Is Excessive Thirst a Diabetes Symptom in Children?

Small boy drinking water
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While it's true that excessive thirst can be a sign of diabetes, it's a tricky one when the patient is a child. Young children often drink plenty of fluids when they are perfectly healthy. That may certainly be the case with your child if she's guzzling water bottles faster than you can fill them, but it's worth a trip to the pediatrician. This symptom must be considered alongside any others, as well as a review of your child’s family and health history (and perhaps test results), to come to any conclusions.

Diabetes in Children

Parents often worry about diabetes in general, but most are really concerned about type 1 diabetes—the kind that typically starts in childhood and requires treatment with insulin shots.

Type I diabetes, however, is actually the least common type of diabetes, affecting only 5 percent of people with the disease. Type 2 diabetes, which used to be thought of as "adult-onset" diabetes, is much more common.

With the increase in childhood obesity—a major risk factor for the disease—pediatricians now actively look for type 2 diabetes in teenagers and even preteens.

Many parents bring their children for a diabetes evaluation because they have frequent urination (polyuria) and increased thirst (polydipsia). These are classic signs of diabetes that occur when the kidneys can't process the excess glucose in the body well and fast enough, causing that sugar to mix into and be excreted with your urine—taking other fluids along with it.

The only problem is that many kids, especially toddlers and preschoolers, will ask for and drink as much juice as you let them have, even if they aren't necessarily thirsty. And if they drink a lot of juice, that means they are going to have to urinate a lot. 

That's why kids who go to their pediatrician with just the symptoms of being thirsty and urinating frequently usually don't end up having diabetes.

Type I Diabetes Symptoms

The symptoms of type 1 diabetes, which typically develop over a short period of time (days to weeks) often include:

  • Frequent urination (polyuria)
  • Being very thirsty or drinking a lot (polydipsia)

The concern about type 1 diabetes increases if other diabetes symptoms are present, such as:

  • Eating a lot or extreme hunger (polyphagia)
  • Unusual weight loss
  • Extreme fatigue
  • Irritability
  • Blurred vision

Weight loss is an especially important red flag symptom for type 1 diabetes. If a child has the classic symptoms of diabetes, such as frequent urination, increased thirst, and weight loss, then a pediatrician will likely suspect diabetes even before a urinalysis or blood sugar test is completed. On the other hand, if a child has other diabetes symptoms without weight loss, it's still important to do these tests, but the chance that diabetes will be found is much lower.

Don't hesitate to see your pediatrician if you think your child might have any symptoms of diabetes.

Also keep in mind that when children have frequent urination associated with diabetes, it is usually large amounts of urine each time. Children who have to urinate frequently, but only void a small amount, likely have another cause instead of diabetes, especially if they don't have other diabetes symptoms. (It is still important to see your pediatrician as conditions such as a urinary tract infection might be causing the symptom.)

Type 2 Diabetes Symptoms

Unfortunately, children with type 2 diabetes may have no symptoms at all, which can make early diagnosis difficult.

Many type 2 diabetes symptoms are actually late symptoms of the condition, which develop gradually after many years of having diabetes. These signs and symptoms can include:

  • Type 1 diabetes symptoms, including frequent urination, increased thirst, weight loss, and extreme hunger
  • Frequent infections
  • Increased risk of infections; for example, catching viruses very easily compared with before
  • Cuts and bruises that heal slowly
  • Blurred vision (a possible symptom of retinopathy due to diabetes)
  • Fatigue
  • Numbness or tingling in the hands and feet (symptoms of diabetic peripheral neuropathy)

Because children with type 2 diabetes may not have any classic diabetes symptoms, pediatricians and parents should instead look for other signs and risk factors for the disease. These can include being overweight, having acanthosis nigricans (areas of darkened skin, usually on the back of a child's neck) or striae (stretch marks), and a positive family history of type 2 diabetes. High-risk kids then get routinely screened for diabetes, including a hemoglobin A1C test, a test which gives an average reading of blood sugar over a period of weeks to months.

Infections in Kids With Diabetes

Children with type 1 diabetes may also have symptoms of an infection, such as fever, cough, vomiting, or a sore throat, as it is often an infection that triggers the diagnosis.

The infection doesn't cause the child to have diabetes, but before the infection—whether it is the flu, strep throat, or a stomach virus—the child may have been able to drink plenty of fluids to keep up with their frequent urination, but falls behind once they get sick. That can lead to dehydration and worsening symptoms, even progression to diabetic ketoacidosis, which can be a medical emergency.

Additional Information to Know About Diabetes

It is important to know how to recognize diabetes symptoms as kids with type 1 diabetes can end up in a diabetic coma if the diagnosis is delayed too long.

In addition to knowing the classic symptoms of diabetes, parents should know that:

  • About 10 percent of children with diabetes have type 1 diabetes.
  • The peak ages to be diagnosed with type 1 diabetes are between ages 5 and 7 years, and then again at the start of puberty.
  • Although genetics is a risk factor for developing type 1 diabetes, as the risk is about 2 percent if a child's mother has type 1 diabetes and 7 percent if their father has diabetes, 85 percent of kids with type 1 diabetes have no family history of diabetes.
  • The weight loss in children with type 1 diabetes can occur because of dehydration (water loss from urinating a lot) or from a loss of body fat (calorie loss from increased sugar in the child's urine), or from both.
  • Most children with type 2 diabetes have a family history of type 2 diabetes.
  • Craving sugar is not typically a symptom of diabetes. In fact, children with diabetes have too much sugar in their blood.
  • Frequent infections and having cuts and bruises that heal slowly are not usually early symptoms of type 1 diabetes, but instead may be symptoms of type 2 diabetes if frequent urination, increased thirst, weight loss, and extreme hunger are also present.

    If your child is exhibiting any of the symptoms mentioned above, it is important to talk to your doctor. Many of these symptoms, even if not related to diabetes, should be addressed by your pediatrician as they could be caused by other important medical conditions, as well.

    As a final reminder, it's important to note that kids are not just "little adults" and they often have unique symptoms related to illness. If you feel anything is just not right with your child, even if you can't describe exactly what that is, trust your instinct as a parent and call or make an appointment to see your pediatrician.

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    Article Sources
    • Kliegman, Robert M., Bonita Stanton, St Geme III Joseph W., Nina Felice. Schor, Richard E. Behrman, and Waldo E. Nelson. Nelson Textbook of Pediatrics. 20th Edition. Philadelphia, PA: Elsevier, 2015. Print.
    • Pociot, F., and A. Lernmark. Genetic Risk Factors for Type 1 Diabetes. Lancet. 2016. 387(10035):2331-9.