Children’s health: Early warning signs of diabetes in children

Parents and caregivers often notice slight changes in their child long before anyone else does. Whether it’s a shift in mood, new habits, or a behavior that just feels unusual. When those changes involve things like constant thirst, extra trips to the bathroom, or sudden tiredness, many families start to wonder if something more serious could be going on. Being aware these early signs can make a big difference when it comes to identifying diabetes in kids.

Diabetes affects how the body uses sugar for energy. Normally, the pancreas makes insulin, a hormone that helps move sugar from the bloodstream into the body’s cells. But when the body can’t make enough insulin, or can’t use it the right way, sugar builds up in the blood.

In children, diabetes usually appears in one of two forms. Type 1 diabetes is an autoimmune disease in which the body mistakenly attacks the cells that produce insulin. Symptoms often come on quickly and are impossible to ignore once they start adding up. Type 2 diabetes, which is more common in teens, develops when the body becomes resistant to insulin. It tends to appear more slowly and is often linked to excess weight and family history.

“Parents know their kids best,” said Dr. Abby Dieguez, a pediatric endocrinologist at Lurie Children’s. “If something feels off, if your child is suddenly drinking a lot more water or seems very tired, it’s important to talk to your pediatrician right away.”

One of the earliest warning signs is frequent urination. When blood sugar is too high, the kidneys try to remove the extra sugar by making more urine. Some parents notice their child using the bathroom much more often than usual, or even starting to wet the bed again after being dry for years.

Extreme thirst usually follows. Because the body is losing so much fluid, children may ask for water all day long, even waking at night because they can’t seem to quench their thirst.

“If your child can’t seem to quench their thirst, that’s a sign worth checking out,” Dr. Dieguez said.

Another common sign is unusual tiredness. When sugar can’t enter the body’s cells, kids may feel weak or low energy, even if they’re eating normally. Parents may see their child pulling back from playtime or needing to rest more often. Weight loss can also happen, sometimes very quickly. If the body can’t use sugar for fuel, it starts breaking down fat and muscle instead, causing children to lose weight even when they’re eating more than usual.

“Rapid, unexplained weight loss is something we take very seriously,” said Dr. Mary McCauley, a pediatric endocrinologist at Lurie Children’s.

In some situations, symptoms can become severe and require emergency care. Doctors urge families to watch for deep, rapid breathing, breath that smells fruity, stomach pain, vomiting, or confusion. These can be signs of diabetic ketoacidosis, or DKA, a dangerous condition that happens when diabetes goes untreated.

“These symptoms mean the body is under serious stress,” Dr. Dieguez said. “Kids with DKA need care right away, and early treatment can be lifesaving.”

Some children may need screening even if they seem healthy. Kids with a family history of Type 1 diabetes or autoimmune conditions may benefit from antibody testing, which can show early signs that the immune system is attacking the pancreas. Children at higher risk for Type 2 diabetes — including those who are overweight or have a strong family history — can be screened for insulin resistance.

“A simple blood or urine test can give us a lot of information,” said Dr. McCauley. “Screening helps us catch problems early, before they cause harm.”

Noticing these changes in your child can be worrying, but doctors stress that families are not alone. With early diagnosis and the right care, children with diabetes can live full, active lives.

“Parents should trust their instincts,” Dr. Dieguez said. “If you’re worried, talk to your child’s doctor. The sooner we know what’s going on, the faster we can help.”

• Children's health is a continuing series. This column was provided by Ann & Robert H. Lurie Children's Hospital of Chicago.