Type 1 diabetes can show up at any age, from babyhood through the teen years. The early signs are easy to miss because they look like everyday things: a growth spurt, a busy week, a child who is drinking more because it is hot outside. Knowing what to watch for helps you get your child checked sooner, before the illness becomes an emergency.
What type 1 diabetes is
Our bodies run on sugar (glucose) from the food we eat. A hormone called insulin, made by the pancreas, moves that sugar out of the blood and into the cells that need it. In type 1 diabetes, the immune system attacks the cells in the pancreas that make insulin. Over weeks to months, the body makes less and less insulin, so sugar builds up in the blood while the cells go hungry.
Type 1 diabetes is not caused by eating too much sugar, and it is not something you or your child did wrong. Doctors do not yet know exactly what triggers it. Having a parent, brother or sister with type 1 diabetes raises the chance, but most children who get it have no family history at all.
Type 1 is different from type 2 diabetes, which is linked more to how the body responds to insulin and is more common in teens with extra weight. Children with type 1 diabetes need insulin every day for life. With good care, they grow up healthy and do all the things other kids do.
The early signs to watch for
When blood sugar gets too high, the kidneys try to flush the extra sugar out in the urine. That pulls water out with it, which sets off a chain of symptoms. Many parents later say the signs were there for a few weeks, but each one seemed small on its own.
- Peeing much more than usual. Your child may need the bathroom constantly, wake up at night to pee, or start wetting the bed again after being dry for a long time. In a baby or toddler, you may notice diapers that are much heavier or need changing far more often.
- Being very thirsty. Your child may refill a water bottle again and again, ask for drinks in the middle of the night, or drink from the bathroom sink.
- Being very hungry. Because the cells are not getting the sugar they need, some children eat a lot more than normal.
- Losing weight without trying. A child who is eating well but losing weight, or whose clothes are getting loose, needs to be checked. Growing children should not be losing weight.
- Being tired or cranky. Low energy, napping more, trouble focusing at school or mood changes can all happen.
- Blurry vision. High blood sugar can change the shape of the lens in the eye for a while.
- Yeast infections. Sugar in the urine can lead to a diaper rash that will not clear up in a baby, or yeast infections in older girls.
In Texas, extra thirst in the summer is common and usually normal. The difference with diabetes is that the thirst and peeing do not settle down with rest, cool air and regular drinks, and they often come with weight loss or tiredness. If you are not sure, it is always fine to ask.
Signs in babies and toddlers
Young children cannot tell you they feel thirsty or tired, so the signs can be harder to spot. Watch for:
- Very wet diapers, or many more diapers than usual
- Fussiness that does not have a clear cause
- Poor weight gain or weight loss
- A diaper rash that does not get better with usual care
- Drinking much more milk, formula or water than usual
Because the signs are vague in this age group, small children are more likely to be very sick by the time diabetes is found. Trust your sense that something is off.
Diabetic ketoacidosis (DKA): an emergency
If type 1 diabetes is not found and treated, the body starts breaking down fat for fuel. This makes acids called ketones. When ketones build up in the blood, it causes diabetic ketoacidosis, or DKA. DKA is serious and can be life-threatening, but it is treatable when caught quickly. Sometimes DKA is the first sign that a child has diabetes at all.
Signs of DKA include:
- Stomach pain, nausea or throwing up
- Deep, fast or labored breathing
- Breath that smells fruity or sweet
- Signs of dehydration, such as a dry mouth, no tears or very little urine after a period of peeing a lot
- Being very sleepy, confused or hard to wake up
- Weakness or flushed, dry skin
DKA is easy to mistake for a stomach bug, because both cause vomiting and belly pain. A clue is that a child with DKA has often been peeing and drinking a lot before the vomiting started, and may be breathing in a deep, heavy way. If your child has these signs, call 911 or go to the nearest emergency room right away. Do not wait for an office visit.
How a pediatrician checks for diabetes
The good news is that checking for diabetes is quick. Your pediatrician can test a small sample of urine for sugar and ketones and do a finger-stick blood sugar test, often during the same visit. If the results point to diabetes, your child will usually be sent the same day to a children's hospital or a pediatric diabetes team to start treatment and learn how to manage it.
When you call, it helps to tell the office about:
- When the extra thirst and peeing started
- Any weight loss you have noticed
- Bedwetting that is new
- Any vomiting, belly pain or changes in breathing
- Family members with type 1 diabetes or other autoimmune conditions, such as thyroid or celiac disease
What happens after a diagnosis
Learning that your child has type 1 diabetes can feel overwhelming. You do not have to figure it out alone. A pediatric diabetes team will teach your family how to check blood sugar, give insulin, count carbohydrates and handle sick days. Many children now use continuous glucose monitors, which read sugar levels through a small sensor on the skin, and some use insulin pumps.
Your child can still play sports, go to school, sleep over at friends' houses and eat birthday cake. Texas schools work with families on a diabetes care plan so trained staff can help during the school day. Your pediatrician stays part of the team for checkups, vaccines and everyday illnesses.
If one of your children has type 1 diabetes, ask the diabetes team whether their brothers and sisters should be screened. Blood tests can sometimes find the early, silent stage of type 1 diabetes before symptoms start, which lowers the chance of a first diagnosis in DKA.
Learn more
- Diabetes in children, from the American Academy of Pediatrics (HealthyChildren.org)
- Diabetes in children and teens, from MedlinePlus
- Type 1 diabetes, from the MedlinePlus Medical Encyclopedia
When to call us
Call your A thru Z Pediatrics office the same day if your child:
- Is peeing a lot more than usual or has started wetting the bed again
- Seems thirsty all the time
- Is losing weight without trying
- Has a mix of these signs along with tiredness or blurry vision
Call 911 or go to the emergency room if your child has vomiting with belly pain and deep or fast breathing, fruity-smelling breath, signs of dehydration, or is very sleepy, confused or hard to wake. These can be signs of DKA.
For questions that are not urgent, you can request a visit online.
This article is general information, not medical advice. If you have concerns about your child's health, call your A thru Z Pediatrics office.