11 Signs of Type 1 Diabetes in Children You Must Not Ignore

Introduction

Diabetes is a condition where the body becomes resistant to insulin or does not produce it to metabolize sugar in the blood. Insulin is a hormone produced by the pancreas in our body, which acts by delivering glucose molecules to the cells for the release of energy¹. 

Type 1 and type 2 are the two major types of diabetes. In type 1 diabetes, the body does not produce insulin at all. In type 2 diabetes, the body becomes resistant to insulin or creates it in insufficient quantities.  

What is Type 1 Diabetes?

Type 1 diabetes is also known as Juvenile Diabetes. It affects children and adolescents more often but can develop in adults even in rare circumstances 

The exact reason why type 1 diabetes occurs is still a topic of debate². Research has proved that genetic expression, inflammation levels, and in some cases, even viral infections have a considerable role to play in this type of diabetes². 

It is believed that the body’s immune system turns against itself and destroys islets of Langerhans, the pancreatic cells which produce insulin^2,3. When there is no insulin in the blood, the level of glucose increases leading to severe complications if left untreated². 

Children are more prone to develop complications of type 1 diabetes like hypoglycemia or hypoglycemia or diabetic ketoacidosis, and there are high chances that the symptoms for these complications are frequently missed and underdiagnosed. Timely intervention is thus crucial.

Dr. Ashish Bajaj, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology

Complications Associated with Type 1 Diabetes in Children

Type 1 diabetes may have the potential to damage major organs or even organ systems in the body. Keeping the blood sugar levels under control is the key to reducing the risks associated with Type 1 Diabetes in children¹. Below are some risk factors which may come along with Type 1 Diabetes: 

• Cardiovascular problems: Type 1 Diabetes in children increases their risk of developing high blood pressure levels, stroke, or other diseases of the blood vessels later in life^1,4. 
• Malfunctioning kidney(s): Type 1 Diabetes may affect the waste filtering capability of one or both the kidneys by damaging the small clusters of blood vessels present in the kidneys^1,4,5. 
• Increased risk of osteoporosis: It may be responsible for reducing the bone mineral density, which gives rise to osteoporosis in late adulthood⁶. 
• Reduced vision capacity: Type 1 Diabetes may be detrimental to the blood vessels present in the retina of the eye, leading to vision problems^1,7.
• Damage to the nervous system: It can cause damage to the nervous system by damaging the walls of the blood vessels which supply blood to the nerves^1,8.

Most of children with type 1 diabetes only get diagnosed when they present with Diabetic ketoacidosis, which is state in type 1 diabetes with very high sugar, vomiting, abdominal pain, and fruity smelled fast breathing¹.

Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)

Warning Signs of Type 1 Diabetes in Children

1. Increased Urination

One of the prominent warning signs of type 1 diabetes is increased urination¹. High sugar levels lead to a toxic environment in the blood. The body tries to bring back balance by eliminating the excess sugar. The kidneys produce excessive urine, and this makes one take frequent trips to the washroom⁹. 

2. Excessive Thirst 

The body can get dehydrated due to frequent urination. To replenish the fluids, it demands more water by making the child feel thirsty. If your child is demanding water too frequently, talk to his doctor. It could be a warning sign of type 1 diabetes¹.

3. Extreme Hunger 

The body converts the food we eat into glucose, the smallest currency of energy. When one suffers from type 1 diabetes, glucose cannot be used by the body as there is a lack of insulin- the hormone responsible for delivering glucose molecules to the cells¹. This makes one feel low in energy. So, the body demands more food to stave off hunger. It is a vicious cycle. If your child has an increased appetite, observe if he is showing other warning signs of type 1 diabetes. 

4. Mood Changes and Irritability 

The continually fluctuating blood sugar levels create havoc on the mood of a person. Children are no different. When the sugar levels are low, we feel morose and irritable. When they are high, we feel full of energy and are in a better mood. When the levels dip too low or go too high, it could make one feeling depressed or manic¹⁰. Frequent and unexplained mood swings in kids could be a warning sign of type 1 diabetes. 

5. Blurred Vision 

High sugar levels affect the fluid levels in eye lens temporarily causing blurry vision. When the blood sugar levels come under control and the diabetes is managed, the vision returns to normal¹. Vision changes are an early warning sign of type 1 diabetes. 

6. Excessive Fatigue 

In type 1 diabetes, there may be a high amount of sugar in the blood but since it cannot be used by the cells, this makes the person feel weak and tired. Excessive and unexplained fatigue and weakness is a visible warning sign of type 1 diabetes¹. 

7. Unexplained Weight Loss 

While the body may demand more food and feel more hungry than usual, since the primary energy-providing mechanism is not working correctly, the patient may experience unexplained weight loss¹. The high sugar levels are not helping the cells, which are deprived of energy leading to a decline in body mass due to loss of fat and muscle in the body¹². 

8. Bed Wetting

This is commonly observed in children who have not been wetting the bed earlier. High sugar levels lead to frequent urination. Children cannot control their urge in the sleep leading to bedwetting, another warning sign of type 1 diabetes¹. 

9. Fruity-Smelling Breath 

When the body uses fat to produce energy, it leads to the formation of ketones. Ketones provide a fruity-smelling scent to the breath. If left unchecked, high levels of ketones in the body lead to ketoacidosis, which is a life-threatening condition^1,2. 

10. Yeast Infections 

This is another warning sign of type 1 diabetes. High sugar levels can lead to an unhindered proliferation of yeast, bacteria, and fungi¹². Especially girls become prone to many vaginal and urinary tract infections. Controlling the blood sugar is the best way to reduce the frequency of these infections. 

11. Nausea and Vomiting 

When the body burns fats and muscles instead of carbohydrates to release energy, it releases ketones- the waste materials of the process. In small amounts, they do not cause much damage, but in high quantities, they can cause toxicity in the blood leading to nausea and vomiting^2,12.

Also Read: Home Remedies for Cold in Infants and Babies

Conclusion

In type 1 diabetes, the symptoms appear quickly, and the onset of the disease is sudden. Since most of the patients who have type 1 diabetes are children, they might not understand the signs of the disease. As parents or guardians, it is crucial to arm oneself with knowledge of the symptoms of diabetes in children. Knowing the early signs can help you detect the condition early on and take measures to achieve sugar control, thereby avoiding long-term complications of diabetes, some of which can be fatal. With consistent care and appropriate medication, the situation can be brought under control. 

References

1. MedlinePlus. Type 1 diabetes: MedlinePlus Medical Encyclopaedia [Internet]. Medlineplus.gov. 2021. Available from: https://medlineplus.gov/ency/article/000305.htm 

2. Sapra A, Bhandari P. Diabetes [Internet]. Nih.gov. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK551501/ 

3. Lucier J, Weinstock RS. Diabetes Mellitus Type 1 [Internet]. Nih.gov. StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507713/ 

4. Health Direct. Type 1 diabetes [Internet]. Health Direct. 2024. Available from: https://www.healthdirect.gov.au/type-1-diabetes 

5. Health Direct. Chronic kidney disease [Internet]. Health Direct. Health direct Australia; 2023. Available from: https://www.healthdirect.gov.au/chronic-kidney-disease 

6. Khan TS, Fraser LA. Type 1 Diabetes and Osteoporosis: From Molecular Pathways to Bone Phenotype. Journal of Osteoporosis. 2015; 2015:1–8.  Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4385591/#:~:text=Abstract,strategies%20in%20this%20patient%20population 

7. Health direct. Diabetic retinopathy [Internet]. www.healthdirect.gov.au. 2018. Available from: https://www.healthdirect.gov.au/diabetic-retinopathy 

8. Juan Carlos Sánchez-Manso, Varacallo M. Autonomic Dysfunction [Internet]. Nih.gov. StatPearls Publishing; 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430888/ 

9. Hanna-Mitchell AT, Ruiz GW, Daneshgari F, Liu G, Apodaca G, Birder LA. Impact of diabetes mellitus on bladder uroepithelial cells. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology [Internet]. 2013 Jan 15;304(2):R84–93. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543662/ 

10. Penckofer S, Quinn L, Byrn M, Ferrans C, Miller M, Strange P. Does Glycemic Variability Impact Mood and Quality of Life? Diabetes Technology & Therapeutics [Internet]. 2012 Apr;14(4):303–10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3317401/ 

11. National Eye Institute. How the Eyes Work | National Eye Institute [Internet]. Nih.gov. National Eye Institute; 2022. Available from: https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/how-eyes-work 

12. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Diabetes | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2020. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes 

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