diabetes in children

Overview

Diabetes is a condition where the body has trouble controlling the level of sugar (glucose) in the blood. In children, the most common type is type 1 diabetes, where the body stops making a hormone called insulin. Insulin helps sugar from food enter cells to make energy. Without enough insulin, sugar builds up in the blood. Some children have type 2 diabetes, where the body makes insulin but cannot use it well.

Diabetes is one of the most common long-term conditions in childhood. Type 1 diabetes is usually diagnosed in children, while type 2 diabetes is more likely to appear in older children and teenagers.

Type 1 diabetes can start at any age, even in babies and toddlers. Type 2 diabetes is more common in teens and in children who have a family history of diabetes or who are above a healthy weight.

Symptoms

Common symptoms

• Being very thirsty
• Needing to urinate (pee) much more often
• Feeling very tired
• Losing weight without trying

Symptoms in children

• Bedwetting or getting up at night to pee
• Becoming irritable or moody
• Having sweet or fruity-smelling breath
• Increasing hunger but still losing weight

Symptoms in older adults

• Dark, velvety patches on the skin, often around the neck or armpits
• Blurred vision
• Slow-healing cuts and sores

Causes

Main causes

• Type 1 diabetes happens when the body's immune system mistakenly attacks the cells that make insulin.
• Type 2 diabetes happens when the body's cells stop responding normally to insulin, and the pancreas can't make enough insulin to keep up.

Risk factors

• Family history of diabetes
• Being above a healthy weight (for type 2 diabetes)
• Certain ethnic backgrounds can have a higher risk
• Having a mother who had diabetes during pregnancy (for type 2 diabetes)

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if your child has new symptoms like extreme thirst, frequent urination, weight loss, or fatigue.
• If your child is breathing quickly, very sleepy, or has fruity breath, call emergency services right away.

Book a routine appointment if:

• If you are concerned about symptoms, request a simple blood test from your family doctor or pediatrician.
• If your child has risk factors for type 2 diabetes, ask about routine blood sugar checks during regular appointments.

Diagnosis

A doctor will ask about your child's symptoms and take a small sample of blood to measure blood sugar levels. They may also test urine. If diabetes is suspected, your child will be referred to a specialist children's diabetes team for confirmation and care.

Tests that may be done

• Random blood sugar test
• Fasting blood sugar test
• HbA1c test (a measure of average blood sugar over 2 to 3 months)
• Urine test for ketones

What to expect at your appointment

When diabetes is diagnosed, you and your child will get education and support. The care team will teach you how to check blood sugar, give insulin or other medicines, and handle sick days. You will have regular follow-up appointments.

Treatment

Treatment helps keep blood sugar levels as close to normal as safely possible. It depends on the type of diabetes. For type 1, daily insulin is always needed. For type 2, healthy eating and activity may be enough at first, but some children still need medicine.

Self-care at home

• Check blood sugar levels as often as your care team advises
• Give insulin or other diabetes medicines exactly as prescribed
• Always carry a fast-acting sugar source (like fruit juice or sweets) in case of a low blood sugar
• Track symptoms and blood sugar readings to share with your care team

Medical treatments

Insulin is given by injection or with a small wearable pump that delivers insulin continuously. For type 2 diabetes, doctors may prescribe medicines that help the body use insulin better. The care team will explain the best plan for your child. Never change or stop any medication without talking to your doctor.

When is surgery considered?

Surgery is not used to treat routine diabetes in children. It may be considered in rare situations, such as for weight management in older teens with severe obesity-related type 2 diabetes, but only after thorough discussion with specialists.

Living with this condition

Living with diabetes becomes part of daily life. You'll learn to plan meals, check blood sugars, and balance activity. Schools and caregivers should know what to do if your child has a low or high blood sugar.

Lifestyle tips

• Keep a routine with regular meals and snacks
• Encourage at least 60 minutes of daily physical activity, but watch blood sugar during and after exercise
• Get enough sleep and manage stress
• Keep a diabetes emergency kit ready at home and school

Diet and exercise

A balanced diet is key. Carbohydrates raise blood sugar, so you'll learn how to match food, insulin, and activity. Exercise usually helps lower blood sugar, but the effect can be unpredictable, so it is important to work with your care team to adjust.

Mental health and emotional wellbeing

Being diagnosed with diabetes can feel overwhelming for both child and parent. Anger, anxiety, and sadness are normal at first. It's important to talk about these feelings and ask for support if they don't ease.

Prevention

Type 1 diabetes cannot be prevented. Type 2 diabetes may be delayed or prevented by maintaining a healthy weight, eating well, and staying active, especially if a child is in a high-risk group.

Vaccines

Keep your child up to date with routine vaccinations, including the flu vaccine, because illnesses and infections can affect blood sugar levels.

Screening programmes

Children who are at high risk of type 2 diabetes may have routine blood sugar checks at doctor visits. There is no routine screening for type 1 diabetes.

Complications

If left untreated

• Diabetic ketoacidosis (DKA), a life-threatening emergency with ketones and high blood sugar
• Slow growth and delayed development
• Frequent infections, such as bladder or skin infections
• Long-term damage to the eyes, kidneys, and nerves if blood sugar stays high

Long-term outlook

With good treatment and support, children with diabetes can have a full and active life. They can play sports, travel, and reach their goals. Modern tools and medical care make it easier than ever to stay healthy and positive.

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