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glucose in urine-possible causes?

(158 Posts)
ariane5 Mon 31-Dec-12 13:51:55

Dd (3) has been unwell lately and urine samples have shown glucose over the past week ranging from a trace to +++

What could cause this? She has been poorly a lot recently with ear/throat infections and has been very tired and had an itchy rash.

Only one of the samples showed wbc and she was treated for a suspected uti but this morning her sample was showing trace of glucose again.her diet is not high in sugar.

What could cause this?

ariane5 Wed 02-Jan-13 13:07:10

We are in Harrow nw london. Dd not having a good day blood sugar keeps going low.then she had insulin before lunch but was refusing to eat and I was panicking.

I feel a bit useless just wish she was ok

paddyclamp Wed 02-Jan-13 15:07:19

is she on novorapid? if so that can be taken immediately after a meal - that's when i usually take it - so if she doesn't eat it all you can adjust the dose accordingly

have the docs mentioned the honeymoon period?

kpandthesunshineband2 Wed 02-Jan-13 18:32:18

Are you still in hospital? Are you getting good support from your diabetic team?
It is tricky in the early stages ( well actually a lot of the time but you will start to feel more confident). Just make sure you are getting good support & advice.

ariane5 Wed 02-Jan-13 19:54:22

Yes we are still in hospital.she is having novorapid but before her meal she hates the inj then gets upset and refuses to eat in protest.

We were meant to see the nurse today but she was off sick.we will be seeing a dietician tomorrow at 2pm though.

I was just confused as dd has insulin before meals but then she gets hungry in between if she has a snack I don't know does that mean she will need another injection or are some foods ok to have as a little snack and you don't need more insulin?

kpandthesunshineband2 Wed 02-Jan-13 20:52:13

It's a little while since we have used injections as on a pump now but we used to have basal injection & then bolus injections for all meals apart from any carb snacks that were less than 10 g of carbs. Check with your team though.
Now we are on the pump we bolus for any carbs at all.
Hopefully the dietician will talk to you about carb counting if they've not done that already. Have you seen anyone from the diabetes team today?
Definitely try to talk to your team about the possibility of an insulin pump as it has certainly made our life easier & I know lots of other parents with little children have found them much better. DS used to hate injections & also makes it easier to be more flexible with food. We used to do a reward scheme for DS for injections - might help I guess.
Really feel for you at the moment as there is such a lot to take on board at this stage for all of you. I would highly recommend the book by Ragnar Hanas - Type 1 Diabetes in Children, Adolescents and Young Adults: How to Become an Expert on Your Own Diabetes
It is a big book but it is easy to dip in & out of & is full of great info.

Goldmandra Wed 02-Jan-13 20:52:22

You need to make sure she is seen by specialists in diabetes not just general paediatricians. It matters and you mustn't allow yourself to be pushed into settling for less for fear of upsetting people.

You need to speak to specialist nurses who can explain everything 100 times if that is what it takes and your DD needs to be seen by doctors who really understand all the ins and outs of diabetes, not just the basics.

focuson Wed 02-Jan-13 20:53:03

Hi ariane5 - read this post and really hope you are all ok. Our son was dxd when he was 8 and now 10 - for 9 months he was on mdi and now has a pump. With mdi we adjusted basal levimir according to exercise and also split to two times a day. Honeymoon started about 10 days post dx. Good snacks between meals meals on mdi were baby bel cheese and other carb free stuff but once we got hang of carb counting he also had injections. Cwd great site as well as FFL.

jmf294 Wed 02-Jan-13 21:31:33

Hi there,
So sorry to hear of your daughters diagnosis.
My son was diagnosed aged 2, he is now 5.
If your daughter is refusing to eat then they should look at giving the injections after she eats.
You need to be under the care of a diabetes team and insist they teach you how to count carbohydrates and adjust insulin doses.
A pump is the best treatment - maybe have a read about them.
We live near you in Watford, we were under their care until we moved to UCLH in London. They are one of the best teams in the country and support pumps. As your daughter has other health problems if you don't get the help you need you could ask to be transferred- GP can do that.

Please also have a look for Children with Diabetes and join the online community. It saved my sanity and I have met some of the most amazing families and children some of whom have posted above.
Knowledge is power in diabetes and it helps so much.

For now you are in the middle of the most awful nightmare - you need to allow yourself time to cry, scream and grieve.

Please let us know how you are getting on .

ariane5 Wed 02-Jan-13 22:13:40

I do feel a bit annoyed that we havnt seen a diabetes nurse yet but I suppose with it being new year things are a bit up in the air at hospital.
Was upset today as dd got unwell with low blood sugar and nurse wanted to give her insulin then lunch (it was 3.7 and dd was floppy and eyes rolling) yest when that had happened a diff nurse had said give her sugary orange juice to raise sugar quickly but today it was different and I was confused but told the nurse no, we would do what we did yest give her sugar not insulin then lunch.
Iam so confused and anxious about it all

jmf294 Wed 02-Jan-13 22:47:29

3.7 and any number less than 4 is a hypo.
You need to give her fast acting sugar-
Preferably dextrose tablets- we use jelly babies.
You can use orange juice but it is not as fast.

You need to give 15grams of sugar and then retest after 15 mins.
Never give insulin when hypo- so you were right- well done.

If a diabetes team don't see you tomorrow- and it's not good they have not seen you yet please transfer yourself to a different hospital.

ariane5 Wed 02-Jan-13 22:57:27

Dh was a bit annoyed at me questioning the nurse when really I don't know anything about it it was only because yesterday the same had happened that I thought it seemed wrong to give insulin when blood sugar so low.
Glad I trusted my instincts though.

kpandthesunshineband2 Wed 02-Jan-13 23:17:16

That is terrible if you haven't seen a diabetes nurse yet regardless of it being New Year.At diagnosis we saw a specialist diabetes nurse as soon as we got the diagnosis & every day in hospital & also saw the consultant every day including the weekends. You need support & information at this time in your diagnosis. Sadly not all general hospital staff know their stuff about Type 1 diabetes. Very poor advice when she was 3.7 - especially as she was acting abnormally! Well done for questioning the advice but you shouldn't be put in that position at this stage.
We use dextrose tablets or mini cans of coke to treat hypos. Fruit juice will work but isn't as fast.
Agree with everything jmf has said. Hope you get better support tomorrow! Please also do get yourself onto the CWD email list.

Goldmandra Wed 02-Jan-13 23:26:44

There is a clear lack of understanding of diabetes management amongst the ward staff. What the nurse wanted to do was dangerous and you did the right thing. Don't be afraid to speak your mind if you need to.

You need to throw your toys out of the playpen a bit tomorrow and make sure you get a referral for specialist advice.

I wonder if Diabetes UK can advise you about the best team to be referred to in your area.

ariane5 Thu 03-Jan-13 00:00:11

We have seen a consultant yesterday and today but both times all he has said was "blood sugars are up and down that's normal at this stage we will carry on with what we are doing".

Managed to beg a couple of leaflets off the dietician today and she will see us tomorrow but I've been reading up on what I can find.will def be insisting on some proper help tomorrow I just want somebody to sit with us, explain everything then go through all the questions I have.

kpandthesunshineband2 Thu 03-Jan-13 00:01:36

Definitely UCLH is regarded as being one of the top hospitals for paediatric diabetes. Prof Hindmarsh & the whole team I believe are excellent. Know a number of families who have moved from their local care to there after very poor care elsewhere.

ariane5 Thu 03-Jan-13 00:05:35

I will be demanding some help tomorrow I can't keep relying on the leaflets I've been given and the booklet that came in the accu chek pack I need a real person to go through everything.

kpandthesunshineband2 Thu 03-Jan-13 00:29:38

Absolutely! Hope you get progress tomorrow.

jmf294 Thu 03-Jan-13 22:43:12

Any news!
Did you see a diabetes nurse??

Ds2 was diagnosed last year aged 4. He would have an injection after each meal, once we'd seen how much he'd eaten. And then up to 20g carbs as a snack mid-morning and mid-afternoon. And carb-free things otherwise (meat, cheese, veg).

shock at the nurse wanting to give her more insulin when she was hypo! Any number under 4.0 you give 200ml juice or 3 jelly babies, wait 10 minutes after she finishes and test again. And if she is still under 4.0, do it again.

Tell the nurses you want injections after meals and if they don't agree they should ask the diabetes nurse and come back when they've checked!

kpandthesunshineband2 Fri 04-Jan-13 00:47:25

How did you get on today? Hope you've had some more help & advice!

OxyMoron Fri 04-Jan-13 01:01:48

Re finding the best teams in your area. There are some reviews on the children's diabetes teams clinic comparison site here

I agree about looking into UCLH. We don't live in London, but had dd's care transferred there. It was like a whole different world. I'm really sorry you're having to deal with this. Dd was all over the place in the early weeks (anything between 1 & 30!) You'll get there, but you're doing the learning curve just now. I hope the care gets better.

ariane5 Fri 04-Jan-13 08:19:50

Dd seemed a lot brighter yesterday and more herself.

Still not seen a diabetes nurse (she's off sick) but saw a brilliant dietician.

Dd had a hypo (2.7) in the aft though and it was a bit scary.also she has been hungry at mealtimes but has the inj then goes absolutely mad and refuses to eat which makes us panic so we asked abt inj after meal instead and they agreed so we feel happier abt that now.

Really hoping to see diabetes nurse today.dd had bad hypo again in night so they will slightly lower her insulin dose as well.

kpandthesunshineband2 Fri 04-Jan-13 14:40:11

Great your daughter is feeling better.
Are you seeing a doctor every day to explain everything to you if the nurse is not available? Who is making decisions about her injection amounts & are they involving you?
Did the dietician start to talk about carb counting?
When do they think she can go home?
Sorry for all questions but just want to make sure you are getting the support & education you need.

Have you seen a diabetes consultant? Or anyone who has training and experience in diabetes? I can't believe how long you're having to wait! We went into hospital Thursday morning and came home Friday night, all trained up to manage, with a diabetes nurse on the other end of the phone.

Have you talked to your EDS consultant? I had a really quick google and there do seem to be links with EDS and hard-to-control blood sugars. Have they done tests to check whether she is producing insulin (a c-peptide test), or whether she has the antibodies produced when the immune system attacks the pancreas (islet cell antibodies and GAD 64 antibodies)? I realise this is getting a bit technical but sometimes doctors need a prod. FIL spent 4 months trying to treat himself for Type 2 diabetes before the docs finally worked out he actually had Type 1 (totally different cause and treatment). And if there is a chance she doesn't have diabetes you want to know now!

Anyhow, I'm glad they're doing injections after the meal, and adjusting her doses. Hypos are scary to start with!

ariane5 Fri 04-Jan-13 20:36:30

Finally saw the diabetes consultant this aft.he mentioned they would be doing some blood tests.we saw the dietician again but diabetes nurse still not there so another nurse went through a few things with us.

They couldn't let dd home today as she had a very bad hypo in the night but throughout today blood sugar has remained around 13-15 apart from before dinner when it was 9.

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