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Diabetes in Children and Teens: Know the Signs and Symptoms

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Diabetes in Children and Teens: Know the Signs and Symptoms

Diabetes can affect anyone, at any age. Children are more likely to be diagnosed with type 1 diabetes, but more and more children and teens are being diagnosed with type 2 diabetes. In the United States, about 27 million people have been diagnosed with diabetes; of those, 210,000 are children and adolescents younger than age 20, including 187,000 with type 1 diabetes.

How do you know if your child or teen might have type 1 or type 2 diabetes? What are the signs and symptoms to watch out for? Read on to learn more!

Type 1 diabetes

Type 1 diabetes, formerly called “juvenile diabetes,” occurs when the pancreas doesn’t make insulin or makes very little insulin. Without insulin, blood sugar can’t get into cells, and it builds up in the bloodstream. High blood sugar levels are damaging to the body and can lead to complications. Type 1 diabetes is usually diagnosed in children, teens, and young adults, but it can develop at any age.

Type 1 diabetes is less common than type 2 diabetes; approximately 5% to 10% of people with diabetes have type 1 diabetes. This type of diabetes is an autoimmune condition in which the beta cells (the cells in the pancreas that make insulin) are destroyed. This process may go on for months or even years before symptoms appear.

Some people may have genes that make them more likely to develop type 1 diabetes, but being exposed to certain environmental triggers, such as a virus, is thought to play a role in the development of type 1 diabetes. Dietary or lifestyle factors don’t cause type 1 diabetes.

Type 1 diabetes is managed by taking insulin every day, either by injection or with the use of an insulin pump. Monitoring blood sugars is necessary and eating healthfully and staying active are other important ways to help manage blood sugars.

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Signs and symptoms of type 1 diabetes

A child may be at an increased risk of type 1 diabetes if they are ages 4 to 6 or 10 to 14. Symptoms of type 1 diabetes can appear quite suddenly and may include:

  • Frequent urination — babies may need frequent diaper changes and children may wet their pants
  • Diaper rash in infants caused by a yeast infection
  • Unusually high level of thirst
  • Dehydration
  • Extreme hunger combined with unexplained weight loss
  • Loss of appetite
  • Fatigue
  • Blurry vision
  • Fruity smelling breath
  • Fast breathing
  • Nausea and vomiting
  • Stomach pain
  • Yeast infections in girls
  • High levels of sugar in the blood and the urine

Diabetic ketoacidosis (DKA) may mistakenly be diagnosed as pneumonia or asthma, especially in infants and toddlers. DKA is a serious, life-threatening condition that occurs when cells don’t get the glucose that they need for energy. The body resorts to using fat for energy, and this creates ketones. When ketone levels in the blood build up, it can lead to DKA. DKA symptoms in children include the above symptoms, along with flu-like symptoms. Always seek medical attention promptly if your child or teenager has any of these symptoms.

Type 2 diabetes

Type 2 diabetes used to be called “adult-onset diabetes.” However, more and more children (some as young as 10 years old) and teens are getting type 2 diabetes, as about one-third of American youth are overweight. People (adults and children) who are overweight are likely to have insulin resistance, which can develop into type 2 diabetes.

Due to certain risk factors, such as family history or being of certain racial or ethnic groups (African American, Hispanic, Native American, Asian American, or Pacific Islander) or lifestyle factors, cells in the body stop responding normally to insulin. This causes the pancreas to make more insulin to help the cells take in glucose. Over time, the pancreas can’t keep up with the demand for insulin, and blood sugar levels start to rise, setting the stage for type 2 diabetes.

Insulin resistance in children may not produce any symptoms, although some kids will develop patches of thickened, dark, velvety skin in body creases and folds such as the back of the neck or armpits, says the (CDC) Centers for Disease Control and Prevention. Children may also have other conditions related to insulin resistance, including high blood pressure, high cholesterol, and polycystic ovary syndrome (PCOS).

Type 2 diabetes is managed primarily by lifestyle factors, including healthier eating and regular physical activity. Weight loss is generally not the goal, as children and teens are still growing, but it’s important to help stop or slow down weight gain if the child is overweight. If blood sugars aren’t managed well with these steps, diabetes medication may be needed. Metformin and noninsulin injectables may be prescribed; sometimes insulin is needed if blood sugars levels are very high. Teens who are significantly obese (meaning, a BMI above 35) may benefit from weight-loss surgery. Early treatment is important to lessen the chances of diabetes complications, such as heart and kidney disease, eye problems, and nerve damage.

Signs and symptoms of type 2 diabetes

Type 2 diabetes can develop gradually in children; for this reason, there may be no noticeable symptoms. Type 2 diabetes may be diagnosed during a routine check-up. However, some children and teens may have these symptoms:

  • Increased thirst
  • Frequent urination
  • Fatigue
  • Darkened areas of skin around the neck or in the armpits (acanthosis nigricans)
  • Weight loss
  • Blurry vision
  • Frequent bladder infections
  • Irritability and mood changes

If your child or teenager has any of these symptoms, be sure to seek medical attention promptly. Treatment depends on the extent of the symptoms, as well as your child’s overall health. The goal of treatment is to keep blood sugar levels as close to normal as possible.

Diagnosing diabetes

Type 1 and type 2 diabetes are diagnosed with a blood test, which may include:

  • A random blood sugar test
  • A fasting blood sugar test
  • An A1C test
  • An oral glucose tolerance test

Urine or blood tests for ketones, and blood tests for antibodies are additional tests that may be used if type 1 diabetes is suspected.

Both type 1 and type 2 diabetes in children and teens can be managed, and they can live a long, healthy life. For more information about diabetes in children, visit healthychildren.org.

Want to learn more about parenting a child with type 1 diabetes? Read “The Type 1 Diabetes Diagnosis,” “Type 1 Diabetes and Sleepovers or Field Trips,” “Writing a Section 504 Plan for Diabetes” and “Top 10 Tips for Better Blood Glucose Control.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

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