This question is about type 1 diabetes in a 14 year old male, which was missed for a long period of time. Symptoms are said to appear “suddenly”. How suddenly is suddenly? How long could a child have type 1 diabetes without anyone noticing? Once onset has occurred, how long before fatal?

The immune process of Type 1 diabetes probably goes on for months, or even years in some people, before the symptoms of diabetes are noticed. The body has extra of many things, including the islet cells that make insulin. When enough of the islet cells are gone, then the blood sugar rises and the signs of diabetes appear (thirst, increased urination, weight loss, etc.). The signs can be subtle at first, but as less and less insulin is available, then the signs of type 1 diabetes are more noticeable. As the level of insulin decreases further, in addition to the blood sugar being high, ketones appear, dehydration, and an imbalance in important salts and acidity of the blood can lead to diabetic ketoacidosis. Ketoacidosis is a dangerous condition. Once diabetes is diagnosed, ketoacidosis should be prevented by always taking insulin injections and following sick day guidelines to see when extra insulin and fluids are needed.

LM