diagnosing diabetes

[annabelle09]

Hi,
I am a 16 year old girl, whom is 5'3,and weigh about 96 pounds.  I just went to see the doctor, and like always, they said I had a bit of ketones and about 300g of protein in my urine.  They didn't test my blood sugar, but I know my fasting glucose level is around the 126 range.  Though there was no sugar in my urine, I am still afraid I might be showing signs of diabetes, but no one believes me.  I also have a high blood pressure.  Any help would be great.  Thanks! Emily

[KatEyes]

I don't know much about protein in the urine, but ketones I think can come from too severe dieting. When I was young (MANY years ago) before we knew the health hazards, I was on a popular fad diet that measured ketones in the urine as a level of success. That is, until it went defunct when people started getting sick. How was your eating in the days leading up to that urine test?

If your fasting (no food OR drink at least 8 or preferably 12 hours before testing) glucose was 126, that is above the expected range. The sugar has to get pretty high before it shows in the urine, so not finding sugar in the urine does not mean there isn't a problem, just that it isn't extremely high. Do you have symptoms of excessive thirst or urination, or periods of lethargy? But again, those would more likely come with higher levels. More revealing than a fasting blood sugar is an A1C that looks at your sugar levels over a period of weeks.

Is having high blood pressure at your age common in your family? How are your tonsils and your breathing? Only reason I mention that is there has been lots of publicity lately about sleep apnea in children, especially those with narrowed airways, and sleep apnea is known to in some affect insulin resistance and blood pressure. Now, don't take that as gospel medical information, just saying what I've read.

Due to your age, it is likely any doctor will look to your parents as to how far to go to research your suspicions. I don't know the financial situation, but tests can be quite costly. It is wise to stand mindful that there are some results from your urine one wouldn't expect to see. Talk to your parent(s) about your concerns. Maybe ask them if there's a diabetic family member or friend who wouldn't mind you checking your sugar now and then, and keep a journal that includes what you ate or drank in the hours before the check. That will either confirm your suspicions or put your mind at ease.

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
Ketones and proteins in the urine can result from many factors, like excessive exercise, dehydration, high protein diet, kidney problems, and diabetes. Diabetes in the initial stages does not produce glucose in urine. However neither will it bring about ketones and proteins in the urine at an early stage. These are generally the signs of uncontrolled diabetes. You need to check the blood sugar fasting (8-12 hours) and two hours after a proper meal.

Since your doctors were not concerned maybe you should explore the other causes—like dieting, drinking less water during the day, exercising a lot, eating a high protein diet. If none of these are true for you, then you must insist on a blood glucose examination and maybe a glucose challenge test.
It is difficult to comment beyond this at this stage. Please let me know if there is any thing else and do keep me posted. Take care!