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Question: My son seems to always be thirsty, urinates frequently and has less energy. Any ideas?
Answer:
These may be the first clues that can lead to a suspicion of childhood diabetes. When a patient presents to us with these symptoms, we perform a lab test to determine the patient’s blood sugar levels. We strongly suspect diabetes if the child’s blood sugar level, taken when he or she is not fasting, is greater than 200 milligrams per deciliter (mg/dl). For comparison, normal after-meal blood sugars should be under 140 mg/dl.
Diabetes is a complicated disease involving blood glucose, or sugar, and insulin. Insulin is a hormone that helps the glucose get inside cells to use for energy and keeps the blood sugar level in the normal range. With type 1 diabetes, the most common type in children, the immune system destroys the cells that make insulin, so the body is unable to make enough insulin and blood sugars become abnormally elevated. When the glucose stays in the blood and this blood circulates to the kidneys, glucose is excreted in the urine and pulls water with it. That’s why the child experiences frequency of urination, thirst because of water loss, and tiredness because of lack of energy.
As the disease progresses, the body tries breaking down fat for energy, which releases acidic molecules called ketones. These ketones make the blood acidic and as they build up in the blood cause abdominal pain, nausea or vomiting, weight loss, tiredness, rapid and deep breathing. In extreme cases, this can lead to altered consciousness and even coma. It is an emergency situation requiring admission to a hospital intensive care unit and treatment with intravenous medications.
Because we want to prevent such a traumatic and unnecessary development, it’s extremely important to pay attention to the warning signs of diabetes, and seek care from a specialist in childhood diabetes. With early detection, we have a much better chance of treating the disease and preventing complications, such as damage to the eyes, kidneys and nerves, heart disease and stroke.
All children with type 1 diabetes require insulin to live. Some children who are diagnosed with type 2 diabetes can be treated with oral medications and sometimes also need insulin. Others may require insulin for a period of time, but if they lose weight, eat healthier and get regular exercise, many people with type 2 diabetes can live without insulin.
If your child experiences markedly increased thirst, increased frequency of urination, lack of energy and weight loss, seek medical care immediately.
