During my daughters annual physical her pediatrician found high levels of glucose in her urine today, but her blood level was 110. She’s had other symptoms (of course in hindsight) constant thirst, bathroom frequency, accidents, excessive hunger (or no appetite whatsoever), even once complained about blurry vision (thought she may have had something in her eye, didnt seem to bother her enough to even press the issue) Her ped seemed confused by the blood reading, I think she was expecting her to be soaring.
My EX-husband is a type 1, oddly enough not her father, I’m remarried. I have an 11 year old son with my T1 ex, who has never shown any signs and I’m constantly on the lookout for them! I guess I never expected to see them in her! I’m pretty familiar with the ins and outs of the disease, I guess I’m just pretty confused right now as to how she could be spilling sugar but remain within normal range. Checked with ketone strips at home and she’s showing trace-small.
She wanted to repeat the test in 2 weeks before seeing an Endo, but it just so happens my ex-MIL works for one of the best in my county and they actually had a cancellation for Thurs and they slipped us in.
I’m so confused. Could this be a gradual onset or just a fluke in the urine test??
I think your feelings are natural. You know what diabetes is and the symptoms. And no parent ever wants to go through having their child be diagnosed with diabetes. But no matter what happens you are prepared. You must reassure yourself that you will be able to be a champion and advocate so that your daughter will get whatever proper care that she needs.
That being said, your questions is about these two tests. Glucose is excreted in your urine when your blood sugar rises above the so-called renal threshold (160-180 mg/dl). This is a normal process and even someone who is non-diabetic may have excursions in their blood sugars which cause some glucose to be excreted. Usually it is not much, but certain things can “concentrate it” such as becoming dehydrated and not drinking enough water. So yes, glucose can appear in your urine even for a non-diabetic, but usually not very high levels. If your daughter does have emerging diabetes her blood sugars may rise after meals (dumping glucose in her urine) even though her fasting blood sugars are in the range of normal.
Now as to ketones. Everyone generates ketones, they are produced anytime we burn fat. And everybody burns fat overnight, when fasting or even when exercising. If you measure ketones at certain times you may notice trace ketones and it means nothing. The only time ketones mean something is when you have a high blood sugar (and by high I mean like 300 mg/dl).
I dearly wish I could tell you that nothing is wrong, but I can’t. Diabetes, even in children, doesn’t just appear in a snap of finger. It involves a process which can take days, weeks or even months. Some adults even find that the process takes years. But in a child it is usually quicker. But you are on top of this. Get a blood sugar meter, monitor your daughter’s blood sugar after meals. The post meal blood sugars are the first thing to go and if your daughter is rising above 200 mg/dl 1-2 hours after meals that indicates diabetes. Given that you have an appointment tomorrow your daughter is unlikely to be at any great risk as long as you don’t feed her a dozen Krispy Kremes (eating low carb in the meantime is probably prudent).
There is not a lot of good data about the onset of T1 diabetes in young children. But there are a lot of anecdotes I’ve heard over my 35 years with diabetes.
It seems likely given the onset of T1 in my case, and given anecdotes other here have posted, that insulin production may be “barely able to keep up” sometimes and other times “not able to keep up” for a good while (months… maybe even years) in some of our histories. While in this state, bg may go high after a meal (above 180), resulting in sugar in urine, but then in the next hours enough insulin is made to bring bg down to near-normal levels. At this point some symptoms of uncontrolled diabetes may be present intermittently, but not full-blown Ketones/DKA.
Then, something that substantially reduces insulin sensitivity, like an infection or a cold or flu, may “push it over the edge”. After bg goes super high, then insulin sensitivity goes down substantially, at which point bg’s just keep going up and up, and it goes into full-blown DKA with every classic symptom in the book.
In retrospect, I had some symptoms for at least a year before diagnosis before I went “competely over the edge” at age 14 into full-blown DKA.
Some here may go greatly into detail of antibody tests etc. But if a young kid with no weight problem is spilling glucose into urine and has occasionally high bg’s/occasional symptoms of high bg’s, I’m not sure why autoimmune tests would have to be run. To me it’s obviously T1 diabetes.
I think docs are sometimes reluctant to deal with T1 diabetes if they are not experts in it, and will hesitate to pronounce an actual diagnosis until it trips over into ful DKA.
Thank you both for your responses! We saw the Endo yesterday and I feel a little better. Her A1C numbers were perfect. They tested her twice over a 4 hour time span and she was 128 both times, although she’s on the higher side of “normal” they don’t think there is any immediate concern. They did a full blood panel and we’ll get the results back in about 2 weeks. Either we’re catching something so early that there is no way to know without time or her threshold for spilling over is lower than usual. They sent me home with a script for BG strips and urine strips and want me to log and monitor periodically. I had already bought the kit and did a couple tests while waiting for the appt, I did get a reading on her of 167 once, but she’s usually hovering in that 120 range. I guess for now it’s just keeping a close eye and testing if she seems out of the norm.
How unsettling, indeed. I hope this is all a false alarm. But more, I wish that any case of diabetes was caught and responded to in this manner! It sounds like you are connected with a great medical team.
You seem to have all your ducks in a row. I hope it turns out to be nothing. Best to you and your family.
Good luck. I am glad you got to see a good endo and very glad that you are monitoring and keeping a close eye on her blood sugar levels. I’m not sure how long my DD actually had blood sugar issues before diagnosis, but prior to diagnosis it is rapid onset. She felt “shakey” in her legs while standing up one month prior to diagnosis. In retrospect, this was probably a low blood sugar. Since you are aware of the symptoms and watching her so carefully, if she is diagnosed, she will not go into ketoacidosis and will be diagnosed early. Kids can get very sick very fast. Praying that all is going to be okay. There are other reasons for high blood sugar in children that are temporary in nature. I’m betting she is going to be fine.
I know this is an older post but hoping the op may still be monitoring. I am wondering what has transpired over the past year because my 5 year old just experienced the same thing. High levels of sugar in her urine but her blood test was in the normal range.
