Type 1 diabetes occurs when the pancreas stops producing insulin altogether, usually appearing in childhood or adolescence. It is not caused by diet or sweets, and it requires insulin from the day of diagnosis for life.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Rapid onset of excessive thirst and frequent urination over weeks
- Marked weight loss despite a good appetite
- Bedwetting in a child who was previously dry at night
- Tiredness, irritability and falling school performance
- Deep rapid breathing, abdominal pain and vomiting in severe cases
- A fruity smell on the breath
When to see a doctor
Do not wait these outIf any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- A child with thirst, frequent urination and weight loss — test the blood sugar the same day
- Vomiting, abdominal pain, rapid breathing or drowsiness in a known diabetic child — this is a medical emergency
- Repeated low sugar episodes with sweating, trembling or confusion
- Any acute illness or fever in a child on insulin, since insulin needs change
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Blood sugar and HbA1c
- Urine and blood ketones
- Arterial blood gas and electrolytes during acute illness
- Thyroid function and coeliac screening, which are commonly associated
- Annual eye, kidney and foot screening as the child grows
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Insulin by injection or pump, adjusted to meals, activity and illness
- Structured education for the child, the family and the school on injection technique and hypoglycaemia
- Regular blood glucose monitoring and record keeping
- Carbohydrate awareness rather than blanket food restriction, so growth is not affected
- Prompt hospital treatment for diabetic ketoacidosis
- Long-term follow-up with a paediatrician and, in adulthood, a physician
This page is general information, not a diagnosisType 1 Diabetes can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Paediatrics department. If a symptom is sudden or severe, call 9281862028.