How did you know?

This is another question I get asked a lot about Emma's diabetes. How did you know that she had diabetes? I think this question comes a lot out of fear - well, if her 2 year old can have diabetes, how do I know for sure that my child doesn't.

There are some clear signs of diabetes - the problem is, they don't usually come until the person has "suffered" for a while.

One important fact to know to understand diabetes - carbs and sugars in foods you eat are absorbed into your body for use as energy. In order for that to happen, insulin has to process the glucose in the carbs and sugars for it to be absorbed into your system. When a person's body stops producing insulin, glucose from food builds up in the blood stream because the insulin isn't present to process the glucose for absorption.

When this build-up begins, you usually don't have any outward signs. But as it proceeds, you begin to have outward signs, which are the symptoms or indicators of diabetes. Because the glucose isn't absorbed into your system, your body tries to find a method to get it out of your system - through urination. So, because you have extra glucose in your system, you pee more trying to get it out. Because you pee more, you are thirstier (you are basically dehydrated). You keep drinking water to quench the thirst caused by the constant release of glucose through urine. So, drinking lots of water and peeing a lot are two very teltale signs of a potential diabetic.

Another problem when the glucose isn't processed into your system is that your cells don't get their energy - which they get from glucose. So, in order for your cells to get the energy they need to function, they find it from other sources - your fat cells. Your body begins to burn fat for energy as its only source of energy. This energy is not as effective as glucose, so you begin to suffer from a lack of energy which eventually turns into extreme lethargy.

A by product of burning fat for energy is the acidic by-product left in your blood stream. These acids are called "ketones". As your body continues to burn fat for energy, the ketones in your blood stream rise. The only way to get rid of the ketones in your system is, ironically, insulin. Because your body isn't producing insulin, they continue to build up. The only way to know that your body has ketones is through a urine or glucose test - there are no outward signs of ketones themselves. However, the burning of fat in your body for energy also results in a loss of weight from the loss of fat. So, an undiagnosed diabetic may be experiencing weight loss.

Left untreated, the buildup of ketones causes ketoacidosis in your system which can eventually result in a coma. Most diabetics, fortunately, are diagnosed before their system reaches this state and can be treated with insulin to reduce the ketones in their system and reduce their blood glucose levels.

So, all of this technical information results in the following simple explanation of how Emma was diagnosed:
- An extreme increase in consumption of water
- An extreme increase in urination (which is easy to tell when they are in diapers)
- Loss of weight (2 pounds in 1 month)
- Extreme lethargy

The lethargy is the factor that finally keyed us in. We had been suspicious for a few days before that and had been researching symptoms on the web. But after Emma got really lethargic (and for anyone who has met her you would understand why this would be unusual), we finally decided something was wrong. And after two finger sticks with my old meter from when I was pregnant confirmed that something was wrong.