My daughter had almost no symptoms.
One night, after a family celebration, she woke up asking for water. Then again. And again. By morning, she had asked for water several times throughout the night. I was 24 years old. She was my second child. I did not think much of it — maybe she ate something salty, maybe she was just thirsty.
But my mother-in-law noticed. Something about the way my daughter kept asking for water that night set off an alarm in her mind. She told me to get her blood tested. The next morning, we went to the lab. From the lab, they sent us straight to the hospital. Her blood sugar was 320 mg/dL.
No other symptoms. None. My daughter was happy, active, laughing — a perfectly normal toddler. If my mother-in-law had not trusted her gut that one single night, we might not have caught it for weeks. By then, my daughter could have been in diabetic ketoacidosis — a life-threatening emergency.
She was two years old. She was diagnosed with Type 1 Diabetes that day.
The Second Time Was Different
Nineteen years later, I knew what to look for. And still — it almost slipped past us.
My son was about four years old when he started getting unusually cranky. Not the normal toddler tantrums — a deeper, persistent irritability that lasted about ten days. I kept telling myself he was just going through a phase.
Then, about three days before his diagnosis, he started vomiting. His stomach hurt. I called a teledoctor. They told us it was a stomach bug — a gastrointestinal infection. “Give him fluids, he’ll be fine.”
But something did not sit right with me. After 19 years of living with my daughter’s diabetes, I had a feeling I could not shake. So I pulled out my daughter’s glucometer and tested his blood sugar.
When I saw the number on the screen, I slid down the wall onto the staircase and started wailing.
At that exact moment, my husband walked through the door. He did not need to ask what happened. He heard my cries, saw the glucometer on my knees, and understood everything without a single word.
His blood sugar was 300 mg/dL. Fifteen minutes later, we were at the hospital.
Why I Am Telling You This
I am sharing these stories because they show the two faces of childhood diabetes. My daughter had one single night of excessive thirst — and nothing else. My son had ten days of mood changes and a misdiagnosis of a stomach bug. Both had blood sugars above 300 when we finally tested.
If my mother-in-law had not spoken up, my daughter’s diagnosis could have been delayed by weeks. If I had not had a glucometer at home from my daughter, my son might have ended up in the ICU with diabetic ketoacidosis.
The difference between catching diabetes early and catching it late can be the difference between a calm hospital admission and an emergency room with your child on an IV drip fighting for their life.
You do not need to be a doctor. You need to trust your gut — and know what to look for.
Type 1 vs Type 2: They Look Different
Before we go through the signs, you need to understand that childhood diabetes comes in two very different forms:
Type 1 Diabetes is an autoimmune disease. The immune system attacks and destroys the insulin-producing cells in the pancreas. It is not caused by diet, weight, or lifestyle. It can happen to any child at any age — including healthy, active, normal-weight children. This is what both of my kids have.
Type 2 Diabetes is a metabolic condition where the body becomes resistant to insulin. It is more common in older children and teens, often (but not always) associated with excess weight and family history of Type 2. It develops more gradually than Type 1.
Some signs overlap. Some are specific to one type. I will note the differences as we go.
The 11 Warning Signs Every Parent Must Know
These signs rarely appear alone. They usually come in clusters. If you notice two or three of these happening together and persisting for more than a few days — act.
1. Excessive Thirst
This is not “I played outside and I’m thirsty.” This is a deep, unquenchable thirst. Your child drinks a full glass of water and immediately wants more. While their friends grab a quick sip and run back to play, your child stays behind, drinking and drinking.
My daughter’s only symptom was asking for water repeatedly throughout one single night. That was enough.
Applies to: Type 1 and Type 2
2. Frequent Urination
You know your child’s bathroom routine better than anyone. If they suddenly need to go every hour instead of every few hours — especially if they are waking up at night to use the bathroom — pay attention. The body is trying to flush out excess sugar through urine.
Applies to: Type 1 and Type 2
3. Increased Hunger
Your child seems to be eating constantly — more than during any growth spurt you have seen — but the hunger never stops. This happens because the body cannot use the glucose in the blood for energy (either because there is no insulin in Type 1, or because the body resists insulin in Type 2), so it keeps signaling for more food.
Applies to: Type 1 and Type 2
4. Weight Loss Despite Eating More
This is one of the most telling signs — and it is primarily a Type 1 sign. Your child is eating more than ever but losing weight or failing to grow as expected. The body, unable to use glucose for fuel, starts breaking down fat and muscle for energy.
In Type 2, children are more likely to be gaining weight or staying the same — not losing it.
Primarily Type 1. Weight gain or difficulty losing weight is more common in Type 2.
5. Mood Changes and Irritability
Children often cannot explain that something feels wrong inside their body. Instead, they become unusually cranky, sad, or emotional. My son was irritable for about ten days before his diagnosis. I thought he was going through a difficult phase. It was diabetes.
If your child seems “not themselves” emotionally — especially combined with other signs on this list — do not write it off as behavior.
Applies to: Type 1 and Type 2
6. Fatigue and Low Energy
This is not the normal tiredness after a long day. This is a persistent, day-after-day exhaustion where a usually active child just wants to lie on the couch. Their body literally cannot convert food into energy.
A note about teenagers: yes, teens are naturally sleepy. But if your normally active teen suddenly has zero energy all day, every day — that is different from wanting to sleep in on Saturday.
Applies to: Type 1 and Type 2
7. Blurred Vision
High blood sugar causes fluid shifts in the eyes, leading to blurry vision. An older child might tell you things look blurry. But a younger child who does not have the words for “blurry” will often say “my head hurts.” If your child is complaining of frequent headaches, it might actually be a vision issue caused by high blood sugar.
Applies to: Type 1 and Type 2
8. Bedwetting or Regression
If a fully potty-trained child suddenly starts wetting the bed every night, this is almost always a physical sign — not a behavioral one. The body is producing so much urine to flush out sugar that the child cannot hold it overnight.
This is one of the most commonly missed signs because parents (and even some doctors) attribute it to stress, behavior changes, or developmental regression. It is not. If your dry child starts wetting the bed — get their blood sugar checked.
Primarily Type 1 (due to rapid onset)
9. Fruity or Acetone Breath
This is a red flag that requires immediate attention. If your child’s breath smells like fruit, nail polish remover, or a strange “rancid” sweetness — especially when they have not just eaten fruit — it could be a sign of diabetic ketoacidosis (DKA).
DKA happens when the body, starving for energy it cannot get from glucose, starts breaking down fat rapidly. This produces ketones, which are acidic and dangerous in high amounts. The fruity smell is the ketones on their breath.
If you smell this, go to the emergency room. Do not wait for a doctor’s appointment.
Primarily Type 1. DKA is rare in Type 2 at diagnosis.
10. Frequent Infections or Slow Healing
High blood sugar weakens the immune system. Watch for frequent yeast infections (especially in girls), recurring ear infections, sinus infections, or simple cuts and scrapes that take unusually long to heal.
Applies to: Type 1 and Type 2
11. Dark Patches of Skin (Acanthosis Nigricans)
Dark, velvety patches of skin — usually on the back of the neck, in the armpits, or in skin folds — are a visible sign of insulin resistance. Think of it as the body sending a warning signal that it is struggling to process insulin properly.
This is primarily a Type 2 sign. If you see this on your child, ask your pediatrician to check fasting blood sugar, A1c, and fasting insulin levels.
The Signs That Fooled Us — Common “Parent Traps”
It is human nature to explain symptoms away. I know — I almost did it twice.
The “stomach bug” trap. My son’s vomiting and stomach pain were diagnosed as a gastrointestinal infection by a teledoctor. Three days later, his blood sugar was 300. Vomiting can be an early sign of DKA. If your child has unexplained vomiting along with any other symptoms on this list — check their blood sugar.
The “growth spurt” trap. During a real growth spurt, kids eat more and get bigger. With diabetes, they eat more and stay the same size — or get thinner. If the math does not add up, something is wrong.
The “just cranky” trap. My son was irritable for ten days. I told myself it was a phase. It was his body struggling without enough insulin.
The “teenager” trap. Fatigue in teens is normal — to a point. All-day, every-day exhaustion in a previously active teen is not.
The “bedwetting is behavioral” trap. A previously dry child wetting the bed is almost always a physical symptom. Check blood sugar before assuming it is stress or acting out.
What to Do If You Suspect Something
Do not wait for your next pediatrician appointment. Do not wait to see if it gets better. Here is what to do:
Step 1: Check blood sugar if you can. If you have a glucometer at home (or can buy one at any pharmacy for about $20 — no prescription needed), check your child’s blood sugar. A normal fasting blood sugar for a child is 70–100 mg/dL. Anything above 200 mg/dL at any time is a red flag. Go to the hospital.
If I had not had my daughter’s glucometer at home, my son’s diagnosis might have been delayed by days. A $20 glucometer can save your child’s life.
Step 2: Go to the doctor and ask for blood work. Do not accept “let’s wait and see.” Request these specific tests:
| Test | What It Tells You |
|---|---|
| Fasting Blood Sugar | Current blood sugar level (should be 70–100 mg/dL) |
| Hemoglobin A1c | Average blood sugar over the last 2–3 months (should be below 5.7%) |
| C-Peptide | How much insulin the pancreas is producing — crucial for distinguishing Type 1 from Type 2 |
| Autoantibody Panel | Checks for the immune attack on beta cells — confirms Type 1 if positive |
| Urinalysis | Checks for sugar and ketones in urine |
| Complete Blood Count (CBC) | Rules out infections and other conditions |
Step 3: If blood sugar is above 250 mg/dL or your child is vomiting — go to the ER now. Do not wait for lab results. High blood sugar combined with vomiting can mean DKA, which is a medical emergency.
A Note for Grandparents
My mother-in-law saved my daughter’s diagnosis. She was the one who noticed something was off that night. She trusted her instinct and told me to get blood work done.
Grandparents — you see things parents miss. You have a different perspective, a wider lens. If something about your grandchild feels wrong to you — speak up. Even if the parents brush it off. Even if you feel like you are overreacting.
You are not overreacting. You might be saving a life.
Screening If T1D Runs in Your Family
If someone in your family has Type 1 Diabetes, your other children and grandchildren have a higher risk. Siblings of a T1D child have a 5–10% lifetime risk — much higher than the general population.
TrialNet offers free autoantibody screening for relatives of people with T1D. A simple blood test can detect the early stages of Type 1 Diabetes — before any symptoms appear — when treatment like teplizumab (Tzield) can delay the onset by years.
After my son was diagnosed, I wish I had known about this screening when he was younger. If autoantibodies had been detected early, he might have been eligible for teplizumab — and his diagnosis could have been delayed by a decade.
Get your children screened: TrialNet.org — free for relatives of people with T1D.
Frequently Asked Questions
My child drinks a lot of water — should I worry?
Context matters. If they just played outside in the heat or ate salty food, probably not. But if the thirst is persistent, unquenchable, and goes on for several days — especially combined with frequent urination — get their blood sugar checked. It takes 5 minutes and could change everything.
Can diabetes appear overnight?
Type 1 can seem to appear suddenly — my daughter went from perfectly healthy to a blood sugar of 320 after one night of symptoms. But the autoimmune attack on the pancreas has usually been happening silently for months or years before symptoms show. By the time you see symptoms, about 80–90% of the insulin-producing cells are already destroyed.
My pediatrician says it’s probably nothing. Should I push for blood work?
Yes. A blood sugar test and A1c are simple, fast, and inexpensive. If your gut says something is wrong, insist on the tests. I have seen too many stories in the T1D parent community of families whose children were sent home with a “virus” or “stomach bug” diagnosis and ended up in the ICU with DKA days later. Trust your instinct.
Can I check my child’s blood sugar at home?
Absolutely. Any pharmacy sells glucometers without a prescription for about $20. It takes a tiny finger prick and 5 seconds. A normal blood sugar is 70–100 mg/dL fasting, or under 140 mg/dL two hours after eating. Anything above 200 mg/dL at any time needs immediate medical attention.
Is Type 1 Diabetes caused by eating too much sugar?
No. Absolutely not. Type 1 Diabetes is an autoimmune disease — the body’s immune system attacks its own insulin-producing cells. It has nothing to do with diet, sugar intake, weight, or lifestyle. It can happen to any child. Please do not blame yourself or let anyone else blame you.
What is the difference between Type 1 and Type 2 in children?
Type 1 is autoimmune — the pancreas stops making insulin entirely. It usually comes on quickly and requires insulin from day one. Type 2 is metabolic — the body still makes insulin but cannot use it properly. It develops more gradually and is often (but not always) linked to excess weight. Both are serious. Both need medical treatment.
My child was just diagnosed — what do I do first?
Breathe. You will get through this. Read our guide: Your Child Was Just Diagnosed with Type 1 Diabetes — What to Do in the First 24 Hours.
How can I get my other children screened?
If one child has Type 1, siblings should be screened for autoantibodies through TrialNet. It is free, requires only a blood draw, and can detect T1D years before symptoms appear — when prevention treatment is possible.
Written by a mom of two children with Type 1 Diabetes — diagnosed 21 years apart. This is not medical advice. Always consult your child’s pediatrician or endocrinologist if you suspect diabetes.