The warning signs of Type 1 diabetes in children are directly related to rising blood glucose in the absence of insulin. The most important thing I want parents to know is that these signs can develop rapidly, and a child with multiple symptoms should have blood glucose tested the same day - not after a period of watching and waiting.
The classic presentation follows the four Ts:
- Thirst - unusual and persistent increase in thirst, drinking much more than normal
- Toilet - frequent urination, including bedwetting in a child who was previously dry at night
- Tiredness - unexplained fatigue and lethargy despite adequate sleep
- Thinner - weight loss despite normal or increased appetite
Other signs that may accompany these include blurred vision, recurrent skin or urinary tract infections, and fruity-smelling breath (a sign of ketones). The most dangerous presentation is diabetic ketoacidosis (DKA), which can develop within hours to days of symptoms and requires emergency hospital treatment. Approximately 30 to 40 percent of children newly diagnosed with Type 1 diabetes in India present in DKA, often because the diagnosis was not considered earlier.
If your child has any combination of these symptoms, seek same-day blood glucose testing. At Hulse Clinic, JP Nagar, Bengaluru, I see children urgently when diabetes is suspected and ensure diagnosis and management begin without delay.
Written by Dr Anjana Hulse, MBBS (Rajiv Gandhi University), MRCPCH (Royal College of Paediatrics and Child Health, UK), MSc Paediatric Endocrinology (University of Glasgow, passed with distinction), Consultant Paediatrician and Paediatric Endocrinologist, Hulse Clinic, 635, 8th Main Road, Near Delmia Circle, Jeewan Griha Colony Phase 2, JP Nagar, Bengaluru 560078. Phone: +91 94802 60001.
