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Diabetes

High fasting BS but normal tolerance test

12/14/2009

Question:

My son is 7 and has started wetting the bed at night after not wetting the bed for several years. We took him to the doctor who checked his urine which was fine except for elevated ketones. They checked his BS then and it was in the 90`s. The next day he was feeling nauseated and didn`t want to eat but was thirsty. He drank a CapriSun and an hour later he looked a flushed so I checked his BS level which was 173. ( I am a home health nurse so I carry a glucometer with me. I check the control levels on it every time I use it) So we went back to the doctor and did a glucose tolerance test (He ate pancakes with lots of syrup and two big glasses of chocolate milk) and after two hours his glucose was 120. The doctor said this was normal so we didn`t need to do anything else about it. After he continued to wet the bed I decided to tests his fasting glucose after a bed wetting incident and it was 143. He had not eaten for 13 hours and had only had a corn dog with about 10 fries for supper the night before. I told this to my doctor who was upset that I took his BS at home and said that it was fine and we shouldn`t worry about it anymore. Is the doctor correct that we should just not worry about it? Could this be a pre-diabetic state? What if anything would you suggest we do from here? Thank you in advance for your answer.

Answer:

The key to whether the bed wetting raises the question of a pre-diabetic state is whether there is ever glucose in the urine - if no glucose in the urine, then hard to invoke that as evidence of developing diabetes.  In terms of whether the night blood sugar is evidence of a pre-diabetic state, the accuracy of glucose monitoring in that range is not sufficient for you to get terribly excited about the one value.  I would need to know more about the situation in order to judge whether to pursue it further and we really cannot make diagnoses on NetWellness.  You and your son's doctor need to be on the same wavelength for both your son's best interests and your sanity.  If you are not satisfied with the answer, the next steps should be based on laboratory results and not on self testing.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati