<s>[INST] My question is... I have an 8 year old step daughter that appears to be going through puberty. Fairly large amount of pubic hair and breast development. She also complains of a stomach ache and urinates frequently in fact she will empty her bladder before leaving the house and return for a second time for what she calls a double check . She also has problems with urine leakage with laughing playing etc. Her urine showed trace protein and ketones. What could be going on? [/INST] Hi,Since there can be many causes of urinary incontinence in children.like nerve injury, neurogenic bladdder, or overactive bladder, diabetes inspidus and diabetes melitus.But from your daughter's history it seems that she might be having juvenile onset diabetes.I would suggest that get blood sugar level  fasting and random both and urine osmolarity test to rule out the cause.Then you  may further discuss with endocrinologist.Hopefully my answer is helpfull.Regards,Dr.Maheshwari </s>