It’s a serious, life-changing condition affecting millions of people in the UK. But how can you tell whether you or a family member has diabetes? As World Diabetes Day approaches on Saturday, four common symptoms could indicate that you or a loved one might have the condition. They are known as the 4Ts – standing for Toilet (frequent urination), Thirsty (unquenchable thirst), Tired (extreme fatigue), and Thinner (unexplained weight loss). But they present differently among different age groups, so here’s what to look out for.
While the 4Ts are the most common symptoms for type 1 and type 2 diabetes, in type 1 – an autoimmune condition where the body stops making insulin – they tend to develop very quickly, usually over a matter of days or weeks. Spotting the 4Ts early is critical to prevent diabetic ketoacidosis (DKA), a life-threatening emergency caused by a severe lack of insulin.
In type 2 diabetes, the 4Ts can also occur, but they often develop much more slowly, over weeks, months or sometimes even years. Because the onset is gradual, it means the signs can be easier to miss. Although the 4Ts originate from the same underlying biological cause – high blood glucose – they may present slightly differently depending on a person’s age.
Babies and Under 5s
Type 1 diabetes is often diagnosed in childhood, and the latest data indicates that the proportion of children presenting in DKA at diagnosis is increasing, with highest rates in children aged under five. Due to the rapid onset of symptoms, it is vital to spot the signs early to prevent DKA. Knowing what to look for could even save a life.
In under 5s, symptoms may appear alongside common illnesses such as flu or gastroenteritis, allowing type 1 diabetes to go undetected. Young children may not be able to explain how they are feeling, and so parents and carers need to look out for the following physical and behavioural changes:
Toilet: Nappies becoming unusually heavy or starting to leak urine. They may need changing much more frequently too. Potty trained children might suddenly start to wet the bed or have frequent daytime accidents. Needing to wee during the night can also be a sign;
Thirsty: Children who can’t speak yet might not be able to say they’re thirsty. Instead, they may become more irritable and appear to want feeds or drinks more often than usual;
Tired: Young children may become very lethargic and sleep more than normal. They might need additional naps throughout the day or seem less interested in play and irritable;
Thinner: Clothes might suddenly seem looser, or a young child may not be reaching their growth targets, such as height and weight. You may notice their facial features looking sharper.
Around 38,000 young people under 19 in the UK live with diabetes, and roughly 96% have type 1. The symptoms of type 1 diabetes can occur rapidly in children and teenagers, and can also be mistaken for common illnesses, just as they can in under 5s. While type 1 is the most common form of diabetes in this age group, an increasing number of children and teenagers are also being diagnosed with type 2 – with the rise thought to be driven by higher rates of childhood and adolescent obesity.
Those under the age of 18 living with type 2 diabetes are also around five times more likely to be from the most deprived areas. While the same as type 1, the symptoms of type 2 diabetes in this age group might be less obvious and develop more slowly, for example over weeks or months. Watch out for these signs of either type:
Toilet: Needing to make frequent trips to the toilet to wee during lessons at school, weeing more often at home and new instances of having to get up in the night for a wee. An older child who doesn’t usually wet the bed could start doing so, which is a hallmark red flag;
Thirsty: Drinking lots of drinks incredibly fast, needing water refills very often at school, carrying a water bottle everywhere and constantly asking for drinks. They may seem unable to quench their thirst;
Tired: A lack of motivation, reduced energy affecting school or sport, irritability or reduced concentration, all of which can indicate tiredness;
Thinner: Sudden, visible weight loss occurring despite the child or teenager eating as much as usual or even more due to an increased appetite.
Type 1 or type 2 diabetes can develop at any age, but type 2, which occurs when the body becomes resistant to insulin or does not make enough of it, is more common in adults. In fact, type 2 accounts for roughly 90% of all diagnosed diabetes cases. Adults over the age of 40 are at increased risk of type 2 as are people from African Caribbean, Black African, or South Asian backgrounds, who can develop it at a younger age. Having a family history of type 2 diabetes also increases the risk as does living with overweight or obesity.
The symptoms of diabetes are all too often not recognised quickly enough. This is true for adults and children. In adults, type 1 diabetes can also be mistakenly diagnosed as type 2, which delays appropriate treatment. And the slower progression of symptoms in type 2 diabetes can mean they are sometimes misattributed to stress, ageing and other health conditions, causing delays in diagnosis which can lead to serious and sometimes irreversible complications, including sight loss, kidney damage and cardiovascular disease. So, it is important not to ignore these signs:
Toilet: Getting up during the night to urinate, having not previously needed to, or noticing an inconvenient increase in daytime bathroom visits. This happens because the kidneys are trying to flush out extra sugar. Elderly people may develop urinary incontinence or find existing incontinence worsens;
Thirsty: A persistent, parched feeling or a constant dry mouth that isn’t satisfied regardless of fluid intake. Thirst may be less noticeable in elderly people, look out for early signs of dehydration which include a dry mouth, feeling dizzy, lightheaded or confused;
Tired: Experiencing a profound, overwhelming fatigue which doesn’t improve regardless of sleep. This can be mistaken for stress, burnout, or a hectic work schedule. In older adults, tiredness or a lack of energy and reduced activity can also be inaccurately attributed to old age, other health conditions such as arthritis, or side effects from medications;
Thinner: Unexplained weight loss is also a classic symptom of diabetes in adults, but it may be attributed to poor appetite, dental issues or muscle wasting in the elderly, causing the underlying diabetes to be missed for longer.
If you notice any of the 4 Ts of diabetes you must contact a GP immediately for an urgent blood sugar test or call NHS 111. For more information about the 4Ts, visit diabetes.org.uk
This story originally appeared on Express.co.uk
