What are the first signs of type 1 diabetes?

The first signs of type 1 diabetes often include unusual thirst, frequent urination, tiredness and unintentional weight loss. Symptoms can develop over a relatively short time, especially in children and young people. Some people also notice blurred vision, increased hunger, dry mouth, or a child beginning to wet the bed after previously staying dry. These symptoms happen because the body cannot use glucose normally when insulin is lacking. A blood glucose test is needed to find out whether diabetes is present.

Type 1 diabetes causes glucose to build up in the bloodstream instead of moving into cells for energy. The kidneys remove some of this extra glucose in urine, which draws more water with it. This can lead to frequent urination and strong thirst. The body may then break down stored fat for fuel, contributing to weight loss, weakness and tiredness despite eating normally or feeling hungry. Children may need to urinate at night or develop new bedwetting. A symptom such as frequent urination has several possible causes, so it should be assessed rather than interpreted on its own.

Type 1 diabetes can occur at any age. Its early features may be easier to miss when they are mistaken for a growth spurt, a busy routine, hot weather or a urinary problem. If several symptoms appear together, arrange prompt medical assessment.

Contact a doctor or urgent-care service promptly if you or your child has a new combination of thirst, frequent urination, tiredness or unexplained weight loss. Tell the clinician when the symptoms began, whether they are worsening, and whether there has been vomiting, stomach pain or a change in alertness. The clinician may check blood glucose and urine, then arrange further assessment if needed. Do not delay assessment while trying to manage suspected type 1 diabetes with food or drinks alone.

Until advice is available, keep a note of drinking, urination, vomiting and medicines. If the person is awake and able to drink, offer their usual fluids. Do not give someone else's diabetes medication or insulin.

Seek emergency care immediately for suspected diabetes with repeated vomiting, worsening abdominal pain, deep or fast breathing, marked drowsiness, confusion, dehydration, or breath that smells sweet or fruity. These can be signs of diabetic ketoacidosis, a dangerous build-up of acids that needs hospital treatment. Do not wait for a routine appointment if these features are present.

A child who is difficult to wake, unable to keep fluids down, or breathing unusually should be taken for emergency assessment. If you have access to a glucose meter, a reading can be useful to share with clinicians, but waiting to obtain a reading should not delay urgent care.

You could ask: Could these symptoms be related to diabetes or another condition? Which blood or urine tests are needed today? What warning signs should make us return urgently? If diabetes is confirmed, how will insulin, meals, activity and glucose checks be taught? Who should we contact outside normal clinic hours?