Will Doctor do a test to distinguish between type 1 and 2 diabetes?

[makingitthroughok]

Right, so DS (15) has been feeling very tired, really thirsty, Urinating frequently has lost (a bit of) weight, and has had cuts that have taken a week to scab over. This hasn't been gradual and has been getting worse day by day (more tired more thirsty ect.) Doctor thinks it could be Diabetes and has sent for bloods. Not going to lie DS is overweigh and has been steadly been losing weight (3.9 stone since january.) The doctors doing a blood test which will test blood glucose levels this does not distinguish between type 1 and 2, or will doctor assume he's overweight its type 2. If it is diabetes (which i am hoping its not) Which doctor believes it is (symptoms and urine test) I want to make sure it gets the right treatment and i wanted to ask if it does come back positive , i wondered if they did do a test to find out. Also (problem for DS not me) he's worried if it is type 2 people will perceive it as the "fat" diabetes which i know is also not always strictly true. Any advice about diabetes would be lovely as well. I wont forgive myself if its type 2. I have never felt so anxious about a doctor appointment. Im sorry if some of this seems a bit naive i dont know a lot! Thank you

Please tell me this appointment is tomorrow? Or that they got a normal finger prick blood sugar test and urine dip before delaying things? On that story, if a GP rang me up, I'd be saying "Send them up to the ward today, because this is a lot more likely to be type 1, and we don't want to wait until they get poorly". Did the GP try ringing up either the local paediatric diabetes team, or for that matter the local general paediatrician?

I'm only a general jobbing paed, but I'd expect someone with that history to be seen by at least us same day, unless the GP had got a normal fingerprick and urine tests, so was only doing tests to rule it out. I know for a fact that our local paediatric diabetes team, which sees the local kids until they turn 18, does not have one single type 2 diabetic on their books, despite us having a major childhood obesity problem. Type 2 is starting to appear in young people, but any health care professional who assumes type 2 in a 15 year old needs their head examining.

Seriously, your young man needs seeing by someone who is used to diabetes in young people, rather than in older adults. Please push. Demand your GP speaks to paeds. Tomorrow. And that's if he's well. If he's unwell: looking dehydrated (dry mouth, sunken eyes), or breathing funny (big sighing breaths), or vomiting, or complaining of abdominal pain, then please go straight to A&E. Immediately. If not sooner.

Sorry to be pushy, but I'm both frustrated and worried. You can't mess around with diabetes in children/young people, but a GP can go years without seeing it. So they tend to think it's like adults with type 2. And it's actually something that if not caught promptly can be very dangerous.

Obviously you have no idea if I have any idea what I'm talking about. So here are 2 links.

The first, you're only going to read a bit of, I would suggest section 1.1.2 "Refer children and young people with suspected type 1 diabetes immediately (on the same day) to a multidisciplinary paediatric diabetes team with the competencies needed to confirm diagnosis and to provide immediate care."

www.nice.org.uk/guidance/ng18/chapter/1-Recommendations#diagnosis

The second is more readible as aimed at normal people, rather than professionals, but explains why I'm being so pushy.

www.aboutkidshealth.ca/en/resourcecentres/diabetes/treatmentofdiabetes/handlinghighslows/pages/diabetic-ketoacidosis-dka.aspx

Hi OP, sorry to hear about your son being unwell and all the worry.
As a GP I agree with nocools advice. If your son seemed stable tonight then best to speak to your GP in the morning and clarify the situation, and if there is any suspicion of type 1 diabetes he needs to be seen again ASAP - on the same day.
If he is very unwell before your own GP surgery re opens in the morning, with symptoms like confusion or drowsiness or funny breathing, then he should be in A+E so please call an ambulance. If you're not sure, then please call 111 and ask for an out of hours GP to call you back to give you tailored advice as strangers online can only give general suggestions.
Best wishes.

Both 1 and 2 need treatment, fwiw thirsty not 2 but needs blood sugars (and pH) done now. Please seek help and I guess type 2 so I have wasted your time by posting on MN but just incase?

If the urine test showed sugars in it you should have been sent straight to the children's ward. Don't let the GP mess around waiting for tests and results, it needs treatment straightaway, too many children are diagnosed when they are really ill as it is missed by GP'd.

Thanks all if anything he seemed slightly better today! His urine did contain is it glucose. (I think thats right!) but not a lot and finger prick test was slightly high. I phoned today he is in for bloods tomorrow. Hes been kept of carbs until that happens (why might i ask gp didn't really explain well) I live 5 min drive from a&e so wont hesitate to take him. Thanks all for your help you're great!

No- sorry to be negative but this sounds really really wrong from the GP. If your DS is already thirsty and tired as well as losing weight then you really need to be worried. He should have been admitted to hospital immediately after the first GP appointment. It is far far more likely to be Type 1. And Type 1 needs treating immediately. The idea of "keeping him off carbs" (to keep the blood sugar down) just isn't enough if this is the start of Type 1. He needs access to insulin immediately.

Maybe given the blood sugar was "only a little bit high" there is something more to this case (do you know the number?) but that needs to be decided by a diabetes consultant - not a GP.

Tomorrow he must go into hospital. I don't know if the "tests" are with a diabetes team in a hospital? If not, go to A&E. Seriously.

Sorry to be hardcore. This all sounds VERY wrong from the GP. Maybe there is something else we don't know but you don't want to take risk here.

(I was admitted to hospital at 15 via A&E to be diagnosed with Type 1, by the way!)

Good luck to your son. Whatever the answer, diabetes is definitely a manageable problem.

My dd2 has type 1

You need to take your ds to hospital. His blood glucose may have been 'slightly high' but did they test for blood ketones?
If it's type 1 it's very serious and needs IMMEDIATE treatment
If it's type 2 it's still urgent

You will only get an answer if you go to the hospital don't let the GP fob you off

Also note that the NICE guidelines linked above say all diabetes in young people should be treated as suspected Type 1 until proven otherwise. And note the point that this should have SAME DAY referral to a paediatric diabetes team (ie specialists).

Sorry, this must all be very worrying. It will all be totally fine, but you do need him seen by a proper diabetes specialist in hospital ASAP (ie tomorrow at the latest).

Hello OP. I don't want to be alarmist but these threads send shivers down my spine. Good to see that your DS is going back tomorrow for blood tests. As other posters have already said, if he starts going downhill before then please take him to A&E.

My Type 1 DS1 was misdiagnosed and he almost died as a result. This was 13 years ago - I'm horrified that it still might be happening. He didn't have glucose in his urine (which I was later told is not unusual, his urine was very dilute by then as his body was trying to flush all the glucose out), but his blood sugar levels were through the roof.

Fingers crossed all will be well with your DS.

The finger prick test and urine dip were NOT normal, and your GP didn't said your son straight up to hospital? Are they mad?!!!

Seriously, sod the blood tests. What your kid needs is to see someone who knows what they're doing. Today.

Please, please, please. I don't want to sound alarmist but untreated type 1 diabetes (which is far more likely than type 2) kills kids. For the love of your son, kick up a fuss, do whatever it takes (camp out at your GP demanding they ring paeds, or rock up to A&E) but don't let your son risk being one of those statistics.

And when you do get to see the paediatrician, tell them what advice your GP gave you. Because if this was one of our local GPs I'd fucking want to know about it.

OP, how is your soon now?

Sorry, that should say 'how is your son now'?

Sorry have not replied for a while! after a pediatrician saw him for bloods they admitted him for a blood glucose test and as a precaution put him on insulin. Hs still in hospital but a lot better. Its all been a bit surreal really, i still cant belive it. They believe it is type 1 Diabetes just waiting for conformation really. We only briefly talked about the way the GP dealt with it (I would like to point out it wasnt are emergency GP as it was an emergency apptment this was just under a week ago) but i said i want to have all my attention on my son for know. Thank you for youre support

Sorry to hear that your son more than likely has Type 1, but glass that you eventually got to hospital and got treatment before he became ill. There is so much to learn but there's lots of support out there, some great Facebook support sites for parents e.g. cwd uk- main group (cwd is children with diabetes), diabetic mums uk are two great groups. It will feel surreal, when my son was diagnosed I was sure they'd ring me to say they'd made a mistake, but fingerprick tests and insulin injections become your new norm.

So sorry to hear this. But pleased your son is now in hospital receiving treatment.
I have had type 1 all my life and am literally HORRIFIED at what this GP did. It just sounds so wrong to me, on every single level. FRIGHTENING!!

Parents of type 1 teens is another useful Facebook site. When my son was diagnosed I didn't know any other children with type 1 so these online communities are great for all of those little queries, moans, tears etc.

Oh, thank god.

Um, sorry. I mean, I am really sorry that your ds appears to have type 1 diabetes. But I'm enormously relieved that he's getting treated. I realise this is a shellshock, but it's amazing how quickly they starts feeling better. But you're all going to have a fair bit of homework learning how to deal with it. Good luck.

How scarily reminiscent of the (eventual) diagnosis of my ds.

We spent six weeks going to and from the gp. I thought I was going mad. And then I thought he had leukaemia. My gp ordered bloods as well. But no dip test.

When ds was diagnosed (thank god for OOH at the local hospital) he was in ketoacidosis properly, his breathing was appalling. The consultant later said she hadn't had a child that ill for over six years. And I felt like such a terrible mother - I had known something was badly wrong, but I hadn't been able to protect him.

I think I have a touch of PTSD as a result actually. It was eighteen months ago and yet I am in floods of tears just remembering how poorly he was.

All my love making to you and your ds.