Diabetes in children: a comprehensive guide for parents to symptoms and early detection

Diabetes in children is a condition that requires immediate attention. Prompt recognition of the signs of diabetes in your child can help in initiating effective treatment and reducing the risk of acute complications. Children can be affected by both type 1 (T1D) and type 2 (T2D) diabetes, although the former is more common¹.This article offers a complete guide for parents, with explanations of the symptoms, early diagnosis and what action to take right from the start, along with some practical advice on daily habits and prevention in the case of type 2 diabetes.

Types of diabetes amongst children

Type 1 diabetes (T1D): An autoimmune disorder in which the immune system destroys the beta cells of the pancreas, which leads to an absolute deficiency of insulin. The child will need insulin for the rest of their life².
Type 2 diabetes (T2D): This condition used to be rarely seen amongst children, but is now increasingly common due to overweight, sedentary lifestyles and an unhealthy diet. In this case, the body still produces insulin, but it becomes less effective due to insulin resistance, and beta-cell function may gradually decline. ³.

The importance of early diagnosis

Late diagnosis can lead to serious complications:

In T1D, there is a risk of diabetic ketoacidosis, which is a medical emergency.
In T2D, accelerated damage to organs such as the kidneys, eyes and heart³.

According to the American Diabetes Association (ADA) diagnostic criteria are⁶:

Fasting plasma glucose ≥126 mg/dL (7.0 mmol/L).
Glycated haemoglobin (HbA1c), above or equal to 6.5% indicates diabetes.
Oral glucose tolerance test (used in cases of suspected T2D).
Detection of pancreatic antibodies to distinguish between T1D and T2D²,³.

Risk factors in children

T1D cannot be prevented, but T2D is closely linked to lifestyle factors. The risk factors include⁴:

Overweight or obesity.
History of maternal gestational diabetes
Family history of diabetes.
Ethnic background (Hispanic, African, or Asian descent)
Sedentary lifestyle.
Diet high in sugars and ultraprocessed foods.
Puberty, a stage when insulin resistance increases.

Diabetes in children is on the increase, especially T2D, which makes prevention absolutely essential⁵, but still remains less common that T1D.

Preventing type 2 diabetes in children

T2D can be prevented in many cases. Some key strategies are:

Healthy diet: reduce sugary drinks, ultraprocessed and fast food. Increase fruit, vegetables, whole grains and lean proteins.
Regular physical activity: at least 60 minutes moderate to vigorous activity a day. Open air activities, sport and walks with the family are excellent options.
Less screen time: limit video games and TV to a maximum of 2 hours a day.
Regular medical check-ups: especially if there is a family history of diabetes or obesity.
Healthy family environment: the parents' habits have a direct effect on the child's dietary habits and lifestyle.

What can I do if I suspect my child has diabetes?

Go to a paediatrician straight away if you see any persistent signs.
Ask for glucose and HbA1c tests to confirm or rule out the diagnosis.
If it's positive, ask for a referral to a paediatric endocrinologist.
Learn as a family: diabetes in children requires education about diet, exercise, insulin and glucose monitoring.
Seek emotional support and help AT school: talking with teachers and psychologists helps the child to adapt without stigmas or unnecessary limitations⁵.

A multidisciplinary team (pediatric endocrinologist, diabetes educator, dietitian, and psychologist) can provide comprehensive support.

Living with diabetes from infancy

With the right treatment, children with diabetes can lead full and active lives. A treatment plan includes:

Insulin (in T1D) or oral medication (in some cases of T2D).
Balanced diet: controlling carbohydrates and planning meals.
Daily physical exercise.
Frequent glucose monitoring, either with traditional blood glucose meters or modern continuous glucose monitoring (CGM) systems that measure glucose in the interstitial fluid.
Constant emotional support to boost self-esteem and trust in self-management.

The parents' role is a vital one: guide, motivate and teach the child that diabetes is not a barrier to growing and fully developing.Diabetes in children requires special attention from parents. Recognise symptoms early and act quickly to prevent complications. Early detection in T1D can save lives, while prevention is key in T2D.

With education, medical support and healthy habits, children living with diabetes can enjoy a healthy and safe childhood with a high quality of life.