Warning Signs of Type 1 Diabetes in Toddlers

Type 1 diabetes, once called juvenile diabetes, is a chronic disease that can appear in children of any age. It can be difficult to notice the signs of type 1 diabetes in toddlers because they can’t clearly communicate to you that they are feeling ill.

Type 1 diabetes is an autoimmune disease that destroys the cells of the pancreas so that it produces little or no insulin. Insulin is a hormone that lowers blood sugar (or blood glucose) by transporting sugar molecules from the blood into cells to be used for energy. When the pancreas cannot produce and release enough insulin, blood sugar remains chronically elevated, causing a variety of problems.

To minimize the risk of diabetes and get help for your toddler as soon as symptoms appear, watch for these warning signs associated with changes in blood sugar.

African American baby having his diaper changed

Rayes / Getty Images

Frequent Urination

When there are high levels of sugar in the blood, the kidneys try to restore balance by excreting excess sugar in the urine. Excess sugar in the urine, known as glucosuria, produces a diuretic effect that causes the body to pass large amounts of water, resulting in the need to urinate more frequently.

For children who wear diapers, this can result in more soaked diapers and the need for repeated diaper changes. For children who are potty-trained, it can cause frequent accidents, and bed-wetting.

Ongoing Extreme Thirst

Because children with type 1 diabetes have an increased urge to urinate, the excessive loss of water leads to a fluid imbalance and dehydration. As a result, despite drinking large amounts of water or other fluids, children with type 1 diabetes will have an extreme thirst that is difficult to quench.

Increased Appetite with Weight Loss

The body relies on insulin to transport sugar into cells to use for energy. Without sufficient levels of insulin, which occurs in type 1 diabetes, the body's tissues become starved of the energy they need to function properly. Because of this, increased appetite and extreme hunger can result, as well as weight loss from improper nourishment.

While young children may not be able to verbalize that they are hungry, they may express their hunger in other ways, such as increased irritability, crying, and whining. Children may also eat average or larger-than-average portions of food but lose weight instead of gaining it as they grow.

Extreme Fatigue

Because the cells of the body are not being supplied with adequate sugar for energy, children can experience extreme fatigue. Signs of extreme fatigue in young children include increased sleeping, drowsiness, and lethargy, or lack of energy.

Sudden Vision Changes

Vision changes can occur with type 1 diabetes because the presence of excess sugar in the blood contributes to damage to blood vessels, including those that supply blood to the retina of the eye. This can result in blurriness and loss of vision.

While young children may not be able to say that they cannot see well or that things appear blurry, they may compensate by bringing objects much closer than necessary to their faces, sitting close to the television, or not responding to people or movement at a distance.

Yeast Infections 

Type 1 diabetes increases the risk of genital yeast infections since increased blood sugar creates an ideal environment for the Candida fungus to grow in moist areas of the body. Urinating more frequently and wearing a wet diaper for a long period of time also put children at risk for diaper rash caused by yeast infections from type 1 diabetes.

Fruity Breath

Because their bodies cannot effectively use sugar for energy due to insufficient levels of insulin, children with type 1 diabetes have to instead burn fat for energy. When fats are broken down, byproducts called ketones are produced. Ketones accumulate in the blood and are used as an alternate energy source.

Ketones interfere with the body’s pH balance (the balance of acidity and alkalinity) and can result in metabolic acidosis. Acetone is one of the primary ketones produced in metabolic acidosis. It is expelled from the body through the breath and gives off a fruity odor.

Unusual Behavior

The development of metabolic acidosis and disrupted pH balance in the body can cause unusual behavior. Children may be disoriented and lethargic or display increased irritability, moodiness, restlessness, crying, and temper tantrums. 

Poor Wound Healing

The transportation of amino acids, which are the building blocks of proteins, into cells requires insulin. Protein is made in cells. Since people with type 1 diabetes don't have enough insulin, they have increased protein breakdown.

Breakdown of the body’s proteins decreases the body’s ability to heal and repair damaged cells. Because of this, children with type 1 diabetes have a delayed rate of healing, may be more susceptible to bruising, and may take longer to recover from rashes and skin irritations.

Impaired immune system function and poor circulation due to nerve and blood vessel damage may also contribute to poor wound healing.

Breathing Problems

Metabolic acidosis disrupts the body’s natural pH balance because ketones can make the blood acidic (a lower pH). To restore pH to a normal level, the body compensates by increasing the rate of breathing. This helps raise the pH level of the blood by increasing oxygen levels while reducing carbon dioxide levels. Labored breathing and rapid, shallow breaths result.


If your child has been showing unusual signs such as weight loss, fatigue, increased thirst and hunger, and an increased urge to urinate, they may be experiencing type 1 diabetes. Fruity breath and delayed wound healing are hallmark signs of type 1 diabetes and require immediate medical attention. 

A Word From Verywell

Identifying the signs of type 1 diabetes in toddlers can be difficult because little ones can’t clearly tell you that they’re feeling ill. Knowing what to watch out for can help you determine the need to speak to your pediatrician about your child’s symptoms and the possibility of type 1 diabetes.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Goodman CC, Fuller KS. Pathology: Implications for the physical therapist. Saunders Elsevier; 2009:487-492.

  2. Rodrigues CF, Rodrigues ME, Henriques M. Candida sp. Infections in Patients with Diabetes Mellitus. J Clin Med. 2019;8(1):76. doi:10.3390/jcm8010076

  3. Reinhart J. Early Detection of Diabetic Ketoacidosis by Breathalyzer in a Sailor Reporting for Duty. Mil Med. 2019;184(11-12):e951-e952. doi:10.1093/milmed/usz127

  4. Funk, GC., Bauer, E., Oschatz, E. et al. Compensatory hypochloraemic alkalosis in diabetic ketoacidosis. Diabetologia. 2003;46:871–873. https://doi.org/10.1007/s00125-003-1119-3

By Kristen Gasnick, PT, DPT
Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.