Diabetes in children and adolescents: signs and symptoms (2020)

With over a third of diabetes cases in the United States occurring in people over 65, diabetes is often referred to as an age-related condition. But around 208,000 children and adolescents are estimated to have diabetes, and that number is increasing.

Type 1 diabetes is the most common form of the disease in children and adolescents.

A 2009 report from the Centers for Disease Control and Prevention (CDC) found that type 1 diabetes prevalence is 1.93 in every 1,000 children and adolescents, while type 2 diabetes affects 0.24 in every 1,000.

In 2014, Medical-Diag.com Reported that, based on a study published in JAMA , Rates of type 1 and type 2 diabetes have been well below American Children and adolescents elevated.

The study found that the incidence of type 1 diabetes in children up to 9 years of age increased by 21 percent between 2001 and 2009, while the incidence of type 2 diabetes in adolescents aged 10-19 years 30.5 percent rose.

The researchers note: "The increases in prevalence reported here are important because these adolescents with diabetes will experience adulthood with multiple years of disease duration, difficulty in treatment, an increased risk of early complications, and increased incidence of diabetes during the reproductive years, which further increases diabetes in the years next generation."

Here are some key points about children’s diabetes. More details and supporting information are in the main article.

Type 1 and 2 diabetes are rising in the youth of America
Often, the symptoms of type 1 diabetes in children only develop few weeks
If type 1 diabetes is not detected, the child can develop diabetic ketoacidosis (DKA),

What is diabetes in children?

A study found that the incidence of type 1 diabetes in children up to 9 years of age increased by 21% between 2001 and 2009.

Type 1 diabetes in children, previously known as adolescent diabetes, occurs when the pancreas cannot produce insulin.

Because insulin is absent, sugar cannot travel from the blood to the cells, and high blood sugar levels can develop if not treated.

Children with the condition require lifelong insulin injections and blood sugar monitoring, with diet and exercise management to help keep blood sugar levels within their target range.

Type 2 diabetes, although less common in young children, can occur when insulin is not working properly, which leads to reduced insulin production. As a result, glucose can accumulate in the bloodstream.

The condition can often be managed through a change in diet, increasing exercise, and maintaining a healthy weight, although some patients require diabetes medication – such as metformin.

Symptoms of diabetes in children

The most common symptoms of type 1 and type 2 diabetes in children and adolescents are increased thirst, urination and fatigue. Some children may also experience an increase in hunger and blurred vision Experienced, while girls could develop a yeast infection.

For those with type 1 diabetes, weight loss is often a common symptom before diagnosis. For those with type 2 diabetes, there may be signs of insulin resistance, such as dark, velvety patches of skin called acanthosis nigricans and polycystic ovary syndrome.

Symptoms of type 1 diabetes in children tend to develop rapidly over a period of a few weeks, while type 2 diabetes symptoms develop more slowly and cannot be diagnosed for months or years.

Parents should take their child to the doctor if they experience any of the above symptoms. But despite an increase in diabetes prevalence among children and adolescents, there seems to be a lack of awareness when it comes to identifying symptoms of the condition.

The importance of early detection

According to a 2012 survey by Diabetes U.K. only 9 percent of parents were able to identify the four main symptoms of type 1 diabetes. A recent charity survey found that this percentage has risen to 14 percent.

Barbara Young, head of Diabetes U.K., believes that this is far from good:

"Too many cases, children with type 1 diabetes are not diagnosed until they are seriously ill, and in some tragic cases, this delay in diagnosis can even be fatal."

Children with a delayed diagnosis of type 1 diabetes – and very rarely a delayed diagnosis of type 2 diabetes – can develop diabetic ketoacidosis (DKA). It is the leading cause of mortality in children with type 1 diabetes. When the body experiences a serious lack of insulin, it is not possible to use glucose for energy. As a result, the body begins to break down fat for energy; This leads to the production of chemicals called ketones, which can be toxic at high levels. A buildup of these chemicals causes DKA, where the body becomes acidic.

If diabetes is diagnosed early and managed effectively, DKA is very avoidable. Unfortunately, this is often not enough.

For younger people with type 2 diabetes, the progression is much faster than adults, and they appear to be at higher risk of complications such as kidney and eye diseases than children with type 1 diabetes.

They also have higher chances of high blood pressure and high cholesterol levels, which increase their risk of marine sickness. For this reason, early detection of type 2 diabetes in younger people is critical.

Doctors who cannot identify diabetes in children

It’s not just parents who can be blind to diabetes symptoms in children. Recently, UK researchers have warned that many health professionals also fail to identify the signs of the condition and put children’s lives at risk.

In a study published in the magazine Archive of Disease in Childhood , The researchers analyzed 261 children aged 8 months to 16 years diagnosed with type 1 diabetes. Symptoms that led to their diagnosis were assessed.

The researchers found that by the time children under the age of 2 were clinically diagnosed with type 1 diabetes, 80 percent of them had already developed DKA.

The co-author of the study comments:

If symptomatic children with undiagnosed type 1 diabetes had multiple contacts with health care professionals, they were more likely to present with DKA, and this is very important, since we know that early diagnosis is for insulin treatment and prevention of complications is essential."

Dr. Kemi Lokulo-Sodipe, research assistant at Southampton Children’s Hospital, U.K..

A 2008 study published in the magazine Pediatric endocrinology, diabetes and metabolism , Found that among 335 children under the age of 17 with new-onset type 1 diabetes, the first diagnosis was wrong in more than 16 percent of the cases.

The study found that in these cases, doctors initially diagnosed 46.3 percent of children with respiratory infection, while others diagnosed perineal candidiasis (16.6 percent), gastroenteritis (16.6 percent), urinary tract infection (11.1 Percent), stomatitis (11.1 percent) or appendicitis (3.7 percent).

In addition, the researchers found that the incidence of DKA was more common in children who received an incorrect – and therefore delayed – diagnosis of type 1 diabetes.

Although children and adolescents with diabetes usually experience four main symptoms, Young notes that all four symptoms "the exception rather than the rule" and noticed that many children can only have one or two. In some cases there will be no symptoms.

As such, a child who suddenly becomes thirsty or tired will not call diabetes alarm bells for a parent. And because diabetes is much rarer in very young children, doctors can attribute any symptoms to other, more common diseases.

Ensuring early detection of children’s diabetes

So what can be done to ensure that children who have symptoms of diabetes are diagnosed early and receive appropriate treatment?

"As a nation, we need to emphasize that type 1 diabetes is common and the incidence is increasing", says Dr. Lokulo-Sodipe. "It can be present in babies and toddlers and should be at the top of the list in every child with increased toileting – including heavy wet diapers and bedwetting – but also weight loss and fatigue."

Diabetes U.K. the "4 thousand" -Campaign – to raise awareness of the symptoms of type 1 diabetes that children can experience.

Campaigns to raise awareness of children’s diabetes symptoms have worked in the past. A 2012 study published in the magazine Pediatric diabetes , Showed that during such a campaign in Australia, the rate of DKA in initial diagnosis of type 1 diabetes in children was reduced by 64 percent.

The 4 Ts that Diabetes U.K. say people should be aware in children are:

T Oilet – with the toilet often, heavier diapers in babies or bedwetting from a previously dry child
T Hirsty – drink more fluids than usual, but unable to quench thirst
T Ired – feeling more tired than usual
T Hinner – weight loss

A video that provides more information about the 4 Ts can be viewed below:

The organization says that if a child shows one of the 4 Ts, parents should take them to the doctor and insist on an immediate type 1 diabetes test. This consists of a finger prick test that analyzes the child’s blood to determine their glucose levels.

In addition to the parents and those who take care of the symptoms and work with children, we need to understand the understanding that a child who has one of the 4 Ts must be tested immediately.

This is because the onset can be so quick that a delay of a matter of hours can be the difference between being diagnosed at the right time and being diagnosed too late."

Barbara Young, managing director of Diabetes U.K..

For those with type 2 diabetes, following the suggested testing guidelines as recommended by the American Diabetes Association (ADA) can help improve the diagnosis.

The ADA recommends examining asymptomatic children who are overweight (over 85 percent for body mass index or over 120 percent ideal weight for height) if they have two of the following risk factors:

Family history of type 2 diabetes in a first or second degree relative
High-risk ethnicity (Native American, African American, Latino, Asian American or Pacific Islander)
Signs of insulin resistance
Maternal history of diabetes or gestational diabetes during the child’s pregnancy

The results for children with type 1 and type 2 diabetes are greatly improved with early detection.