10 Easy-to-Miss Signs of Diabetes in Children

In children, the initial symptoms of type 1 and type 2 diabetes can sometimes be easy to miss. Here's what to watch for, according to health experts.

According to the American Diabetes Association approximately 283,000 people under age 20 have received a diabetes diagnosis—and the number keeps on growing. There are two types of diabetes (type 1 and type 2) and each has different causes, risk factors, and complications.

Type 1 Diabetes: Type 1 diabetes is an autoimmune disorder that causes your immune system to attack cells in the pancreas, stopping the natural production of insulin. Insulin is important because it helps sugar (also known as glucose) in the bloodstream get into the body's cells, where it's used for energy. Sugar can build up in the blood without insulin, which can lead to severe consequences. According to the Centers for Disease Control and Prevention (CDC), type 1 diabetes is more common in children, teens, and young adults. It's not known what causes type 1 diabetes, but genetics and environmental factors might play a role.

Sleeping girl
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Type 2 Diabetes: Although not as common in young people, type 2 diabetes diagnoses are increasing with the ongoing obesity epidemic in youth. It occurs when the body doesn't respond to the insulin that's being made. The "body doesn't use insulin well and can't keep blood sugar at normal levels," according to the CDC. Besides being overweight, other risk factors for type 2 diabetes include inactivity, family history, diagnosed prediabetes, and more.

Wondering if your child might have diabetes? Below, we broke down some diabetes symptoms in terms of intake and output. Intake relates to what your child is consuming; output relates to what your child is secreting and releasing from their body.

Common Signs of Diabetes in Kids

Many signs of type 1 and type 2 diabetes overlap in children. One major difference involves presentation of symptoms. According to the CDC, type 1 diabetes can develop quickly (in a few weeks or months) and it can be severe. Parents sometimes notice that their child isn't acting like themselves, but they can't exactly pinpoint the reason, says Larry Deeb, M.D., past-president of the American Diabetes Association and director of Tallahassee Memorial HealthCare's Diabetes Center, in Florida. Symptoms might be easily dismissed as normal growing pains.

On the other hand, type 2 diabetes tends to develop slowly over time, and many kids don't experience any symptoms at all. Type 2 diabetes is often diagnosed during a check-up or appointment not related to a potential diagnosis.

Indeed, common indicators of diabetes are synonymous with childhood in general, according to Maya Feller, M.S., R.D., C.D.N., an adjunct professor of nutrition at New York University who has a private dietetics practice in Brooklyn.

Here are 10 possible signs of diabetes in children—but note that this list isn't exhaustive. Always talk to your health care provider about any concerns.

1. Changes in Eating and Sleeping Habits

According to the American Diabetes Association, people with diabetes tend to drink more water than usual. The health condition can make you feel very thirsty or hungry—no matter how much you eat.

2. Weight Fluctuations

Weight changes are common before a diabetes diagnosis—especially significant weight loss in type 1 diabetes or slow and excessive weight gain in type 2 diabetes. The Mayo Clinic says that "unintentional" is the key word when discussing weight loss as a potential symptom of diabetes.

3. Changes in Urinary Frequency

An increase in the amount of times your child is going to the bathroom has a direct correlation to a sudden increased water intake, and it could be cause for concern. Noticeable changes in urination and stool contents also warrants an eyebrow raise.

"We would hear him up all night long using the bathroom. During the day, he would sometimes go every 15 minutes," says Kim Streif, a teacher in Iowa and a parent of a child with type 1 diabetes. That warning signal was enough for them to go to the hospital. By the time they got there, their son's blood sugar level was 768, compared to a normal range of 80-150.

"Throughout the week leading up to that day, Chris (husband) and I had noticed that Sam was using the bathroom more frequently and drinking a lot of water and Gatorade," Streif said. "It was nice outside and the kids were bored from being home all week, so we just attributed it to being more active outside."

4. Altered Energy Levels and Exhaustion

Extreme fatigue and shifts in energy levels are reasons to raise a red flag, especially if your child is feeling more slow-moving and sluggish than usual. "In terms of the symptoms, they can actually be kind of similar to adults, so you may notice that there's a little more lethargy and the child is tired, they may have ups and downs in their energy levels," Feller said.

5. Stomach Problems

According to the CDC, people with diabetes "may also have nausea, vomiting, or stomach pains." These gastrointestinal symptoms tend to be more common with type 1 diabetes.

6. Blurry Vision

High blood sugar can cause the eye lens to swell, leading to blurred vision. As a result, children may be unbalanced and unable to focus clearly.

7. Numbness or Tingling

High blood sugar can cause diabetic neuropathy, which is a form of nerve damage. It can present in many different forms, including feeling "pins and needles" in your hands or feet.

8. Sores That Heal Slowly

If your child has a sore, wound, or infection that's sticking around longer than normal, it could be a sign of type 2 diabetes. You can blame factors like high blood sugar, diabetic neuropathy, and decreased circulation. Note that frequent infections are also more common with diabetes.

9. Darkened Areas of Skin

People with diabetes may notice darkening in their skin folds, such as the armpits and neck region. This symptom, called acanthosis nigricans, doesn't necessarily look like bruises, and it can have a velvety texture. This is caused by resistance to naturally produced insulin and is associated with type 2 diabetes.

10. "Fruity" Breath

Children may develop breath that smells fruity—often compared to a stick of Juicy Fruit gum. This potentially life-threatening symptom might indicate diabetic ketoacidosis, and it's usually only present for type 1 diabetes.

My Child Has Diabetes Symptoms—Now What?

Does your child have symptoms of type 1 diabetes or type 2 diabetes? Feller recommends scheduling an appointment with your pediatrician for a possible diagnosis. "The first thing that I usually say from a nutrition perspective is if a parent sees any significant change in their child's behavior, in terms of their intake (meaning what they're eating or drinking) or the output (a change in urine or stool, like the amount that they're going to the bathroom), they should absolutely go to the doctor," says Feller, who also wrote Southern Comfort Food Diabetes Cookbook. "That's number one, just in general across the board."

Children with diabetes should begin insulin therapy as soon as possible to prevent permanent vision and nerve problems. High blood sugar can also damage blood vessels, which has been associated with kidney disease, stroke, and heart attack. "Be aware, but not be frightened all the time," Feller says.

If your kid is diagnosed with diabetes, they might not be able to grasp the concept of monitoring blood sugar levels, meaning it's important they have people behind them that do. Feller encourages parents to assemble a multidisciplinary team, including pediatricians and dietitians to help them understand their children's diagnosis. "They really have to work with a healthcare team to find what works with the family. Because what works for one family might not work for another, especially with pediatric diabetes," Feller says.

Children diagnosed with type 1 versus those diagnosed with type 2 may follow different treatment and care plans according to their needs.

"Learning to care for a diabetic child is exhausting and overwhelming," says Streif, whose child was diagnosed with type 1 diabetes after they noticed changes in urinary frequency. "We spent the next three days learning how to count carbs, figure out insulin ratios for different times of day, prick his finger to check blood sugars, and give shots. Sam is a warrior though, and by the time we left the hospital, he was pricking his own fingers to check his blood sugar! The first six months were a roller coaster ride, but we were lucky to have great doctors and nurses, as well as the great support of other type 1 families in our area. Sam has had diabetes for almost two years now, and every day is still a learning experience."

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