Pediatrician Questions Diabetes

How is diabetes diagnosed in children?

I think my 9 year old has diabetes based on what I've read. What do I do now? How is diabetes diagnosed in children?

7 Answers

There are usually 2 types of diabetes in children- Type 1 and Type2. At age 9yrs, Type 1 is more common, unless child's weight severely over than normal. Type 1 Diabetes is diagnosed by blood test and also urine test. Please see your physician as soon as possible if you suspect Diabetes, because Type 1 can lead to life threatening situation if delayed. Hope this helps.
Take him to a pediatric endocrinologist as soon as possible.
Diabetes diagnosis involves a careful history, examination, and labs. Symptoms of new diabetes can include increase in thirst, increase in urination, increase or decrease in appetite. Some children will have recent weight loss, abdominal pain or vomiting, headaches or change in vision. A lab test checking for glucose is needed to confirm the diagnosis. A random glucose of 200 or more is the most common test obtained, however a fasting glucose of 126 or more along with symptoms can also be diagnostic. All children with suspicion of new diabetes should be seen immediately for evaluation and treatment.
Take your child promptly to your primary care provider or the closest emergency department. There they will check the level of sugar in your child's blood to diagnose diabetes.
Diabetes is a common metabolic disorder. It is caused by either insulin deficiency or insulin resistance. Most children will have type 1 diabetes which is a state of absolute insulin deficiency. It is mainly an autoimmune process where by insulin producing cells called beta cells are destroyed in the process. Diabetes can be diagnosed clinically and biochemically.

1) Any person with symptoms of excessive urination, excessive thirsty, bed wetting, weight loss and abnormal blood sugars above 200mg/dl have diabetes unless proven otherwise.
2) Any random blood sugar greater than 200 mg/dl at more than one occasion.
3) Any fasting blood sugar (at least after 8 hrs. fasting) >126 mg/dl at more than one occasion.
4) Any blood sugar >200 mg/dl on more than one occasion using the 2 hour standard glucola test of 75 gm. ( 1.75 mg/kg up to 75 grams) performed after 8 hours of fasting on more than one occasion.
5) Hemoglobin A1c greater or equal to 6.5%
Another entity call a prediabetes state can also be established using blood sugar reference ranges if the individual is at risk for diabetes.

Biochemically, a prediabetes state can be established as follows:
1) Fasting blood sugars between 99-126mg/dl at least in more than one occasion.
2) Blood sugars between 140-200 mg/dl in the standard 2 hour glucola test on more than one occasion.
3) Hemoglobin A1c between 5.7-6.4%

Gestational diabetes has slightly deferent reference ranges than the above classification.
If you suspect your son has symptoms of diabetes or if he is at high risk for diabetes, you should check his blood sugars fasting and random (if you have access to glucometer). If you get >200mg/dl persistently with or with out frank symptoms of diabetes, you may take him to his doctor promptly. If you do not get high blood sugars you may be dealing with other conditions that share similar symptoms. If you do not have an access to glucometer and you suspect diabetes you should take him to his doctor or to the emergency room.
Good luck.
The symptoms of diabetes in children is about the same as in adults though more severe. The most prominent symptoms are Polyuria (over production of urine), Polydipsia ( increased thirst) & Polyphagia (overly hungry usually associated with wt. loss). These are the BIG 3. Other symptoms are dehydration, fatigue, dry skin, rapid breathing & some level of loss of brain power leading eventually to coma. If you suspect any of these, you should see a Physician ASAP since neglect results these symptoms can get worse leading to coma & death. Diagnosis is based on symptoms, a simple urine test, a simple blood test for sugar level in the blood or a test called Hemoglobin A1c (abbreviated HbA1c). The latter test measures the amount of sugar that has been in the blood stream over the last 3 mo. & can be done on very little blood in some physicians offices. If you suspect diabetes don't put it off. Get to your Dr. or an ER very soon . I hope you are wrong & he or she doesn't have diabetes but it can be treated & controlled. I have had it foe 27 years & have learned to live a fully normal life. Your child can also do so.
Checking fasting glucose and this is greater than 140 checking hg A1c and this is greater than 6.1 or checking urine and there is glucose in the urine. However you would then check glucose in blood if urine is positive