Pediatrics/Signs of diabetes type 1???
Hello Dr. Olson,
My nearly six year old daughter has been ill since late November, it seems. During the past two and a half months she's had a stomach bug, then Type A flu (even though she was vaccinated), followed by severe stomach pains for a day or two and now two back-to-back nasty chest colds. Shortly after she got over the flu (for which she was prescribed Tamiflu), she suddenly started wetting the bed again. She had been consistently dry at night for 6+ months. I initially thought she may be constipated (because of the stomach cramps she had off and on), and that was causing the enuresis. I tried about a week of Miralox, under the advice of her pediatrician, but didn't notice any bowel changes. She has not had any daytime accidents, though she continues to soak through a pull-up nearly every night now.
Then, a few nights ago shortly before bed, she became HIGHLY anxious and fearful. She was extremely agitated and wouldn't allow me to put pajamas on her, stating she wanted to sleep. She quickly fell asleep - on the floor - but she was very restless. From about 7:30 pm - 1:00 am she had very loud and fast breathing. She woke up about every hour or so moaning and whimpering. She was aware of her surroundings and could answer questions when she awoke during the night. (She said she was not sick and nothing hurt.) I noticed some odd behavior similar to tics - when awake each hour or so, she would repeatedly poke her lip quickly and without reason. At one point, she told me she wanted to get in the bed, and once she climbed in bed, she began methodically tapping on each of the rails of her bed. It was very odd behavior, unlike anything I've ever seen before. Not knowing how to help her, I laid next to her and just held her. I noticed that her body was shaking as if she was cold or terribly frightened. (She has had febrile seizures before, but this was not seizure-like shivering.)
Suddenly, around 1:00 am I noticed her breathing became normal and she slept soundly until 5:30 am. She behaved normally the next day, though I kept her home from school to monitor her.
I spoke to her pediatrician the next day as well. He thinks her behavior may have been a "sugar or caffeine high" from having a bowl of Dairy Queen chocolate ice cream, which she had never eaten before. He did tell me to call him - even if it's in the middle of the night - if it ever happens again.
I am concerned that her sudden bedwetting (following a series of illnesses) coupled with this odd behavior may be indicative of Type 1 diabetes. She has high-functioning autism and tends to struggle with her attention span in general. I have not noticed that it has decreased recently though. She is rather thin, but always has been. Though she hasn't lost weight (46 lbs.) in the past 2 months, she hasn't gained any either even though she has gotten a bit taller. She has always been a great (usually healthy) eater who frequently eats as much as an adult woman, but I've not noticed any kind of appetite increase. She seems to be drinking a bit more than usual - asking for juice, when I usually just offer milk or water - but her fluid intake hasn't increased significantly. She also said that her eyes are "fine", but I've noticed that she is rubbing them very frequently in the past few days. So I'm not sure if she is experiencing any vision issues.
Do you feel that it is possible she could have Diabetes type 1 and that I should speak with her pediatrician about this? He is aware of the bedwetting and recent nighttime behavioral 'issue', so I'm assuming that he would have brought up diabetes if he thought it was possible, but the more I'm learning about it, the more I am concerned that she may have some symptoms of it. Of course, I have come to realize that I'm a bit of a worrier when it comes to my daughter's health, so I appreciate any expert advice you can provide.
Just bring a urine specimen into your doctor and have it checked for glucose. If it is negative, then she doesn't have type I DM. If it is positive, then she probably does. I doubt she does, but the test is so simple that to ease your mind, do it.
I don't have a great explanation for the one isolated night time episode and probably would, as your pediatrician did, recommend watchful waiting.
Good luck, Dr. Olson