Signs And Symptoms Of Type 1 Diabetes In Children

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Signs And Symptoms Of Type 1 Diabetes In Children

The signs and symptoms of type 1 diabetes can develop rapidly in children. It’s essential to be aware of them so that you can get medical help quickly. The most common symptoms of diabetes in children are the four Ts – tired, thirsty, toilet, thinner.

Your child may appear:

  • Lethargic
  • They need to wee more often
  • Lose weight without trying
  • Seem thirsty all the time

However, not every child will have these symptoms; some may have tummy pain, vomiting, or new behavioural problems. If you’re worried, contact your doctor. It’s easy to check for diabetes, and early treatment can prevent your child from becoming severely unwell.

Symptoms of diabetes in children

It’s important to contact a doctor if you’re worried that your child may have diabetes. The symptoms of type 1 diabetes in children include:

  • Going to the loo more frequently – their body gets rid of excess glucose by passing it out in the urine. You may notice that younger children have many more heavy, wet nappies
  • Being very thirsty, despite drinking lots of fluid
  • Feeling tired and lacking in energy
  • Weight loss
  • Increased hunger – their body isn’t getting the energy it needs so that they may seem ravenously hungry all the time
  • Recurrent infections
  • Cuts and scrapes take a long time to heal
  • Blurred vision
  • Recurrent tummy pain
  • Headaches
  • Behavioural problems
  • Fruity-smelling breath

Around one in three newly diagnosed patients with type 1 diabetes presents with diabetic ketoacidosis, a serious diabetes complication that requires urgent treatment to prevent coma and possible death.

Hyperglycemia in children

Hyper means too much; when it comes to diabetes, hyper happens when there’s too much glucose in the blood. It’s short for hyperglycaemia and is the other end of the scale from hypo or low blood sugar.

Your diabetes team will set you targets for your child’s optimum blood glucose level, but in general, a hyper is higher than 7mmol/l before a meal or above 8.5mmol/l a couple of hours after they’ve eaten. However, their glucose levels may need to climb quite a bit higher before they start to notice any symptoms.

What are the symptoms of hyperglycaemia in children?

When your child’s sugars are high, they may experience some of the symptoms they suffered when they were first diagnosed with diabetes. So, you may find that they’re tired, thirsty, have blurred vision, suffer recurrent thrush, and are passing urine much more frequently. However, they may have few symptoms, which is why it’s so important to monitor their glucose levels regularly. When they are old enough, you should teach them how to check their own levels so they can start to take control of their diabetes.

Having high blood sugar for a short time is unlikely to be a problem, but if your child becomes increasingly unwell with hyperglycaemia, they may complain of tummy pain, nausea and vomiting, and you may notice the smell of ketones on their breath. These smell like pear drops or nail varnish remover.

If you notice the smell of ketones, do not delay, they must be treated in hospital urgently because of the risk of diabetic ketoacidosis, a serious complication of diabetes.

What causes hyperglycaemia?

You manage your child’s diabetes by carefully balancing their activity and the food they eat with insulin. However, it’s challenging to achieve perfect control all of the time, so some highs and lows are inevitable. A hyper is more likely if your child has:

  • Eaten too much sugar or carbohydrate
  • Taken too little insulin
  • They’re ill or suffering from stress – a cold, COVID, or a chest infection could send their blood sugars up
  • They’ve been given too much glucose or glucagon for a hypo

Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is a serious diabetes complication that can develop when your child’s body doesn’t have the insulin needed to use glucose as fuel. Instead, their body breaks down fat, creating chemicals called ketones. When these acidic chemicals build up in your child’s bloodstream, they can become extremely unwell, with the symptoms of hyper, including thirst, tiredness, and blurred vision.

Diabetic ketoacidosis is more common in children who have just developed type 1 diabetes. It can also develop if their diabetes isn’t controlled and they have hyperglycaemia or are unwell with an infection.

Symptoms and signs of diabetic ketoacidosis in children

  • Nausea and vomiting
  • Abdominal pain
  • The child may appear tired, floppy, and lethargic
  • As the condition develops, they may become difficult to rouse
  • Unconsciousness and coma
  • The smell of ketones on their breath – a smell like nail varnish remover or pear drops
  • Dehydration – dry lips and no tears
  • A deep and laboured pattern of breathing

DKA is a medical emergency, which needs prompt and careful management in hospital. The hospital team can effectively treat DKA with insulin and careful fluid balance. So get help urgently if you’re worried about your child.

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Carol Willis - Diabetes Clinic Facilitator

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