The number of people affected by diabetes mellitus, a disease that causes abnormal blood sugar levels, has been increasing worldwide in all age groups, including teenagers, since the mid-1990s. The two main types of diabetes mellitus -- type 1 and type 2 -- can occur in teenagers, yet often they cause very different symptoms. Both types of diabetes are related to insulin, a hormone that helps move sugar from the blood to the body's cells. Symptoms of both type 1 and type 2 diabetes are caused by inadequate insulin activity in the body, either due to lack of insulin production or resistance of the body to using insulin. These symptoms range from subtle appetite changes to life-threatening complications.
Type 1 Symptoms
In type 1 diabetes, the insulin-producing cells of the pancreas have been largely destroyed. In the absence of insulin, blood sugar becomes too high because it cannot be ushered into the cells to use for energy. This produces the classic diabetes symptoms -- increased thirst, increased appetite and frequent urination. In addition, despite eating more, teens with type 1 diabetes often lose weight in the weeks before being diagnosed, largely due to dehydration but also as a result of loss of muscle and body fat. Symptoms of type 1 diabetes in teens usually occur over several weeks before being checked by a physician. While symptoms of high blood sugars may be more severe at diagnosis, they can occur any time the blood sugars are abnormally high.
In type 1 diabetes, the body’s lack of insulin prevents the use of sugar for energy. As the body instead turns to fat for energy, ketones are produced. This causes the body to become very dehydrated and acidic, leading to a condition called diabetic ketoacidosis, or DKA. Symptoms of DKA include weight loss, fatigue, shortness of breath, vomiting, abdominal pain and fruity breath odor. DKA is common at diagnosis. According to an April 2015 study published in the "Journal of the American Medical Association," 39 percent of youth were suffering from DKA at the time of their type 1 diabetes diagnosis. DKA can also occur after diagnosis, if insulin is omitted or in situations such as illness when the body's increased insulin needs are not met. DKA can be a life-threatening condition because it can lead to swelling of the brain, or cerebral edema. Therefore, this condition requires emergency treatment.
Type 2 Diabetes
Type 2 diabetes is occurring increasingly in teenagers. According to the February 2013 clinical practice guidelines published in "American Academy of Pediatrics," type 2 diabetes is diagnosed in 1 of 3 new diabetes cases in youth under the age of 18. In contrast to type 1 diabetes, type 2 diabetes usually causes little to no weight loss and, at diagnosis, only mildly increased thirst and urination – or no symptoms at all. Less commonly, type 2 diabetes can cause similar symptoms to type 1 -- significant weight loss and increased thirst and appetite. In fact, these guidelines also report that between 5 and 25 percent of adolescents who are identified as having type 2 diabetes suffered from ketoacidosis at the time of diagnosis.
When to Be Concerned
A teenager experiencing frequent urination, extreme thirst or unintentional weight loss should be evaluated by a doctor. In addition to the potential long-term complications of diabetes such as cardiovascular disease, kidney failure, visual impairment and limb loss, high blood sugars pose short-term risks that may require urgent medical attention. It is important to recognize diabetes symptoms and get treatment as early as possible and keep blood sugar levels in good control if already diagnosed. In the short term, uncontrolled diabetes can cause life-threatening dehydration, and in the case of type 1 diabetes breathing abnormalities and swelling in the brain may develop. However, both type 1 and type 2 diabetes can be well controlled with daily self management and ongoing medical care.
- World Journal of Diabetes: Type 2 Diabetes Mellitus in Children and Adolescents
- Diabetes Care: Care of Children and Adolescents With Type 1 Diabetes
- American Academy of Pediatrics: Management of Newly Diagnosed Type 2 Diabetes Mellitus (T2DM) in Children and Adolescents
- American Family Physician: Diabetic Ketoacidosis: Evaluation and Treatment
- Journal of the American Medical Association: Incidence of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Colorado Youth, 1998-2012