DD (9yrs) breath smells of pear drops - worrying

[SarfEast1cated]

Hi there, would appreciate some advice. DD9 is not well, high temperature, tummy cramps and headache. she has been a bit delirious and floppy all day but is a bit better now. This morning her breath smelt of pear drops which happened when she was a newborn and we had trouble feeding. I googled and it is apparently a sign of diabetes. She also said that when she went for a wee it smelt funny. I am imagining that she either has kidney failure or diabetes. Please tell me I am being stupid? all of the advice on google to similar cases said 'take you child to A&E', so I am fretting a bit. Can you reassure me?

"random OR fasting" sorry

Also, sorry to labour a point, but whilst peeing a lot and drinking a lot are classic signs of type one diabetes, they don't always present. Ketones and floppiness are enough to trigger an urgent visit to A&E.

Children die every month in the UK because of un diagnosed T1D and hundreds more are critically ill in ICU at the point of diagnosis. Never ignore the symptoms.

How is DD doing OP?

Black alert means 'unable to cope with demand'.

So you're definitely better off staying away from A&E - the experience of you going will be worse for her

I've just see your posts T1mum3 and you have completely freaked me out! She went back to school today and seems 100% better now. Do you think I need to make a doctors appointment? I doubt they'd take me seriously now.

I have type 1 diabetes. It is easy and cheap to test this and running around with uncontrolled diabetes can harm your body. I'd have it checked out tomorrow just to be sure.

I kept doing everything with uncontrolled diabetes, partying in the wwleekend, going to work et cetera. When I had it checked out I ended up in the hospital with kidneys almost shuttibg down and close to coma.

I hope your kid is ok though.

Another parent of a T1 here, and I agree with T1mum and Chinny. for your own peace of mind please get her checked.

It could also be that her blood sugar got low as she was not eating much and she was producing some ketones due to that rather than it being diabetes or DKA. My son is not diabetic but gets ketotic hypoglycaemia when he's unwell as he stops eating. He can get pear drop breath when he is like that. When he starts eating again the ketones clear but he often requires in patient treatment to do that. I'd definitely take her to a GP as you feel she is well now just to check off on some of the things mentioned above and put your mind at rest. It's not worth messing around with diabetes and you need to rule it out. Take a urine sample with you as they can test for glucose and ketones using a dipstick in the surgery.

Genuinely sorry to have freaked you out a bit. I'm really glad that you DD is feeling better. In part I was posting because if someone else comes across this thread with the same symptoms, they need to know the immediate action to take.

If your DD is fully better now, then fingers crossed everything is fine. On my DS's day of diagnosis he went to a bushcraft party and performed in a show for two hours. With his blood sugars at diagnosis that evening he should have already been in a coma and if we had waited to see a GP we could have lost him. In retrospect, I believe that he'd been going in and out of the danger zone for a while.

That said - what should you do now? If your DD is back in great health then it may be difficult to find a GP who will take you seriously, and it's possibly just one of those things. My DD (who doesn't have a diagnosis of T1D) had high ketones and elevated blood sugars with a bug a year ago, but hasn't been out of range on a BG test since.

One option is just to read up on the symptoms and be aware (excess hunger and skin infections were my DS's key symptoms - the thirst only kicked in noticeably at the last minute - so make sure you look at them all). Or you could take her to the GP for a test. A final option might be to buy a home BG testing kit and test her in the evening an hour after a high fast acting carbohydrate meal (include a sugar sweetened drink). If it's over 7, then that's a cause for guarded concern. If it's over 11, it's a diagnosis and she needs to go to hospital.

Sorry - I feel like I bang on and panic people about DKA and undiagnosed T1D, but it's much more common than meningitis and goes untreated until too late in way to many circumstances.

I wouldn't worry about the doctors appointment. The pear drops smell is ketones. This smell occurs when the body starts to use fat stores for energy. Ketones are the byproduct. It occurs when a diabetic is in a serious state of ketoacidosis and the body is consuming fat for energy as it can't access the carbs/sugars it normally uses because the pancreas isn't producing insulin to process the carbs.

It also occurs in starvation, Atkins diet and dehydration/viral illness/vomiting.

The first is deadly serious and the child doesn't recover but gets progressively worse. There are also other symptoms like drinking and weeing excessively.

In the second instance the child recovers, starts eating normally and drinking (super important to drink) and is self limiting.

If her breath now smells normal then I wouldn't bother wasting your time going to the dr.

Some chemists do a finger prick test so any worries that's also a quick option.

I do sympathise with T1 and agree it can easily go overlooked.

I used to work in A&e and a mum brought her little boy in having come straight from the GP who had told her (for the 2nd or 3rd time) it was just a virus. This boy was pale, emaciated and disorientated and from 4 feet away I could smell waves of ketones coming off him. I whisked him through and he was on PICU within the hour. Honestly it scared me he was so ill. Some people actually are unable to smell ketones. Luckily I have a very acute sense of smell.

I'm a senior sister in A&E and I can't smell ketones.

someday. I can smell the faintest whiff, even in a baby's nappy when no one else can!

You have a serious disadvantage there