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8 Red-Flag Symptoms of Type 1 Diabetes in Children

Type 1 diabetes, previously called juvenile diabetes, develops when the pancreas no longer produces insulin. Here’s how to tell if your child might be affected.

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What is type 1 diabetes?

Type 1 diabetes, previously called juvenile diabetes, is an autoimmune disease that causes your pancreas to stop producing insulin—an essential hormone that allows blood sugar (aka “blood glucose“) to pass into cells so that the cells can then use it as energy.

Around 64,000 people in the United States are diagnosed with type 1 each year. Far less common than type 2 diabetes, type 1 accounts for five to 10 percent of all diabetes cases in the U.S. And while it can strike at any age, it’s most commonly diagnosed somewhere between infancy and late 30s. The peak age of diagnosis in the U.S. is around age 14.

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What’s it like to receive a type 1 diabetes diagnosis?

Beth Bernstein recalls all the questions that filled her head when her daughter was diagnosed with type 1 at age 14. “What do we do? What are our next steps? I was very linear in my thinking,” says Bernstein, owner of SQN Events, a wedding planning company in Chicago. “To see my daughter in so much discomfort and pain was horrible.”

The symptoms came without warning. “It literally came out of the blue,” she says. “At first, I felt guilty, but then I learned there’s nothing we did to cause this.”

Bernstein soon realized that understanding the major characteristics of type 1 diabetes is critical to managing the illness. A child with type 1 may demonstrate the following symptoms:

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Excessive thirst

What’s known as polydipsia—excessive thirst—is easy to dismiss as dehydration. “Parents’ initial thoughts go to things like, ‘It was hot out,'” says Marlisa Brown, RDN, spokesperson for the Association of Diabetes Care and Education Specialists. “But if you see your kid drinking two liters of soda, or glass after glass of water, and they’re still thirsty,” that may be a sign of high blood sugar.

High blood sugar levels trigger a reaction in the body that pulls fluid from tissues, resulting in dehydration. Prolonged dehydration can lead to nausea, dizziness, headaches, and fainting. It can also make your child’s blood sugar levels rise more quickly than normal since she’s expelling less urine—and glucose.

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Frequent urination

As glucose levels accumulate, the kidneys try to remove the excess glucose by increasing the frequency and volume of urination (a condition called polyuria), says Brown. A child will have to urinate often—sometimes around the clock. The kidneys work through the night to eliminate the buildup of glucose, so you may notice new episodes of bedwetting.

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Headaches or blurry vision

As blood sugar levels begin to climb out-of-range, some children experience recurrent headaches. They may also experience periods of blurry vision. “This is different from permanent damage to the eyes as a consequence of long-term diabetes,” explains Brown. “The cloudy vision sometimes is how diabetes is identified. Parents think glasses are needed, but then an eye doctor suspects diabetes as the cause.”

The good news? “Vision usually returns to normal after a few months of normal blood sugars,” says Brown.

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Increased hunger

The lack of insulin causes glucose to collect in the blood, as opposed to entering the cells where it’s needed to make energy. Even after your kid has eaten, he may continue to feel hungry while the cells attempt to get the fuel they need to function.

“Insulin acts like a key to let glucose into the cells,” explains Diana Isaacs, PharmD, a clinical pharmacy specialist and CGM program coordinator at Cleveland Clinic’s Endocrinology & Metabolism Institute. “If there’s not enough insulin, the glucose stays in the bloodstream and can’t be absorbed into the cells for energy. Your child can keep eating and eating, but because the glucose isn’t absorbed, he’ll continue to feel hungry.”  

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Unexplained weight loss

“Weight loss or the inability to gain weight in a growing child can be signs of type 1 diabetes,” says Dr. Isaacs. “Because there’s a lack of insulin, your child isn’t able to absorb the energy from food. The body then breaks down fat and muscle to try and produce energy. All of this leads to weight loss. The amount will vary depending on how early it’s caught.”

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Extreme fatigue

If your child is tired all the time it may be a sign her body is struggling to turn sugar in the bloodstream into energy. “Due to the lack of insulin, food can’t be absorbed into the cells for energy,” says Dr. Isaacs. “Your child can keep eating and eating, but her body will still be starving. This causes fatigue.”

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Vaginal yeast infections in girls who haven’t reached puberty

There are many reasons for a young girl to develop a yeast infection—the common vaginal infection caused by an overgrowth of the Candida fungus. Diabetes is one possible culprit.

“Although typically yeast infections present with hormonal changes, during and after puberty, they also commonly present in those with undiagnosed diabetes,” says Julia Blanchette, RN, a registered nurse and certified diabetes care and education specialist at the Cleveland Clinic Diabetes Center. “When blood glucose levels are high, there is often an increase in the glucose in mucus membranes of the vagina. That creates a place for yeast to grow.”

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Mood swings and irritability

A review of studies, published in 2012 in Diabetes Technology & Therapeutics, shows that elevated blood glucose in people with type 1 has a negative impact on mood. “The brain uses glucose for energy,” explains Blanchette. “When the body can’t use glucose appropriately due to lack of insulin production, mood swings and irritability can occur.Extreme irritability can be a sign of the life-threatening diabetic ketoacidosis (DKA) and should be assessed by a medical professional immediately.” 

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What’s next after a type 1 diabetes diagnosis?

There is no cure for type 1 diabetes. But taking daily insulin—via injections or a pump—counting carbohydrates, frequently checking blood sugar levels, and maintaining a healthy weight are key to managing this chronic illness.

“Type 1 can be overwhelming and scary when first diagnosed,” says Brown. “The first thing I do is let parents know there was nothing they did to cause it. Then I let them know how many innovative tools we have to make it easier to manage.”

Once a treatment plan was in place for her daughter, Bernstein felt a flood of emotions as she realized all the challenges her  daughter would face. “To get through each day, we tell ourselves ‘things could be worse,’ ” she says. “This condition is manageable.”

For parents trying to navigate their kid’s type 1, Bernstein offers this advice: “Trust your doctors,” she says. “Don’t be afraid to ask questions. You must advocate for your child with the doctor and with your school. Talk to your child’s teachers and tell them what to expect. Also, a peer support group for both the parents and the child is very important.”

Sources
  • JDRF, "Type 1 Diabetes Facts"
  • Beth Bernstein, wedding planner and owner of SQN Events in Chicago
  • Marlisa Brown, RDN, CDCES, spokesperson for the Association of Diabetes Care and Education Specialists
  • Diana Isaacs, PharmD, CDCES, a clinical pharmacy specialist and CGM program coordinator at Cleveland Clinic’s Endocrinology & Metabolism Institute
  • Julia Blanchette, RN, CDCES, a registered nurse and certified diabetes care and education specialist at the Cleveland Clinic Diabetes Center
  • Diabetes Technology & Therapeutics, "Does Glycemic Variability Impact Mood and Quality of Life?"