4 y/o daughter sugar in urine during physical

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).

And as to your visit with the Endo, our fellow member @Melitta has a very good description of the proper tests that should be performed to diagnose autoimmune T1.

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