In 2017, the National Institutes of Health reported that 208,000 children and teens under 20 years had a diagnosis of either type 1 or type 2 diabetes in the United States.
Each year, they say, the prevalence of type 1 increases by 1.8 percent and type 2 by 4.8 percent.
Young people who develop diabetes have a higher risk of health challenges throughout their life.
Being able to recognize the signs and symptoms can help a child to get an early diagnosis, which in turn gives a chance of a better outcome.
Type 1 and type 2 diabetes are different diseases, but they both affect the body’s use of insulin.
Type 1 diabetes in children, previously called juvenile diabetes, occurs when the pancreas is unable to produce insulin.
Without insulin, sugar cannot travel from the blood into the cells, and high blood sugar levels can result.
- lifelong insulin use and blood sugar monitoring
- diet and exercise management to help keep blood sugar levels within the target range
Type 1 often appears during childhood or adolescence, but it can start at any time.
Type 2 diabetes is less common in young children, but it can occur when insulin is not working properly. Without enough insulin, glucose can accumulate in the bloodstream.
People can often manage type 2 diabetes through:
- a change in diet
- more exercise
- maintaining a healthy weight
Sometimes the person will need medication.
The chance of getting type 2 diabetes increases as people get older, but children can also develop it.
Some symptoms are common to both types of diabetes.
The most common symptoms of type 1 diabetes among children and adolescents include:
- increased thirst and urination
- weight loss
- fruity smell on the breath
- blurred vision
Girls might develop a yeast infection. Weight loss is often a common symptom before diagnosis.
Diabetes U.K. urge people to be aware of “4 Ts” in children:
- Toilet: Using the bathroom frequently, infants having heavier diapers, or bedwetting after being dry for some time
- Thirsty: Drinking more fluids than usual but being unable to quench thirst
- Tired: Feeling more tired than usual
- Thinner: Losing weight
This video provides more information on the 4 Ts:
Symptoms of type 2 diabetes include:
- urinating more often, especially at night
- increased thirst
- unexplained weight loss
- itching around the genitals, possibly with a yeast infection
- slow healing of cuts or wounds
- blurred vision, as the eye’s lens becomes dry
Other signs of insulin resistance include:
Symptoms of type 1 diabetes in children tend to develop rapidly over a few weeks. Type 2 diabetes symptoms develop more slowly. It may take months or years to get a diagnosis.
Parents should take their child to the doctor if they notice any of the above symptoms.
Some children do not receive a diagnosis until their symptoms are already severe, and, in some cases, fatal.
Don’t miss the symptoms
Children and adolescents with diabetes usually experience four main symptoms, but many children will have only one or two. In some cases, they will show no signs.
If a child suddenly becomes more thirsty or tired or urinates more than usual, their parents may not consider diabetes a possibility.
Doctors too, since diabetes is less common among very young children, may attribute the symptoms to other, more common illnesses. For this reason, they may not diagnose diabetes at once.
It is important to be aware of possible signs and symptoms of diabetes in order to get a diagnosis and treatment as soon as possible.
One of the most serious consequences of undiagnosed type 1 diabetes is diabetic ketoacidosis (DKA).
Diabetic ketoacidosis (DKA)
If a child does not receive a diagnosis of type 1 diabetes, or more rarely, type 2, they can develop DKA.
DKA is the leading cause of mortality in children with type 1 diabetes.
If insulin levels are very low, the body cannot use glucose for energy. Instead, it begins to break down fat for energy.
This leads to the production of chemicals called ketones, which can be toxic at high levels. A buildup of these chemicals causes DKA, where the body becomes acidic.
Early diagnosis and effective management of diabetes can prevent DKA, but this is not always possible.
A study of children aged 8 months to 16 years who had a diagnosis of type 1 diabetes found that, by the time children under the age of 2 received their diagnosis, 80 percent of them had already developed DKA.
Another investigation, published in 2008, found that among 335 children under the age of 17 with new-onset type 1 diabetes, the initial diagnosis was incorrect in more than 16 percent of cases.
Instead, they received the following diagnoses:
- respiratory system infection: 46.3 percent
- perineal candidiasis 16.6 percent
- gastroenteritis: 16.6 percent
- urinary tract infection: 11.1 percent
- stomatitis 11.1 percent
- appendicitis 3.7 percent
Researchers also found that DKA was more common among children with an incorrect, and therefore delayed, diagnosis of type 1 diabetes.
Type 2 diabetes complications
Without treatment, type 2 diabetes appears to progress faster in young people than in adults.
Younger people also seem to have a higher chance of complications, such as kidney and eye disease, earlier in life than children with type 1 diabetes.
Type 2 diabetes in children nearly always occurs with obesity, which may contribute to these higher risks. Because of this, the early detection of type 2 diabetes and attention to managing overweight in younger people is crucial.
This may include encouraging children to follow a healthful diet and get plenty of exercise.
Any child with signs or symptoms of diabetes should see a doctor for screening.
This may consist of:
- a urine test to look for sugar in the urine
- a finger-prick blood test to check the child’s glucose level
The American Diabetes Association (ADA) recommend testing for children aged over 10 years who do not have symptoms of diabetes but who are overweight (over 85 percentile for body mass index or over 120 percent ideal weight for height) if they have any two of the following risk factors:
- family history of type 2 diabetes in a first- or second-degree relative
- high-risk ethnicity (Native American, African American, Latino, Asian American, or Pacific Islander)
- signs of insulin resistance
- if the mother had diabetes or gestational diabetes while pregnant with the child
The outcomes for children with type 1 and type 2 diabetes are improved greatly with early detection.
It is not currently possible to prevent type 1 diabetes, but a child can take steps to reduce the chance of developing type 2 diabetes:
- Maintaining a healthy weight: Overweight children are at risk of developing type 2 diabetes, as they are more likely to have insulin resistance.
- Staying active: Keeping physically active reduces insulin resistance and also helps manage blood pressure.
- Limiting sugary food and drinks: Consuming lots of foods that are high in sugar can lead to weight gain. Eating a balanced, nutrient-rich diet, with plenty of vitamins, fiber and lean proteins, will lower the risk of type 2 diabetes.
My child has had a diagnosis of type 1 diabetes. Will they be able to join in the same activities as other children?
Finding out your child has type 1 diabetes can be a scary and unsettling time. But children with type 1 diabetes can participate in most of the same activities as their peers, though they will need your help and that of all their caregivers to do so safely. Your child’s diabetes care team can help you and your child learn how to manage their diet and medications in different situations such as parties and when playing sports or exercising. And check out the diabetes camps available for kids with diabetes and their families! These are a great way for kids to learn all they can do and to meet others living with diabetes as well.
Click here for a link to information about diabetes camp that you might find useful.Karen Gill, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.