Campaign launched to encourage earlier diagnosis of Type 1 diabetes in children and adolescents

25% of Type 1 diabetes cases diagnosed in children and adolescents are delayed, resulting in critical illness!

Diabetes Ireland has joined forces with the Irish Childhood Diabetes Register to launch a campaign to encourage parents and healthcare professionals to be aware of the signs and symptoms of Type 1 diabetes. The campaign was triggered by the alarming rise in the number of children and adolescents being admitted to Irish hospitals with a potentially life-threatening condition called diabetic ketoacidosis (DKA) which can occur if a Type 1 diabetes diagnosis is delayed. A simple finger prick glucose test can lead to prompt diagnosis and avoid the risk of developing DKA. In 2014, 1 in 6 children diagnosed with Type 1 diabetes were admitted to hospital with DKA.

Fiona Smith and her daughter Lauren were one such case. Fiona describes how she presented Lauren to a clinic on a Wednesday and was sent home. She was still concerned on the Friday so called the clinic and was told as policy they could not perform blood tests on young children. “We had a weekend of worry and anxiety and when we contacted the nurse helpline over the weekend we were told to be vigilant of Laurens bathroom use as she was close to teenage years! I had to carry her into the doctor’s surgery on Monday morning to be told, there is no time to wait for an ambulance just drive straight to hospital. If a simple finger prick glucose test was done in the preceding week, we would never have had to go through such torture. I would not want any other family to go through what we did”. Fiona’s story is only one of the many that Diabetes Ireland hear on their helpline and from their members, thankfully Lauren has recovered and is now living life to the full with Type 1 diabetes.

Dr Anna Clarke, Head of Health Promotion at Diabetes Ireland, says “knowing the signs and symptoms of Type 1 diabetes is vital. Up to five children and teenagers are diagnosed each week with Type 1 diabetes in Ireland, up to 25% of these cases have delayed diagnosis resulting in critical illness”.

The four main symptoms of Type 1 diabetes are easy to remember; thirst, toilet, tiredness and weight loss. However, in younger children, more obscure signs such as hunger, lack of concentration, vomiting and abdominal pain, start bedwetting again, mood swings or recurrent infections may be an indication. A simple urine or blood glucose test can be carried out by any healthcare professional straight away to rule out Type 1 diabetes.

If parents recognise these symptoms they should seek medical attention straight away. “Ask your GP for a glucose test and check for Type 1 diabetes rather than wait, early diagnosis and immediate hospital referral is very important” added Dr Clarke.

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For interviews or further information please contact Sinead Deasy on 01 842 8118 or [email protected]

Notes to Editor

Type 1 and type 2 diabetes are 2 very different conditions, for more information on the differences please visit diabetes.ie/about-us/what-is-diabetes/ or see table below.
Type 1 diabetes is an autoimmune condition affecting 1 in 500 children with onset over days or weeks.
The condition tends to occur in childhood or early adult life and will require daily insulin therapy.
It is caused by the body’s own immune system destroying the insulin-making cells (beta-cells) of the pancreas.

Diabetes Ireland

Since 1967, Diabetes Ireland has been the national charity dedicated to helping people with diabetes. We achieve this by providing support, education and motivation to everyone affected by diabetes. Diabetes Ireland also raises public awareness of diabetes and its symptoms and funds research into finding a cure for diabetes.

Irish Childhood Diabetes Register

A prospective national diabetes register was commenced on Jan 1st 2008 to monitor epidemiological changes in the Irish population. In collaboration with other international Registries and the Eurodiab network the register aids further insight into the causation of this complex condition. Monitoring the occurrence of diabetes in populations also allows improved healthcare planning and appropriate resource allocation which ultimately results in enhanced patient care. It is for this reason that most developed countries have established registers of Type 1 diabetes.

The differences between type 1 diabetes and type 2 diabetes

Characteristics of the condition	Type 1 Diabetes	Type 2 Diabetes
Risk Factors - Very different	• Having another autoimmune condition • Having a parent or sibling with type 1 diabetes combined with environmental factors and a common infection which may trigger onset	• Over 40 years of age • Have a parent or brother/sister with diabetes • Had diabetes during a pregnancy • Are overweight for your height • Do not take 30 minutes of physical activity daily • Have high blood pressure and/or high cholesterol
Symptoms: Some overlap	Fast onset of extremely high blood glucose levels which leads to: • Extreme thirst • Frequent urination • Weight loss • Hunger • Fatigue	High blood glucose levels which lead to: • Thirst and frequent urination • Urinary tract infections • High blood pressure • Fatigue • Neuropathy • May also have no symptoms or just mild thirst or repeated infections
Nature of illness: Very different	Autoimmune condition that causes your cells to kill off your insulin producing beta cells, as a result your body no longer makes insulin.	Your body makes insulin but it isn’t used properly by the body or there is not enough insulin to meet your body’s demands resulting in an insulin inefficiency.
Onset: Very different	Quick onset, generally within a few weeks or months.	Slow onset, may be several years after glucose levels begin to rise. On average 12 years pass between onset and diagnosis of type 2 diabetes.
Treatment: Some overlap	• Intense daily self-management of insulin to balance food intake or exercise • Must take multiple injections of insulin or infusion through insulin pump	• Daily self-management of food intake, exercise and medication • Over time roughly 40% may need to use insulin injections
Age of diagnosis: Typically different	Typically early childhood or adolescence but can occur at any age.	Typically adulthood but can occur at any age.
Complications: Same but to varying degrees	• Short term complications give rise to acute emergencies such as hypoglycemia and ketoacidosis • Long term exposure to low glucose levels can cause hypoglycemic unawareness • Long term exposure to high glucose levels can cause blood vessel damage • Blood vessel damage can cause blindness, retinopathy, heart disease and foot problems including amputation and earlier mortality.	• Many people at diagnosis of type 2 diabetes may have already had up to 12 years exposure to long term high blood glucose levels and have complications at diagnosis • Damage to large and small blood vessels throughout the body which causes blindness, retinopathy, heart disease, kidney disease, amputation, gastroparesis, early mortality.
Is it preventable?: Very different	No	• Yes, up to 40% of diagnoses may be prevented with healthy diet and weight management • A further 40% may delay the onset of the condition with alterations to dietary intake and healthy activities to curb weight gain.