Potentially Diabetic Child - Wait for Blood Tests?

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I can't work out if I should ask the GP to escalate this or not.

DC(3) saw a doctor yesterday who mentioned given the symptoms (frequent, urgent urination) and tested urine sample (with high level of ketones and absence of infection markers) that DC could potentially be diabetic and advised me to call this morning to arrange for a blood test as this is done at local hospitals. From our discussion and the evident high energy from DC, there's not an immediate concern of DC passing out or anything like that from their behaviour at the moment but something to watch out for. However, I've called for a test and the next one is in 3 weeks but was told it could be escalated through the normal GP with their advice they think it's necessary.

I'm trying to work out whether a 3 week wait to have the blood test undertaken in these circumstances is unreasonable or not? Surely a child shouldn't go 3 weeks with uncontrolled sugars if they are diabetic?

I'm a GP too. A+E tonight if you can't get a quick OOH/111 appointments. Needs a finger prick glucose test and repeat urine if you can catch some but don't delay presenting just for that.

If you have a walk in centre then go there. By pass GP completely. You need an immediate blood test so get youvto hospital.

I have diabetes. I don’t want to worry you, but in children if it is diabetes it really can come on very quickly. There are cases of a child being absolutely fine (as in, no symptoms of diabetes) and being in serious DKA within 24 hours.

I’d follow up with the GP but in the meantime I would see if anyone you know has a finger prick blood glucose meter. That will at least tell you if the levels are massively high or not at the moment. You can buy them in pharmacies too and they usually come with 10 test strips initially. (The meters themselves are not too expensive as it’s the test strips that the companies make the money on.)

It sounds like it’s now been 24 hours since the original GP first mentioned this. I would be seriously considering whether a trip to A&E is necessary if your DC is still weeing excessively/thirsty.

www.nhs.uk/conditions/diabetic-ketoacidosis/

Right, a family member is going to pop their meter by. What range am I looking for? DC has just had a snack not long ago so I assume it needs to wait 2 hours?

Normal range is 4-7 - my DS 's level was 28 when diagnosed via fingerprick in the GP's surgery.

Good luck

As PP say, 4-7 is normal range. Over 11 would (I think) be an automatic diagnosis. My son was 33 at diagnosis.

Glucose levels over 7 when fasting or over 11.1 if a random check suggest diabetes. If it is new type 1 diabetes the glucose can be very high.

Was the finger prick reading okay? (Passing paediatrician having palpitations at the thought of the proposed wait)

Hope all is OK,, OP. The finger prick should give you an idea. Don’t hesitate to go to A&E if you are even the tiniest bit unhappy. The speed at which they go downhill is....very fast.

Hi all, DC was getting quite grumpy and tired by the time they arrived so about half an hour after white carbs (bead - completely without thinking!) the reading was 5.9. The strips were used by(?) 2019 so I'm not sure how accurate it is but I'm thinking that the reading is fine. I've read about dips after eating which is why they say 2 hours but I'm sure it wouldn't dip to that level if it was extremely high otherwise would it?

Not sure we can put DC through another, it was horrible.

Oh, thank goodness for that. That gives a fair bit of reassurance for now.

That seems normal and is reassuring. In new type 1 diabetes the glucose is normally persistently high whenever it is checked.

Yes, it's reassured me for now!

I'm going to keep an eye on her. The results are making me think it's reasonable to wait for the time being.

That’s a good reading. I’m sorry you have been through this worry! Ketones by themselves can happen for many reasons but if there’s suspected diabetes that’s very much an emergency. I think the doctor has been unfair here to worry you with that then not do the test there and then.