Diabetes in children and teens: types, signs and daily care

Hearing that a child may have diabetes is a big worry for any parent. The good news is that diabetes in young people is well understood and a care team can guide you. This article sets out what health agencies say, so you know what to look for and what to ask. It is general information, not a diagnosis.

Types in young people

MedlinePlus explains that in type 1 diabetes the pancreas does not make insulin, and that this was long the most common form in young people. It says type 2 diabetes, where the body does not make or use insulin well, is becoming more common in children and teens, mainly because of rising obesity. The NHS says type 1 diabetes is often diagnosed in childhood but can occur at any age and cannot be prevented.

Signs to watch for

The NIDDK describes type 1 symptoms in children as frequent urination, thirst and weight loss despite eating more, and says symptoms usually develop over days or weeks. The NHS uses the 4 Ts as a reminder: toilet, thirsty, tired, thinner. It says children may have heavier nappies or start wetting the bed, and that colds, tonsillitis, tummy pain or nappy rash can hide the signs.

Risk factors for type 2

MedlinePlus lists being overweight or having obesity, a family history of diabetes, physical inactivity, and being African American, Hispanic, Native American or Alaska Native, Asian American or Pacific Islander. Its prevention tips include helping children keep a healthy weight, encouraging regular physical activity, serving smaller portions of healthy foods and limiting time spent on screens.

How it is tested

The NIDDK says children and teens aged 10 to 18 who have overweight or obesity plus another risk factor should be tested for type 2 diabetes. Children with symptoms of type 1 diabetes or possible diabetic ketoacidosis are often diagnosed with type 1. Autoantibody tests can suggest type 1 diabetes, and relatives of people with type 1 may be able to join a free research testing programme. A1C and blood glucose tests are used, and a doctor interprets the results.

Treatment basics

MedlinePlus says children and teens with type 1 diabetes usually need insulin. For type 2 diabetes, diet and exercise come first, and if those do not control blood sugar, doctors may prescribe oral diabetes medicines or insulin. The A1C test shows how well diabetes is being managed, and ketone tests may also be used. The NIDDK says some continuous glucose monitors are approved for children as young as 2. The NHS says children with type 1 diabetes should check glucose at least 5 times a day. A paediatric diabetes team agrees the plan, targets and insulin approach with the family.

Emotional support

The NHS says managing diabetes can be challenging and may lead to burnout. Ask your child's team about counselling and peer support.

Emergencies

The NHS says diabetic ketoacidosis can be the first sign of undiagnosed type 1 diabetes, particularly in children. It describes thirst, frequent urination, stomach pain, nausea or vomiting, deep or fast breathing, fruity-smelling breath, drowsiness and confusion. Low blood sugar can cause shakiness, hunger, sweating, confusion and, if severe, seizures or unconsciousness, according to the NIDDK and NHS.

When to see a doctor

See a doctor promptly if your child has strong thirst, frequent urination, weight loss, tiredness or new bedwetting. The NHS advises an urgent GP appointment or a call to NHS 111 if you suspect type 1 diabetes, and to call 111 for children under 5.

Go to hospital for fruity-smelling breath, fast or deep breathing, vomiting with stomach pain, confusion, drowsiness or fainting. In an emergency, call your local emergency number (112 in India, 911 in the United States).

This article is for education only and does not replace advice from your child's doctor.