Diabetes in children: Warning signs parents shouldn't ignore

In both adults and children, the symptoms of diabetes can be easy to miss but early detection of the condition is vital in maintaining good health and avoiding serious complications. In this article, highly esteemed consultant paediatrician Dr A R Moodambail gives expert insight on the signs of diabetes in children parents shouldn’t ignore. He also gives a detailed explanation of the condition’s impact on the body and the importance of good management of the condition.

What is diabetes?

Diabetes is a condition where the glucose (blood sugar) levels are overly high in a person’s blood. This happens when the body isn’t able to utilise the glucose for conversion into energy because of one of two possible reasons:

• the body doesn’t have enough insulin
• the body’s insulin isn’t working well enough

Because the body cannot produce energy from the glucose, the body gets tired and also the excessive glucose goes out of the body through urine. This can give rise to the symptoms of diabetes.

Does diabetes differ in children and adults?

Yes, to a great extent. In adults, more than ninety per cent of diabetes cases of diabetes are categorised as type 2 diabetes whereas in children, more than ninety per cent of cases are of type 1. Types 1 and 2 have many things in common but they also have many differences and importantly, the way the two conditions are managed differs widely.

What is the difference between type 1 and type 2 diabetes?

In type 1 diabetes, the body doesn’t produce any insulin or the levels it produces are insufficient to utilise the glucose in the body as fuel for energy. This happens because the body, for an unknown reason, produces immunogenic antibodies and cells that destroy the cells in the pancreas that produce insulin.

Whereas in type 2 diabetes, the pancreas does produce insulin, at least in the beginning, but this insulin doesn’t function well enough to allow the blood glucose to be converted into energy.

What are the symptoms of both type 1 and type 2 diabetes in children?

The symptoms are similar but in type 1 diabetes, the signs develop rather quickly, over a period of just days or weeks. In the case of type 2 diabetes, symptoms can develop over months or years, which means they can often go unnoticed.

When the blood glucose level is high, the body tries to adjust by eliminating the glucose in the urine, meaning the patient (child or adult) goes to the toilet very often to pass urine. Especially in the beginning, parents may notice that their child starts waking up in the night to go to the toilet many times.

Also, because patients pass lots of urine, they get very thirsty and will drink a lot. Additionally, they get tired easily and have low energy levels because the body isn’t able to produce energy effectively. In spite of a good appetite, patients will lose weight because the body tries to produce energy by utilising the fat stores in the body.

Children with the risk factors of being overweight or obese are sometimes detected as having diabetes incidentally.

How does a child get diabetes?

The vast majority of children with diabetes have type 1. Most of the time, we don’t have a specific answer as to why any given child may develop type 1 diabetes.

We do know that the body produces immunogenic antibody cells and products that destroy the cells of the pancreas which produce insulin. This results in deficiency of insulin in the body but the reason behind this is not yet clear.

Research is still being carried out to understand the development of type 1 diabetes which may, in the future, lead to preventative treatment, improved treatment or a cure of type one diabetes, which at present is not available.

Type 1 diabetes isn’t hereditary as such but there are some families at higher risk. With type 2 diabetes, there are clear risk factors such as obesity or being overweight and also some ethnic communities at are higher risk, which is not seen in type 1 diabetes.

What is the life expectancy of a child diagnosed with type 1 diabetes?

A child with type 1 diabetes can live just like any other child if they can manage their condition well with appropriate use of insulin and good lifestyle management. This means a healthy, balanced diet and regular exercise, much like anyone else.

There are many people with type 1 diabetes living in their nineties. If you look in to their past, you can see that they have managed their diabetes very well across their whole lifetime, without succumbing to any complications, having learned how to do so in childhood. If diabetes of either type isn’t managed well, however, there is a risk of getting into complications which can impact life expectancy.

What are the warning signs of diabetes in children that parents shouldn't ignore?

If a child develops any of the following symptoms, parents should look to get the child’s blood glucose levels checked at their GP surgery or with a paediatrician. Symptoms to look out for include:

• urinating a lot, especially with greater frequency than before during the night
• an onset of bedwetting which wasn’t present beforehand
• greater than usual thirst
• low energy levels
• weight loss
• frequent thrush in the bottom
• frequent skin infections

Even if the signs are present only in just the last few days or weeks, it is important to seek medical advice, especially if there is a family history of diabetes. If these symptoms and signs are ignored, there is a risk of a high-risk, emergency situation called diabetic ketoacidosis where the child needs to be admitted into high dependency care or intensive care as they will require very urgent treatment to regulate the imbalances in their system.

With early diagnosis, children can receive the right treatment from the very beginning and learn how to effectively manage their diabetes.

If you are concerned about symptoms of diabetes in your child, you can book a consultation with Dr Moodambail by visiting his Top Doctors profile.