Signs and Symptoms
After the autoimmunity begins and the islet cells slowly begin to die, the child (or person) affected begins to show signs and symptoms that can add up to a diagnosis of Type 1 diabetes. Many parents don't know the symptoms, but some lucky ones do. The sooner you can recognize the symptoms, the sooner your child can get treatment.
After a diagnosis, more than one parent has beaten themselves up about the “obvious” signs that they just didn't see. The fact is that events, trauma, and illness happen to children. Most parents are not aware of all the symptoms of Type 1 diabetes, and so they attribute the symptoms they notice as being caused by other events.
The first sign most parents or caregivers become aware of is a higher frequency of urination. Parents of small children report noticing soaked-through diapers on what seems to be a constant basis and extremely heavy diapers at changing time.
Older children will visit the restroom more often. One reason many children seem to be diagnosed on family vacations is that is a time when parents notice a child's bathroom visits. At home, a child can slip off to the powder room; on a vacation, however, Mom or Dad has to hunt down a restroom each time.
Oftentimes, a child (even a teenager) begins to experience bed-wetting. If a child has just transitioned into kindergarten or become an older sibling for the first time, parents often attribute this symptom to regression or relate it to stress.
At the start of a diagnosis, it is important to tell a child that his or her bedwetting was a symptom of the onset of diabetes. Wetting the bed can be a source of shame or guilt for some children, so reassure your child that this bedwetting was beyond his control.
The second obvious sign is weight loss. The body cannot use food for fuel, and so it must find the fuel elsewhere. Most patients lose weight because their bodies are forced to eat away at fat and muscle for fuel. A child can drop a good amount of weight quickly, and in fact, most patients lose weight prior to diagnosis. But here again, it's easy for parents to misinterpret this symptom, thinking the weight loss is due to losing baby fat, engaging in more exercise, or just growing into a different type of body. Also, most parents don't weigh their children regularly.
Less Obvious Signs
There can be other hints that diabetes is present. Behavior changes often accompany constant high blood sugar. Many parents report “losing control” of their children just before diagnosis; the child becomes irritable, uncooperative, even sullen. These changes, on their own, would never lead a parent to think about diabetes, but combined with other symptoms, they can provide another piece of the puzzle.
Children can also develop excessive thirst or hunger before diagnosis. The thirst comes from the increased production and loss of urine, or osmotic diuresis, discussed earlier. Some children, even tiny ones, can hurriedly guzzle giant glasses of water or other drinks. Hunger comes from the body's inability to find fuel, since it is not being told to do so by the insulin. Again, parents can attribute the thirst to playing outside on a hot day and the increased appetites to a growth spurt. But the pieces of the puzzle are now beginning to fall into place.
If these signs remain undetected, more drastic symptoms such as vomiting, stomach pain, and rapid breathing can follow. These symptoms should be treated as an emergency, and immediate, hands-on care should be sought.