Type 1 Diabetes in Children: The Signs You Must Not Miss

For ten days, your 5-year-old son has been asking for water non-stop, getting up at night to go to the toilet and, twice this week, has wet his bed although he has been dry for a long time. He also seems to have lost weight. This picture should make you think of diabetes in a child, and more precisely type 1 diabetes. It needs to be checked the same day.

This kind of diabetes has nothing to do with the one adults often develop. It appears fast, gives no warning, and can become serious within days if it is not recognised. Here are the signs to know, the emergency not to let slip by and what changes after diagnosis.

What is type 1 diabetes?

It is an autoimmune disease: the child's defence system mistakenly destroys the pancreas cells that make insulin. Insulin is the key that lets sugar in the blood enter the cells to give them energy. Without it, sugar builds up in the blood, and the body, deprived of fuel, burns its fat and muscle.

The Mayo Clinic states that the exact cause remains unknown. Genes and certain viruses seem to play a role, and the risk is higher when a parent, brother or sister is affected. Sugar, sweets or upbringing are not to blame, and there is no proven way to prevent it.

In Morocco, the International Diabetes Federation, cited by Aujourd'hui le Maroc in December 2024, counts about 43,300 children and teenagers under 19 with the condition, which places the country among the top ten for this age group.

What are the signs of diabetes in a child?

The UK's NHS sums them up with a memory aid, the "4 Ts" in English: toilet, thirsty, tired, thinner. In practice, the child:

• urinates a lot, including at night;
• wets the bed again after being dry, or fills unusually heavy nappies;
• is very thirsty, keeps asking for drinks, has a dry mouth;
• loses weight for no reason, sometimes while eating more than usual;
• is tired, with no energy, irritable.

Other signs may be added, according to the NHS, SickKids and the Mayo Clinic: blurred vision, fruity-smelling breath, repeated thrush infections, and in babies a yeast nappy rash that resists creams. The NHS also notes that an ordinary sore throat, a cold or a tummy ache at the same time can muddy the picture.

These signs set in over a few days to a few weeks. In France, the Île-de-France regional health agency insists: excessive thirst, heavy urination and bedwetting in a child who used to be dry, when they come together, justify urgent medical advice. Isolated bedwetting, without thirst or weight loss, is most often something else: see our article on bedwetting.

Ketoacidosis: the emergency not to let slip by

When insulin has been lacking for a while, the body produces large amounts of acidic waste, ketones. This is diabetic ketoacidosis. SickKids notes that it can lead to coma and death.

Its warning signs, according to the NHS and SickKids:

• tummy ache, nausea, vomiting;
• fast, deep breathing;
• unusual fruity-smelling breath;
• a child who is drowsy, confused, hard to wake.

This picture looks like a stomach bug, and that is the whole trap. A child who is vomiting and breathing fast, having drunk and urinated a lot in the previous days, must be seen urgently. Late diagnosis is a known factor of severity, notes a thesis carried out at the Fès university hospital on ketoacidosis in children. In France, in 2023, 42.3% of children still arrived at hospital in ketoacidosis at the time of diagnosis, according to the Île-de-France regional health agency. Other causes of abdominal pain are covered in our article on children's tummy aches.

How is it diagnosed?

Very simply. The NHS explains that a doctor can do a capillary blood sugar test, a drop of blood taken from the fingertip, and bringing a urine sample helps look for sugar and ketones. The test takes a minute and is done at the surgery as well as in the emergency department. If the blood sugar is high, the child is sent to hospital the same day to confirm the diagnosis and start treatment.

What is it like to live with type 1 diabetes?

Treatment relies on insulin, for life, by injections or a pump, with regular monitoring of blood sugar. The paediatric diabetes team sets the doses and teaches the family to adjust them to meals, activity and illness. No dose is ever changed outside this framework.

The early days are intense, then a routine settles in. In Morocco, the first education centre dedicated to children with diabetes opened in December 2024 at the Rabat university hospital, with the Moroccan Society of Paediatric Endocrinology and Diabetology (SMEDIAP). Ask your care team what education sessions and support exist near you.

At school. Tell the head and the teacher in writing, with a document from the doctor explaining how to recognise low blood sugar in your child, what to give them in that case and who to call. Pack a snack and some sugar in the school bag.

Celebrations. Birthday cakes, Eid gazelle horns, Ashura sweets: a child with diabetes can taste them, provided the insulin and the timing of the snack are adjusted. Ask the team how to manage those days rather than banning everything.

Ramadan. A child with diabetes does not fast on impulse: it is discussed with the diabetes doctor several weeks beforehand. Our article on Ramadan and children explains at what age fasting becomes an obligation and how to support little ones who want to try.

The regular paediatrician remains a pillar for vaccines, common illnesses and growth: find pointers in our guide to choosing a paediatrician.