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?

GI symptoms are related to type 1 diabetes, particularly when someone has reached DKA stage. I wonder if your friends frightening experience is causing you to worry excessively about your dc. Maybe arrange another gp appt and hopefully you will be able to get further reassurance from the Gp.

They can fingerprick a child, but he would need to do more extensive testing than a finger prick.

I would say falling asleep on the couch without the usual bedtime routine was the reason for the wetting for the last few nights.

What is the usual bedtime?

A&E is not the place to take someone for this. Wait for the pediatrician.

Untreated diabetes that is an emergency would have symptoms of diabetes. The child would be acutely unwell. Your child is not. That means they either don't have diabetes, or at the very, very, most, have the early stages.

Seeing as he only just started wetting the bed recently - I would be looking at other factors while you wait for the GP referral. Have you recently changed anything? Is he sleeping in a new bed, a new room? Stress and trauma can cause bed wetting in children.

Another thing to consider is his diet - he may be intolerant/allergic to something, or constipated. Is he eating ok at all meals, any complaints of gas/stomach pain? How is his bowel movements?

Except that nocturnal has been enough fir my GP to do a test.
You don’t always notice an increase in drinking or going to the loo. Esp in the early stages.
And tte getting thin and be extremely tired are signs of regular serious hypoglycaemia. Again not always obvious in the early stages.

Not when they have been dry fir years though. That’s much more unusual.

Bed wetting can be a symptom of lots of things and if it's been happening for months its probably nothing that a&e can really do. unless he's extremely ill they'll just tell you to wait for an appt.

If worried it's easy enough to get glucose monitor or urine sticks at a chemist/on amazon. but if his urine was clear in June then it's unlikely that this is diabetes. he would have deteriorated quite a lot since may if it was.

is he peeing a lot more at other times or just at night? is he also very thirsty.

There are many other options than diabetes.

8% of children develop secondary enuresis, the number of children with SNE as a % of all cases of enuresis increases with age.
A family history of bedwetting is found in 50% of children with SNE.

It's more common than diabetes in children, which is approx 0.25%

Buy a kit and prick his finger at home ? You can buy them quite easily

Hi,

Completely sympathise with your worries about diabetes but there are other causes for secondary wetting which should be considered once this is ruled out. The ERIC website is a good start. Constipation can cause wetting as there's less space in the bladder. Emotional upset can play a part as distress inhibits vasopressin which is the hormone which causes the kidneys to produce less urine at night. So children can start wetting again because of stress.
Hope you get to the bottom of it.

They absolutely finger prick kids.

Ds and dd have both had it done several times as im diabetic.

You can buy a kit from the pharmacy/amazon.

Does he drink a lot of squash at all? My friends little girl went through the exact thing and they ended up seeing a specialist and they said cut the juice out and it stopped it. Not sure why, don't know whether it was the sugar?

He needs a finger prick urgently ideally 1-2 hours after eating something high in carbs. Either the friend’s monitor or a pharmacy or the nurse at the GP can do it or you can buy a meter in the pharmacy. 4-7 mmol/l is normal, over 11 is basically a diagnosis of diabetes.

Obv there are further tests if that is high but it will give you a good idea if t1 is likely or not. My son’s blood sugar was 32 the day he was diagnosed and he wasn’t unwell (it was after a day at school!). He had lost weight, been drinking and weeing more and was tired however.

Surely the first thing to try is restricting fluids from an hour or 2 before bed, and making sure he's been to the toilet before bed.

Can the friend fingerprick him?

You say he's not deteriorated AND you're worried about his LACK of fluid intake during the day.

No, definitely not an A&E job. A serious, rapid decline can be dangerous but his only symptom is bedwetting (and you admit you took him to be without a toilet visit most recently).

Chase the gp, if not for the referral for bedwetting advice. And ask them about your own health anxiety.

it is only a finger prick!! do you know any diabetics for a test strip?

Why would I have health anxiety? My son has started doing something he hasn't previously done. I sought advise from the GP and have waited patiently for the referral. The problem has persisted and I've chased the GP up today. I've then asked on a parent forum what you would do if in a similar situation. I've not taken him to A&E. I think I'm being a responsible parent and naturally being concerned.

Parents don't usually jump to their child having diabetes and asking if they should urgently attend to a&e because they are wetting the bed OP. That is an extreme reaction and does indicate you are feeling overly anxious.

You're right that untreated diabetes type 1 is an emergency, but your son has no symptoms.

I don't think you are being particularly anxious @thesurreymum . It is natural to be concerned when your child is showing symptoms that aren't easily diagnosed. It sounds as though the GP has tested a urine sample and not found anything concerning which is why they've referred you to the paediatrician. Unfortunately there is going to be a wait - blame the chronic underfunding of the NHS.

Obviously you have a friend who has experienced a child being diagnosed with diabetes so you naturally think of that but do keep an open mind, especially when you see the paediatrician as it will help them get to the root cause of the problem. It might be something different so don't focus on the diabetes symptoms.

Have you started keeping a diary? If not, I would recommend doing that. Record exactly what your DS has eaten and drunk each day and when, along with when he has been to the toilet, and perhaps other information like what he has done during the day and whether there were any problems at school. That will help build a picture for the paediatrician to see if there are any specific triggers.

"He had lost weight, been drinking and weeing more and was tired however."

So he had all 4 Ts. He didn't seem unwell, but pulling those symptoms together in retrospect, he was.

If anyone came on to Mumsnet and said "My child has lost weight, is weeing more, is really thirsty and seems very tired" we'd be shouting to get medical attention.

I dint think you are particularly anxious either @thesurreymum

You have a young child presenting with symptoms that are serious enough that the GP referred you back to a paediatrician.
Id say that’s a good sign that there is something going on, even though it hasn’t been established yet (with good reason. That’s the whole point if the referral!)

and I also get that you want answers. Any of us would! And a system that is asking you to wait months whist the condition is potentially getting worse is infuriating.

On thé other side, it was enough for the GP to check urine levels and do a referral to a paediatrician.

Do you think the GP is also overly anxious too??

This ^^