From West Chester, Pennsylvania, USA:
My four-year-old was sick with a virus, vomiting for two days, a fever for five. He was complaining of back and stomach pain so my pediatrician was worried he may have had a bladder or kidney infection. The doctor tested my son's urine and was surprised to find a high amount of sugar in his urine--no infection, no ketones. He sent me right to the Emergency Room since it was a Sunday. My son's blood glucose levels were normal--94 mg/dl [5.2 mmol/L]. Two days later, the pediatrician tested my son's urine again and there was no sugar. He sent both samples to the laboratory, the +1 glucose from Sunday and the negative reading from Tuesday.
So, is my son at risk for developing diabetes? My pediatrician thinks this episode was a fluke, but was going to ask a pediatric endocrinologist for a second opinion.
An informal consultation by your pediatrician to the friendly neighborhood pediatric endocrinologist is probably reasonable. Your child likely does not have diabetes mellitus.
Just as "not all that glitters is gold," then "not all that is high glucose is diabetes." First of all, depending on the testing method, some chemicals and different sugar-like chemicals can react with the "urine sugar test" and can give a "false positive" result for glucose/sugar. Furthermore, there are various kidney ailments (some serious, some NOT), but completely unrelated to diabetes mellitus whereby true glucose can "leak" into the urine and lead to a "true positive" test for glucose, but this, again, is not diabetes
In an otherwise normally functioning kidney, the blood glucose must be about 180 mg/dl [10.0 mmol/L] to allow "spillage" of glucose into the urine. A normal fasting glucose is about 60 to 100 mg/dl [3.3 to 5.6 mmol/L], but diabetes is not diagnosed unless one of the following is shown:
- fasting serum/plasma glucose more than 125 mg/dl [7.0 mmol/L] ("126 mg/dl [7.0 mmol/L]" or greater) or;
- random serum/plasma glucose of 200 mg/dl [11.1 mmol/L] or greater but WITH the presence of typical diabetes symptoms of increased thirst and increased urination or;
- during a formal, properly performed oral glucose tolerance test, the two hour serum/plasma glucose value is 200 mg/dl [11.1 mmol/L], or more.
During your child's illness, it is possible that the "stress" of the illness could have made his blood glucose as high as 180 mg/dl [10.0 mmol/L] or more, which then was filtered into the urine, and then, as he improved, the glucose went down. This would be a pretty non-worrisome scenario.
But the answer to your question regarding your child's risk of having or developing diabetes actually hinges on a number of possible variables including any family history of type 1 (or less likely type 2 diabetes, given your son is only four); his health; his medication use; his weight; his past health history; and the family health history. So, without a more complete medical history, overall, I'd say that the odds are in your favor that he has a low risk of developing diabetes given the story you have provided. Nevertheless, have your pediatrician speak with the pediatric endocrinologist because more health information might be available and provided which then might lead to a possible formal consultation by that specialist.
Original posting 30 Apr 2010
Posted to Diagnosis and Symptoms
Last Updated: Friday April 30, 2010 21:32:36
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