last Updated: Tuesday April 06, 2010 15:10:12
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