Type 1 Diabetes: Early Detection Can Lead to DKA Prevention
Nov 07, 2023
Type 1 diabetes, an autoimmune disease against the pancreas, is one of the most common chronic conditions of childhood. The pancreas makes insulin, the key hormone for the body to use glucose (or sugar). Without insulin, the body is unable to use glucose for energy, and glucose instead builds up in the blood.
Classic Symptoms: The 4 P’s
High glucose causes the classic symptoms of diabetes, which can be thought of as the “4 P’s” (with the help of some French):
Polydipsia: being very thirsty or drinking a lot more than usual
Polyuria: urinating more than usual, including waking up at night to use the bathroom, or new bedwetting
Polyphagia: bigger appetite or eating much more than usual
Perte de poids/Loss of Pounds: unintentional weight loss
These symptoms can start slowly and be subtle, or they can seem sudden and very obvious. In some cases, children are so thirsty they may drink from unusual places like the bathtub, or they can lose so much weight their clothes no longer fit.
DKA: A Medical Emergency
Over a third of children with new onset type 1 diabetes present in diabetic ketoacidosis (DKA). DKA is a potentially life-threatening complication of diabetes in which the body makes ketones for energy if there is not enough insulin to use glucose for fuel. High levels of ketones can cause the acid level in the blood to rise and lead to typical symptoms including:
Stomach pain, nausea, and vomiting
Rapid, deep breathing; parents have described this as panting like a dog on a hot day
In severe cases, changes in mental status and cerebral edema (or swelling of the brain)
With proper treatment, most children recover from DKA without lingering effects, but early recognition of the classic symptoms of diabetes is critical for parents and healthcare providers alike to prevent DKA in the first place.
Type 1 diabetes can affect children of any age but has the highest new onset rate in the early school-age years (4 – 6 years old) and during puberty (10 – 14 years old). It can also be more common in those with a family history of type 1 diabetes or other autoimmune diseases, but many children who develop type 1 diabetes do not have anyone in the family who has also been diagnosed.
Parents or caregivers of children who develop type 1 diabetes often feel a lot of guilt. However, it is important to remember that the development of this autoimmune disease is not something the child or any family member did, or did not, do. It is not caused by eating too many sugary treats or not being active enough; it just happens.
While type 1 diabetes is not currently curable, it can be successfully treated with insulin so that complications such as DKA are avoided and children can live long, fulfilling lives.
Take Home Points
If your child is drinking more than usual, urinating more than usual, bedwetting, or losing weight that they do not mean to, it is important to see a healthcare provider right away. Doing so may help lead to an earlier diagnosis of type 1 diabetes and prevent DKA.
Jennifer Ladd, MD, MSc is on the endocrinology physician team at Nationwide Children's Hospital. She is also the founder and medical leader of the new Turner Syndrome Clinic at Nationwide Children's.
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