Question re possible diabetes in child

[GingerIvy]

I wasn't sure if I should post this in here or in children's health, but here goes. This may be nothing to be concerned about, but my 8yo has been quite thirsty lately, drinking quite a bit more than usual. He has also been urinating a lot more frequently, getting up at night a few times. His appetite has been a bit off the last few months - nothing drastic, but just "off" - which I know is hard to explain. He's not having any specific UTI symptoms (such as lower abdominal discomfort or pain/burning on weeing). This has been going on for awhile now,possibly a couple months if it goes back to when his appetite changed a little. He's not lost any weight that I can see (weighing him is a struggle - he's autistic and doesn't stand still on the scale).

Anyway, we have a massive family history of diabetes in my family, including a number that are insulin dependent. I made a routine appointment with the GP but it's not until the 29th (soonest they could get him in for routine appointment). Should I be taking him in sooner, or using the next 2 weeks to note any possible things that might be related and jot them down, watching what he eats, just in case? Is this even a concern? I don't want to ignore something important, but neither do I want to be alarmed over nothing.

He will NOT cooperate for a blood test, so I anticipate an almighty shrieking session and the need for him to be held to get that done. I was hoping desperately that it could be checked by finger stick, but is that ridiculously naive?

You're doing the right thing in having him checked, so well done for spotting it.

You could do a finger prick but it will only give you an illustration, unless it's sky high. It's like a little snapshot. So you'd still need to take him to the dr for a full test sadly. However it should give you an idea of how urgent it is and whether you need to expedite the appointment. Just be aware of when you're doing it; fasting would be the easiest to interpret.

This will give you an idea of the type of tests they do and the normal reading range. Just remember you might need to convert the readings depending on which country you are in - there are conversion charts online:

www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/diagnosis-treatment/drc-20355312

Has he had any weight loss? Children with diabetes often lose a large amount of weight in a short period of time so keep a close eye on that. I would take him to hospital if he has lost more than 5% of his body weight since the increased urination began.

You can take a urine sample to the practice nurse and ask them to check for ketones. This will be quicker then waiting for a gp appointment.

If you’re worried get a gp appt today and ask them to do a fingerprick test. It’ll be over before he even realised and diabetes isn’t something you can muck around with my dd2 developed it aged 3 and the diagnosis was delayed it was terrifying

The test doesn’t need to be a fasting one. Just a simple fingerprick at any time is what he needs doing if diabetes is suspected

The GP will likely do a urine test and not be concerned if that's clear.
Fasting blood glucose is the last thing to be high usually with t1 as the pancreas recovers overnight so I've heard of lots of children with high post meal bloods that are normal again by morning.
Evening after a meal is best time to check or really any time two hours after eating. Two hours post eating should really give you lower than 6.7 depending on what was eaten and how many carbs. Some foods will spike later if high fat or starchy.

Thank you for the info.

I've not noticed a particular weight loss, but I will keep a closer eye on that. I may ring the GP surgery tomorrow and speak to the triage GP and ask about it.

It's probably not (fingers crossed) but with such a high family history, I don't want to take unnecessary chances.

If you are worried, you might want to buy a BG meter from the chemist. You could then test him yourself (ideally two hours after a heavy carbohydrate meal). That might be less unsettling for him. Please do keep the GP appointment though, even if the finger prick test is OK. If you smell pear drops (ketones) or he becomes very drowsy, sick or breathless, please take him immediately to A&E.

How many carbs do you think counts as carb heavy? Sorry, I always wonder this...

He's been drinking and weeing quite a bit today. He doesn't appear drowsy, but he has been a bit more tired lately in the mornings, and struggling to get to sleep at night. He is definitely more moody/temperamental in the last month or two, but Christmas is a bear for lots of children with autism. His anxiety/stress level has really been high. He's had what appeared to be a stomach bug a couple times in the last few months - just a 24 hour thing - that none of us have caught. That's a bit unusual, too. He has asthma, so we keep an eye on the breathing, and that's been fine lately. I haven't noticed any odd breath smells, but then he's always drinking something so it's hard to tell.

I'm going to ring tomorrow and speak to the triage GP and ask them if he can get in tomorrow and get checked.

Okay, he's got an appointment today around lunchtime.

Good luck OP and little one 🤞🏻

Thanks. Copy/pasting from the other board with a wordy and baffling update.

GP sent us immediately to hospital where we waited a few more hours (with two autistic children - one in meltdown almost the whole time). When he was willing to let them do the finger stick, the doctor said they wanted to take the history first (knowing by the GP's letter why we were there and knowing it would have to be done). By the time the history was done, they talked more and then ds was over-anxious and didn't want to do it. Finally talked him around, and doctor then stood waffling for 10 minutes about whether or not to do a finger stick or if she'd need an IV for fluids for him and succeeded in upsetting him yet again. Finally talk him around again and got finger stick. Result: 6.5

She then took the urine sample we'd brought,and said she was going to go check it. She was gone almost an hour. By that time, ds was sobbing and screaming that he wanted to go home. THEN she came back and wanted to examine him. (Instead of initially when he was cooperative!!!) She told me she absolutely had to listen to his chest. I explained that he was absolutely frantic with anxiety and didn't want anyone to touch him now and that the GP had JUST listened to his chest thoroughly earlier this afternoon. She insisted for a few more minutes, succeeding in pushing him into meltdown again. Then she decided maybe she didn't need to listen to his chest. She told me there were no ketones, but then said she had to check his urine (which she was supposed to have been checking during that hour she was out of the room). He was by this time screaming over and over IwanttogohomeIwanttogohome. She came back a few minutes later and said he didn't have diabetes, but they were sending him to a diabetic clinic anyway... that the blood sugar never goes down if they have diabetes, so it should have still been 19.5... that she had no idea why it was 19.5 but as it wasn't diabetes we shouldn't worry. Then she said maybe it's diabetes insipidus, told us to go home and they'd ring in a week to arrange him to go to diabetic clinic.

Were his fingers definitely clean for that first test??

19.5 is much too high and in early t1 it can come back down on its own so I don't know what the dr was talking about. I wouldn't be happy with that at all.

yes, they were clean. He'd washed them just before we left the house (after using the toilet) and he'd not touched any food between that and getting the first test.

Plus the GP wiped the finger off with some type of swab/gauze (alcohol wipe?) prior to jabbing it.

I'm just uncomfortable with the whole "well, it went down on it's own,no idea why it was up, could be any number of reasons, but we'll ring you in a week" and no diet instructions or anything to watch for other than "write down how often he goes to the toilet and how often he's drinking."

No I wouldn't be happy with that. At all.

Sorry not to come back before. I would not be happy with this at all. One slight possible comfort, we are advised not to use alcohol wipes before testing as they can give a falsely elevated reading. BUT... everything Waiting says. Did you get a chance to buy a BG meter that you can use at home?

Going to do so tomorrow. Clinic scheduled for about 2 weeks time.

Good. This really may be fine but so important to make sure

That's exactly how I feel.

Okay. Ds ate a meal of crunchy tacos (corn tortillas, cheese, minced beef, black olives) and water about an hour ago. Tested just now at 5.3.

So that's okay.