Introduction

My friend kept a two-litre bottle of water on his desk and refilled it twice before lunch, and we used to rib him about it. He was up four times a night to pee. He had dropped a belt size without trying and put it down to a busy few weeks at work. None of us, him included, joined the dots, and about ten days after that he was on a drip in an emergency bay being told he had type 1 diabetes. I have since learned how ordinary that story is, which is the whole reason I want to walk through the signs, because every one of them is easy to explain away one at a time.

The thirst you cannot drink your way out of

The thirst is usually the one people notice first, and it is a specific kind. Not the pleasant thirst of a hot afternoon. More the sort where your mouth is dry again a few minutes after a full glass, and you find yourself planning your day around where the water is. What is actually going on is that sugar is building up in the blood and your kidneys are trying to flush it out in the urine, and to do that they pull water from everywhere they can reach. You are essentially being wrung out from the inside, so you drink, and it is not enough, and you drink again.

Living in the bathroom

Hand in hand with the thirst goes the peeing, because all that water has to come back out. Through the day it is annoying. At night it is the thing that wears people down, up at two and four and again before the alarm. With kids there is a tell that parents catch when nothing else has clicked yet, which is a child who was dry at night for years suddenly wetting the bed again. It is not naughtiness and it is not a phase. It is the kidneys dumping sugar and dragging water along for the ride, and it is worth taking seriously the first time rather than the fifth.

Losing weight while eating more

This is the one that fools people, because it looks like something going right. The weight comes off. For an adult it can feel like a stroke of luck after years of the opposite. But look closer and it makes no sense, because the appetite is often up, not down, and the pounds are still dropping. Here is why. Without insulin the body cannot get the sugar from food into its cells, so as far as your muscles and everything else are concerned there is a famine on, and they start breaking down fat and then muscle to burn instead. You are eating, but your body cannot reach the fuel, so it eats itself.

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A tiredness with a different texture

Everybody is tired. That is what makes this sign so easy to wave away. The exhaustion of early type 1 is a bit different though, heavier, the kind where climbing the stairs feels like a decision and the middle of the afternoon flattens you completely. It comes from the same root as everything else. Your cells are surrounded by fuel they cannot use, so they are running on empty no matter how much you eat or sleep. Somewhere in here the eyesight can go blurry too, on and off, as the fluid balance in the eye shifts with the sugar. That one tends to frighten people into a doctor faster than the rest.

When to stop waiting

The trap with all of this is that each sign has an innocent explanation, so people talk themselves out of it for weeks, and type 1 does not give you weeks to spare. If you or your child are drinking and peeing constantly, losing weight, and worn out, please get a blood sugar test now rather than at some point. It is a finger-prick, it takes a minute, and a pharmacy or a GP can do it. Left too long, untreated type 1 slides into something called diabetic ketoacidosis, which is a medical emergency, and the difference between catching it early and catching it late is often the difference between a clinic appointment and an intensive care bed.

Key points

  • The classic warning signs are constant thirst, weeing all the time (including waking at night), weight dropping off, and a heavy tiredness. Blurred vision can come with them.
  • A child going back to bed-wetting after being dry for years is a giveaway parents often catch first.
  • Losing weight while eating more is not luck. It means the body cannot reach the fuel in food and is burning fat and muscle instead.
  • Each symptom on its own is easy to explain away. Together, and coming on fast, they point at type 1.
  • Do not wait it out. Get a blood sugar test the same day, because untreated type 1 can tip into DKA, which is an emergency.