Should I take my DC to A&E over concerns for diabetes

[thesurreymum]

DS is 6 has been completely dry day and night since before he was 3, never any accidents. Back in May/June this year he started sporadically wetting the bed. No known emotional changes, checked with the school etc all okay. We went to the doctors, did a urine test no infection, no sugars in the urine. Did a referral to the paediatrician as it is a concern why he has started after being previously dry.

Still waiting for the referral now, over the past few months continued with very sporadic vet wetting, going weeks without any accidents and then wetting. The last two nights he has been wet so I've called the doctor and explained. She is going to chase the referral.

I said my concern is type 1 diabetis, its a common symptom and I asked if he could be tested. Her response was that urine was clear in June, he's well in himself and she doesn't want to put him through a blood test before being seen by the paediatrics. She didn't believe that they could finger prick a child?

Now do I wait for this referral, it's been going on around 4 months and he's not deteriorated or do I take him to A&E with my concerns and let them deal with it properly.

I am sensitive to diabetes as a close friends child was diagnosed earlier this year and he had no symptoms only a bout of sickness.

Also the last two nights he fell asleep on the sofa and therefore didn't have a wee before bed like he usually does so could this be a contributing factor?

Presumably you didn’t leave him on the couch all night, so he should have been told to go to the toilet on his way to bed.
No, A&E is not for a child that has not deteriorated, and is waiting to be seen in clinic.

They absolutely can finger prick a child.

Is he drinking excessively? Going to the loo loads in the day? Weight loss? Bed wetting alone wouldn't make me think diabetes.

Finger pricks in children are common! Not sure why the go said this. Diabetes can go bad very quickly so if you have a concern I would get him checked. However I think as it’s been going on for a while it probably isn’t diabetes but best to be sure.

I wouldn't go to A&E with this .Is this a test that a chemist could do?

No it’s not an A&e issue ..

did you take him to the loo before bed when he sat on the loo .

us he going to bed too late - falling asleep on the sofa suggests he is very tired. He may be sleeping deeper if very tired

He’s not deteriorated so A&E wouldn’t be appropriate. You could call 111 for advice but as the paeds referral has already been done I’d be surprised if they can do anything more

GP can do a diabetes test. Unless you think he's at risk of falling unconscious A&E isn't the right place.

OP has he fallen asleep on the sofa due to being unexpectedly tired? Or was he kept up later than usual?

Does he have any other symptoms such as headaches, visual disturbances, dizziness/balance/co-ordination issues, personality changes (more or less emotional etc), impulse control issues etc?

If yes to any of these I would go back to the doc and present them too to give a bigger picture.

The GP should have done the blood test as well as the urine test as part of the referral process to Paediatrics (or at least that would be completely standard in our area). Go back to your GP.

Ask for a anp appointment if no gp one available. They can do a finger prick and urine dip test.

It's not impossible to be diabetes but there are four main 'flags':

Thirst - drinking more than normal
Thin - extreme/losing weight despite a normal diet
Tired - excessive tiredness despite a normal bedtime routine
Toilet - needing to wee a lot.

If the only symptom is night time wetting, it's been happening sporadically for 4 months and he's well in himself, I wouldn't spring to diabetes.

Are you making sure he doesn't drink late at night? He needs to wee before bed. You could also try waking him before you go to bed for a wee.

Find the number for the paediatric secretaries and find out if you have been allocated an appointment our if you are on the list for when the next batch of appointments are released.

We had to rearrange one of my daughter paediatric appointment. After 2 months of hearing nothing I called the secretaries. We were on the appointment list but all the available slots were taken and we were waiting for the next batch to be made available. The secretary put us on the cancellation list. It took a week to get an appointment with a 3ish week wait for the appointment. We could have had on sooner but the appointment offered was 20 minutes after the call and that wasn't achievable! I always find that knowing the date makes the wait easier

Has he had an accident (bed wetting isn't included)? - No.
Is it an emergency? - No
Do you go to a&e? - No

You pester your GP - the referring doctor and chase up with the paediatric clinic that you've been referred to.

Thank you for all the advice and responses. No changes in his physical or mental health. I know a few people have said that the bed wetting alone wouldn't be a concern for diabetes but my friends son had none of the symptoms of diabetes when he was diagnosed.

The other possibility I have been considering is that he is not drinking enough/ going to the toilet during the day and then overcompensating at night.

I know that people have said not an A&E job but if left untreated diabetes can be fatal.

Untreated Diabetes is an emergency. As I am not a medical professional to diagnose myself if he has it, seeking urgent help is not unreasonable

Definitely not something for A&E. It is neither and accident nor an emergency. All A&E will do is refer you back to your doctor. It's just a waste of everyone's time.

There are lots of possible reasons(psychological, neurological, pathological) for bed wetting, of which diabetes is just one. I would wait for the referral. By all means go back to the doctor to chase it up again and/or ask for a second opinion on the finger prick test, but don't go to A&E.

How was your friends son diagnosed if he had no symptoms? I wouldn’t go to a and e in your situation.

He had what was thought to be a stomach bug. Wasn't getting better, gp sent him to A&E because he looked dehydrated and they finger pricked him.

@thesurreymum well I am a medical professional and am telling you not to go to a&e, and to contact your GP or the paediatric team. It's what you asked in your OP.

You're right untreated diabetes is an emergency. However a 6 year old wetting the bed for the last 5 months with no other symptoms is far from suggestive of diabetes or an emergency.

6 year olds generally deteriorate over a time with type 1. In 5 months i would have expected some weight loss, tiredness, increased thirst and output. Often parents claim there were no obvious symptoms but when you dig down a bit there was. Drinking more/more tired/hunger that they put down to summer and holidays. Being busy etc.

Don't diagnose your child based on a friends sons experience. You also mentioned he was unwell prior. Which is also common. Theres probably more to the story and his experiences.

Diabetes isn't catching, and although anecdotally it does appear in clusters it would be unlikely to be this close with same presentation.

GP's can fingerprick a child. Part of the reason for children often being picked up too late is GP's reluctance to finger prick. Ask for it but don't go to a and e unless your son is clearly unwell (look up symptoms of DKA).

Alternatively buy a monitor theyre not expensive and check him yourself and/or sign up to the ELSA study and have him screened for diabetes risk.

Finally in all seriousness I'd also have a think about your anxiety and health anxiety. This seems incredibly OTT for the symptom you describe.

This is not a reason to go to A&E. You've said he hadn't deteriorated so it would be a complete waste of resources. Chase the GP to do some bloods and wait for the paediatric appointment.

Diabetes can be a medical emergency but he would be drowsy, confused, fainting, sweating etc. Not going about life as usual. I can't say he doesn't have diabetes but I can say he doesn't need emergency treatment at A&E right now.

You can buy urine test strips in pharmacies. Untreated diabetes would likely be positive for glucose and/or ketones.

Bedwetting on its own is not an A&E matter.

https://www.elsadiabetes.nhs.uk/

For anyone concerned about their childs risk of type 1.

So he did have symptoms.

It sounds like your son has enuresis. I would check out www.eric.org.uk for advice.

It's very common : 15% of 7 yo wet the bed regularly.

Untreated diabetes can be an emergency. But your DS hadn't been diagnosed with diabetes. His symptoms are bed-wetting and you've leapt to that conclusion with no evidence other than what happened to a friend.

It's not an emergency. You shouldn't go to A&E.