Medically reviewed by Dr. Jordan Pinsker, Vice President & Medical Director, Tandem Diabetes Care.

Type 1 diabetes (T1D), once referred to as juvenile diabetes or insulin-dependent diabetes, is an autoimmune condition that occurs when insulin-producing cells in the pancreas stop producing insulin — the hormone that allows sugar (glucose) to be used as energy.

Causes of Type 1 Diabetes in Children

While researchers have made dramatic strides in helping people living with diabetes manage the disease, there is no cure and the specific reasons why someone develops type 1 diabetes are still unknown. We do know that people living with type 1 diabetes have shown a genetic predisposition that is coupled with a causative event. For some people this could be a virus, an infection, or possibly another illness.

Additionally, a recent study from the Centers for Disease Control and Prevention (CDC) shows that cases of type 1 diabetes in children and teenagers “significantly increased” over a period from 2002-2015.

Testing for Type 1 Diabetes in Children

There are several ways to confirm a type 1 diabetes diagnosis, but the most common way is simply by having high blood sugar readings with signs and symptoms of diabetes. Other testing methods include:

• Fasting plasma glucose: This measures glucose levels after fasting for a set amount of time, typically longer than eight hours
• Random plasma glucose: The blood is tested with no fasting
• A1c: An elevated glycated hemoglobin (A1c) blood test

Antibodies

Antibody testing specific to type 1 diabetes can also be performed. “Most people with type 1 diabetes have antibodies in their blood that show this is an autoimmune disease,” said Dr. Jordan Pinsker, vice president and medical director of Tandem Diabetes Care, who is also a leading pediatric endocrinologist. “Not everyone has them, but most people do. We’re always discovering antibodies. We’re up to five now. A diagnosis can be made by repeated high blood glucose values, fasting, or after meals. An elevated A1c value can support the diagnosis.”

Even without testing, there are still symptoms of diabetes in children and symptoms of diabetes in teenagers that a parent or caregiver can monitor.

Who Can Get Type 1 Diabetes?

Type 1 diabetes is typically diagnosed in children, teenagers/adolescents, and young adults. However, it can develop at any age. The CDC estimates that 5-10% of people with diabetes have type 1, which they estimate to be approximately 1.6 million Americans. Beyondtype1, a non-profit advocacy group and community partner with Tandem Diabetes Care at sponsorship events, estimates that by 2050 that number is expected to be 5 million.

The symptoms of type 1 diabetes in children and teenagers are similar. It is worth noting that in some cases, puberty can also impact the symptoms of type 1 diabetes in children because the hormones released during puberty can alter how cells use insulin.

T1D should not be confused with Type 2 diabetes — which is more common and has to do with resistance to insulin, rather than not having any insulin.

Knowing the signs and understanding pediatric diabetes symptoms is an important first step.

Symptoms of Type 1 Diabetes

Note: The following symptoms may not be an indication of type 1 diabetes. Please consult a healthcare professional for further information.

In Children

• Frequent urination: Can occur when there is a buildup of glucose in the urine
• Thirst: Like frequent urination, frequent thirst can be caused by an excess of high blood sugar
• Blurred vision: Due to an excess of glucose in the blood, it’s possible for fluid to move into the eyes. It can take multiple weeks for proper vision to return.
• Hunger: With type 1 diabetes in children, the body struggles to convert food into energy, which can cause increased hunger
• Weight loss: Even with an increased hunger and diet, weight loss is still a symptom of type 1 diabetes in teenagers and children. The weight loss can be a byproduct of dehydration because of excess urination and sugar that wasn’t converted into energy.
• Fruity-scented breath: This can be a sign of diabetic ketoacidosis (DKA)
• Fatigue: Acute fatigue could also be attributed to hyperglycemia. In either instance, it is important to test blood glucose levels.
• Nausea: An inconsistent metabolism from fluctuating glucose levels may lead to a feeling of nausea
• Vomiting: Experiencing high or low blood sugar levels can lead to vomiting
• Irritability: Mood swings can occur when there are changes in blood glucose

In Teenagers

The signs of diabetes in teenagers are similar to those of diabetes in children. While not everyone will experience the same symptoms, it is important to look for the same warning signs.

What are Healthy Glucose Levels in Children?

The American Diabetes Association recommends most children aim for less than 7% for their HbA1c level. An A1c test can give an average of blood glucose levels over a two- to three-month period.

Blood glucose levels can fluctuate throughout the day, so constant monitoring is essential to make sure there aren’t highs or lows. Current guidelines recommend aiming for >70% of blood sugar readings in the range 70-180 mg/dL (milligrams per deciliter).

When to See a Doctor

If a child or teenager is experiencing the symptoms described above, consult with a healthcare provider to have them evaluate if there are signs of diabetes.

Furthermore, if a child does have type 1 diabetes and the symptoms become more severe, they could be at risk for diabetic ketoacidosis (DKA), which can lead to nausea and vomiting. DKA is a medical emergency.

A doctor can perform a series of tests to determine if the child does have pediatric diabetes.

Next Steps

If a child is diagnosed with pediatric diabetes, the next step is to decide the best way to manage it. There are several ways to manage diabetes in children, including the use of an insulin pump for insulin therapy.

If you’re interested in learning more about the t:slim X2 insulin pump to help manage type 1 diabetes in children, visit the Tandem Diabetes Care Pediatric section for more information.

Unless otherwise noted, all medical information was provided by Jordan Pinsker, MD, and Molly McElwee Malloy, RN, CDCES of Tandem Diabetes Care, Inc.

Important Safety Information

RX ONLY. The t:slim X2 insulin pump with interoperable technology is an alternate controller enabled (ACE) pump that is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in people requiring insulin. The pump is able to reliably and securely communicate with compatible, digitally connected devices, including automated insulin dosing software, to receive, execute, and confirm commands from these devices. The pump is indicated for use in individuals six years of age and greater. The pump is intended for single patient, home use and requires a prescription. The pump is indicated for use with NovoLog or Humalog U-100 insulin. Users of the pump must: be willing and able to use the insulin pump and all other system components in accordance with their respective instructions for use; test blood glucose levels as recommended by their healthcare provider; demonstrate adequate carb-counting skills; maintain sufficient diabetes self-care skills; see healthcare provider(s) regularly; and have adequate vision and/or hearing to recognize all functions of the pump, including alerts. The t:slim X2 pump, and the CGM transmitter and sensor must be removed before MRI, CT, or diathermy treatment. Visit tandemdiabetes.com/safetyinfo for additional important safety information.