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Pediatrics/inexplicable symptoms


QUESTION: Thsnk you for this wonderful opportunity you are affording all of us grateful parents. I, for one, am most appreciative.
My son is a healthy and active soon to be 10 year old. However, the last three days he has stated that he is tired. He has energy, wants to do things, yet keeps complaining that he is tired, though he is a positive, upbeat child. When I have asked him to explain, he says that his legs feel tired sometimes. I have tried to do a differential diagnosis..."he has not had enough sleep" [he has always gone to sleep when he he is ready and wakes up on his own...he sleeps around 10 hours a night, sleeping patterns have not changed] "he is worried or anxious" again, nothing has changed from our day to day activities, and we are very open and communicative] sorry for my lack of brevity, but i also wanted to share with you that he states he is thirsty. i know that these symptoms could have something to do with diabetes. we have no hx of it in our family. and even more importantly, we are plant based and thus eat mostly vegetables and legumes and not much fruit. he is eating kabucha squash as i am writing this. he does not eat sugar. so my query is first is there anything to be concerned about? if there is not, what would you oh wise one think is going on? if there is, would you please explain to me why this could be happening? and can we be patient and wait and see. thank you again for your kindness in sharing your medical acumen.

ANSWER: Hi, jj,

The onset of type 1 diabetes really has little to do with a healthy diet.  Vegetarians develop as type one DM just like anyone else.  

My take on this is to be sure he sees his pediatrician for a yearly exam, explain the symptoms, have a good history and physical and explore targeted blood tests.  Tiredness in kids can  be just about anything, and generally a careful history and exam will go far to finding out.  At least this can eliminate most worrisome problems. A test to rule out diabetes is as easy as checking the urine for sugar. I would wait for a week and be sure the symptoms just don't go away.   

Good luck, Dr. Olson

---------- FOLLOW-UP ----------

QUESTION: thank you for your response. you state that the "onset of type 1 diabetes has little to do with a healthy diet"...please, please would you be willing to tell me what factors need to exist to cause this disease and thus, what would and could cause the onset of diabetes?

ironically, we did see a pediatrician a week ago, albeit for a perfunctory was a free service, and the doctor took a thorough history and conducted an examination of him and found him to be very healthy.

he said today when we rested that his legs felt better, and he seemed to be less thirsty. he has never, ever complained that he was tired. this is the first time wherein he woke up on his own after a good night sleep and said "i"m tired" Though there is no apparent reason for his being tired, could this be a case of "a cigar is just a cigar" [freud] meaning, could this be as innocent as he just feels tired??? for example, if he feels less tired in a few days, may i be comfortable in thinking it is nothing to be concerned about?

sadly, with finances being an issue, seeing a doctor is not a foregone conclusion. if it is important and necessary to rule out something [even if his major complaint goes away] i would certainly find a way, but i was wondering if this symptom might be an indication of something serious or be an indication of little more than what he states?

i guess the last [thankfully, for you] query would be if there are other symptoms to be on the lookout for as we take this day to day or might even go away and then come back. again? he has never been sick and never had any complaints [we are so incredibly fortunate], so this happening out of nowhere is an enigma, at least for me.

we would so love any more enlightenment you could share with us to help us navigate this murky situation. thank you again for being so giving!!!

Hi, j.j.,

Think about this.  If crappy diet were a big causative factor in type 1 DM, then half of the country would have diabetes.  Crappy diets are a big factor in the development of type 2 DM, but genetics, viral illnesses and probably bad luck cause one to have type 1 DM.

Kids can just feel tired.  If this is a pervasive, continuing symptom, then some evaluation is probably warranted.  If one is in all other respects healthy and the tiredness is not inexorably progressing, then frankly a lot of tests will probably find nothing amiss. Keep a good watch for consistent and increasing symptoms and otherwise, the "I am tired" notion is probably just that.

As long as he is his cheery self, eating well, playing well and sleeping well, really I would do nothing at this time.

Good luck and have a great Memorial Day weekend. Dr. Olson


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David Olson, MD


I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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