Recognising diabetes in kids early: What parents need to look out for

From increased thirst to sudden weight loss, early symptoms of diabetes in children can be easy to miss. Experts explain what to watch for and how parents can manage it.

Recognising diabetes in children can be challenging, especially when early symptoms appear mild or resemble routine childhood behaviour. But doctors warn that delays in diagnosis can allow the condition to progress rapidly. As India continues to see rising cases of diabetes in young people, early awareness becomes critical for parents, schools, and communities.

 

Early signs parents should never ignore

 

Children often show both physical and behavioural changes when blood glucose levels rise. Dr Vinit Banga, Director–Neurology, Fortis Hospital, Faridabad, says parents must be alert to sudden shifts, “Watch for increased thirst, frequent urination including bedwetting, unexplained weight loss, increased hunger, fatigue, and irritability.”

Fruity-smelling breath, blurred vision, recurrent infections, and slow-healing wounds are other warning signs. Young children may also become unusually drowsy or dehydrated.

 

Dr Aravind Badiger, Technical Director, BDR Pharmaceuticals, adds that early signs can be subtle but consistent: increased thirst, sudden weight changes, persistent tiredness, irritability, recurrent yeast or skin infections, and failure to gain expected weight. If these symptoms happen repeatedly or appear together, he recommends a blood test.

 

Type 1 vs Type 2: How symptoms differ

 

Type 1 diabetes often appears abruptly and escalates quickly. Children may show the classic “3 Ps”: polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger), along with weight loss and fatigue. Vomiting can also be an early sign. Both experts caution that Type 1 can rapidly progress to diabetic ketoacidosis (DKA), a life-threatening condition where lack of insulin leads to dangerous ketone buildup. Red flags such as vomiting, deep or rapid breathing, abdominal pain, confusion or fruity breath require immediate hospital care.

 

Type 2 diabetes, once rare in children, now increasingly affects adolescents, particularly those with obesity. Symptoms develop slowly and may include fatigue, darkened skin patches (acanthosis nigricans), or simply being overweight. But Type 2 can still present with severe hyperglycaemia (high blood sugar). Persistent thirst and urination, abdominal pain, vomiting or lethargy must be treated urgently.

 

Factors that increase diabetes risk for kids

• Family history - having a first-degree relative with Type 1 or Type 2 increases the risk, especially in the case of Type 2.
• Obesity and rapid weight gain are strong risk factors for insulin resistance and youth-onset Type 2 diabetes.
• Sedentary lifestyle and unhealthy diet - high intake of sugar-sweetened beverages, processed food, and low physical activity increase risk.
• South Asian children have a higher metabolic risk at a lower BMI level.
• Emerging evidence links urban living, pollution, and other toxic exposures to higher Type 2 risk.
• Autoimmune markers or other autoimmune diseases may increase Type 1 risk.

 

How early can diabetes be diagnosed?

 

Type 1 diabetes can occur at any age, including infancy, though it is most common between 4 and 14 years.

Type 2 typically appears after age 10 but is being seen earlier due to rising childhood obesity, say experts.

Diagnostic tests, including fasting glucose, HbA1c and oral glucose tolerance, are reliable tests, shares Dr Badiger.   In very young or acutely unwell children, a simple plasma glucose test confirming hyperglycaemia is enough to guide immediate action.

 

Screening is recommended for overweight children with risk factors such as a family history of Type 2 diabetes, acanthosis nigricans (dark, velvety patches of skin), maternal gestational diabetes, or polycystic ovary syndrome.

"Early screening helps avoid metabolic complications and ensure stability in the child’s health over the long term,” says Dr Banga.

 

Treatment and day-to-day management

Treatment depends on the type of diabetes.

• Type 1 requires lifelong insulin from the time of diagnosis. Families are taught insulin administration, carbohydrate counting, glucose monitoring, and emergency management of hypo- and hyperglycaemia. Emotional support and structured routines play a vital role.
• Type 2 management begins with lifestyle changes like better diet, weight control, and daily physical activity. If glucose targets are unmet, medications like metformin may be prescribed. Regular monitoring of blood glucose, blood pressure, lipids, and complications is essential.

 

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This report is for informational purposes only and is not a substitute for professional medical advice.