Diabetes is a chronic condition that can appear at any age, even in the first year of a child’s life. Sometimes, the diagnosis is delayed in babies and young children because diabetes symptoms are similar to those of other illnesses. The most common signs of diabetes in toddlers include an increase in thirst and more frequent or increased urination. Read on to find out more about the signs of diabetes and how diabetes is diagnosed, as well as what treatments may be available, and what you can do day-to-day to manage diabetes in your toddler.
What Is Diabetes?
Diabetes is the more common term for diabetes mellitus, which is a metabolic disorder that affects how the body uses blood sugar (also known as blood glucose, or just glucose).
Blood sugar is the source of energy the cells in the body need. It provides energy to the tissues, muscles, and organs, including the brain. When we eat, the nutrients we consume, such as protein, fat, and carbohydrates, get broken down into glucose, which becomes fuel for the body.
When someone has diabetes, the body does not produce enough insulin, a hormone that transports the glucose in the blood to the cells. Insulin is produced by the pancreas, an organ located behind the stomach. When the pancreas doesn’t produce enough of this hormone, the blood sugar cannot reach the cells or be used properly. Because sugar stays in the blood, this leads to high blood sugar levels. When the blood sugar levels are high for long periods of time, this can cause health problems.
Although diabetes can’t be cured, it can be managed. If your toddler is diagnosed with this condition, there are steps you can take to manage it, and your little one can lead a full and healthy life.
What Types of Diabetes Are There?
There are two types of diabetes: type 1 diabetes and type 2. So what is the difference between them?
Type 1 Diabetes
People with type 1 diabetes have a low supply of insulin or no insulin supply at all. When someone with type 1 diabetes eats, the blood glucose levels rise considerably. This is sometimes called hyperglycemia.
With type 1 diabetes, nutrients in food are not used by the cells for energy, and the sugar just stays in the blood. Because the cells cannot get their fuel, they think they are starving, which triggers the liver to respond by making even more sugar from the body’s fat and protein stores.
This becomes a vicious cycle, as without insulin, the body cannot use the extra glucose and actually produces more. Type 1 diabetes can cause weight loss and weakness. If a toddler is diagnosed with diabetes, it’s more likely to be this type of diabetes.
Type 2 Diabetes
For children and adults with type 2 diabetes, the pancreas is able to produce insulin, but the body doesn’t respond to it as it should. With type 2 diabetes, the glucose in the blood is unable to enter the cells and cannot supply the energy the cells need—this is also known as insulin resistance—so the sugar builds up in the bloodstream. After a time, the pancreas works harder to produce more insulin, but this can strain the organ, and it struggles to produce enough insulin to keep the blood sugar at a healthy level. This type of diabetes is more common in adults, but some children and adolescents can develop type 2 diabetes, often associated with obesity.
You may have also heard the term prediabetes, which refers to having blood sugar levels that are higher than normal, but not high enough to qualify as type 2 diabetes.
Prediabetes can develop into type 2 diabetes. However, there is good news, as changes to diet and activity levels, along with reaching and maintaining a healthy weight, can help a child with prediabetes avoid getting type 2 diabetes. Positive lifestyle changes may even bring children’s blood sugar levels back to normal.
What Causes Diabetes in Toddlers?
The cause or causes of diabetes in children and toddlers is unknown. However, experts have formed some theories and have identified risk factors for both types of diabetes:
- Type 1 diabetes. This type of diabetes usually occurs in people whose immune system, which usually fights viruses and harmful bacteria, destroys the insulin-producing cells in the pancreas. Although why this happens is not well understood, experts believe that genetics or environmental factors, like exposure to viruses that trigger this autoimmune response, could be responsible.
- Type 2 diabetes. Type 2 diabetes is more common in adults—the risk increases with age—but it can appear in children. This kind of diabetes has links to family history and genetics, but a sedentary lifestyle and excess fat, especially in the belly area, can also play a role.
What Are the Warning Signs of Diabetes in Toddlers?
Some of the symptoms of diabetes are similar to things that can happen in everyday life —like increased thirst on a hot day. However, if you notice any of these diabetes warning signs in your toddler, it's safest to contact your healthcare provider, who can either rule out or diagnose diabetes:
- Increased thirst or dehydration. The excess glucose in the bloodstream pulls fluid from tissues, and this can cause increased thirst or dehydration. Although your toddler asking for more water could have many natural causes, including hot weather or him being especially active, increased thirst can sometimes be a sign of diabetes, especially if the thirst is prolonged or is combined with other symptoms.
- Frequent or increased urination. You may find that you're changing a lot more diapers than usual, or if your little one is toilet trained you may see more frequent bedwetting or notice that your toddler needs to pee more often.
- Weight loss. Either your toddler shows an increased appetite and eats more but still loses weight, or there is a persistent loss of appetite resulting in weight loss. A loss of appetite is the more common symptom in younger children.
- Severe diaper rash. Although a more severe form of diaper rash can have many causes (such as a food allergy or a yeast infection), it could be a sign of diabetes if the diaper rash does not respond to treatment such as more frequent diaper changes or the use of a barrier cream.
- Tiredness or fatigue you cannot explain. You may notice your little one is unusually tired all the time without any obvious reason. This fatigue is caused by the cells of the body not getting enough energy in the form of blood sugar.
- Persistent vomiting. Especially if accompanied by drowsiness or weakness.
- Blurred vision. High blood sugar can pull fluid from the lenses of your toddler’s eyes, which can cause problems in focusing. If your child complains about not being able to see properly, for example, let your toddler’s healthcare provider know about this symptom, as it could be a warning sign of diabetes.
- Sores and cuts that take longer to heal than usual.
How Is Diabetes Diagnosed in Toddlers?
If your toddler’s healthcare provider suspects diabetes, she may recommend testing to check your toddler’s blood glucose levels. Here are some common tests your provider may perform:
- Random blood sugar test. A blood test is done at a random time to measure glucose levels.
- Glycated hemoglobin (A1C) blood test. This test measures the percentage of glucose attached to the hemoglobin, a protein in red blood cells that carries oxygen.
- Fasting blood sugar test. For this test, a blood sample is taken after an overnight fast.
- Oral glucose tolerance test. If your healthcare provider suspects type 2 diabetes, an oral glucose tolerance test may be recommended. The first blood test is taken after an eight-hour or overnight fast. Then your little one will drink a sugary solution and his blood sugar levels will be rechecked via a blood test several times over the next few hours.
Your toddler’s healthcare provider will explain the testing process and go over the results with you.
Is There Any Way to Treat Diabetes in Toddlers?
If the diagnosis comes back positive for diabetes, treatment can begin immediately.
Your child may be assigned a diabetes treatment team—including a doctor, dietitian, and diabetes educator—who will work closely with you to help keep your toddler’s blood sugar level as normal as possible.
Although there is no cure for diabetes, with treatment and consistent care your little one can go on to have a normal life. Treatment depends on whether your toddler has type 1 or type 2 diabetes, but the treatment plan may include:
- Blood sugar monitoring. You will need to check your toddler’s blood sugar levels frequently, at least 4 times a day for type 1. Testing helps you make sure your little one’s blood sugar levels are within the target range. Your healthcare provider will tell you what this range should be, as this will change as your child grows.
- Taking insulin. If your toddler has type 1 diabetes, then life-long treatment with insulin will be necessary. Some cases of type 2 diabetes also require insulin. Insulin is often given as an injection but is sometimes administered through a pump. Your toddler’s healthcare provider will show you how to give injections or use the pump, and when your child grows old enough the provider will be able to show her how to do it for herself.
- A healthy diet. Eating well and timing meals appropriately is a big part of any diabetes treatment plan, and your little one’s healthcare provider or dietician will come up with a tailor-made plan for you to follow.
- Regular exercise. Encourage your little one to get at least an hour of physical activity a day. You can get involved and even make it a part of your family routine—there are so many ways to do this. Go outside and play ball together, take the family on a hike, play tag, or bounce around on a trampoline.
- Counting carbohydrates. If your toddler has type 1 diabetes, your little one’s healthcare provider or dietician will explain how to count carbohydrates in foods, so her insulin dose can be calculated accurately.
- Medication. Children with type 2 diabetes may be prescribed medications like metformin, which reduces the amount of blood sugar the liver releases into the bloodstream, or liraglutide, administered by injection, which makes the pancreas release more insulin after meals.
Tips for Parents: How to Manage Diabetes in Your Toddler
If your toddler is diagnosed with diabetes, your medical team will make sure your little one gets a great treatment plan.
Diabetes does require lots of attentive care and lifestyle changes that can be challenging to explain and enforce with a toddler, but there are steps you can take to make things a little easier and help reduce the risk of complications:
- Help your child make healthy food choices. Diet plays an essential role in managing diabetes, so try to help your little one establish good habits at a young age. You can do things together as a family such as cooking healthy meals together and sitting down to eat without distractions. Try to introduce more fruits and veggies with each meal, and set a positive example for your little one when it comes to your own eating habits.
- Get your toddler active. Exercise is important when it comes to diabetes, so take advantage of any fun ways to get your toddler moving each day.
- Have your child wear a medical identification tag or bracelet. If a medical emergency occurs, this tag or bracelet identifies that your child is diabetic to the medical team or anyone who comes to your child’s aid. You can ask your healthcare provider for more information about getting one of these.
- Help your little one develop a relationship with the diabetes treatment team. Explain to your child that the members of her treatment team are there to help her and are her friends; help her develop positive associations with them.
- Teach your child about the importance of lifelong diabetes care when she's old enough to understand. Work together with your toddler’s diabetes team to help her understand the importance of diabetes care; you could also find books or videos on the topic that can help explain it to her.
Can Diabetes Be Prevented?
At this time there is no known prevention strategy for type 1 diabetes, but type 2 can sometimes be prevented with healthy lifestyle choices.
If you have a family history of type 1 diabetes, you notice symptoms of diabetes in your toddler, or your little one has been diagnosed with type 1 diabetes, you can prevent complications by:
- Helping your little one maintain good blood sugar levels as much as possible
- Helping your toddler follow a healthy diet
- Encouraging your toddler to get active
- Scheduling regular visits with your child’s healthcare provider or diabetes specialist (endocrinologist).
Type 2 diabetes can be prevented by making appropriate lifestyle choices, so encourage healthy habits in your toddler from an early age by:
- Providing healthy meals and snacks. Give your little one a range of nutritious foods, focusing on fruit, vegetables, lean sources of protein and dairy, and whole grains, and avoiding giving sugary sweets and drinks, high calorie treats, and food high in fat.
- Keeping your toddler physically active. Try to get your little one active for at least 60 minutes a day—make it fun and maybe even do it together. Staying fit and active together can have great health benefits for you too!
FAQs at a Glance
- Can a 2-year-old have diabetes?
Yes. Diabetes can even appear in the first year of a toddler’s life.
- What is the first sign of diabetes?
There is no single sign, but symptoms can include
- increased thirst
- frequent urination
- unexplained weight loss
- unexplained tiredness.
- What causes diabetes in toddlers?
The exact causes of diabetes in toddlers are not known, but it seems genetics and environmental factors play a role.
- What are the warning signs of prediabetes?
Increased thirst, frequent urination, fatigue, and blurred vision could be symptoms of prediabetes. Testing is usually recommended, especially if your toddler is overweight or obese, or there is a family history of type 2 diabetes.
The Bottom Line
Although diabetes is a lifelong condition that requires consistent care and management, it's a condition that can be treated, and there is support out there to help make sure your child remains healthy throughout life. Turn to your healthcare provider if you ever have questions about your toddler’s health or diabetes treatment plan.
