Presentation and phases of diabetes

Presentation

• Diabetes in young people most often has a sudden and acute onset with polyuria, polydipsia and evidence of ketosis
• A minority of young people have a slower onset with symptoms presenting over several months

Additional clinical presentations

• Recent-onset or persistent enuresis
• Abdominal pain with or without vomiting
• Vaginal candidiasis
• Poor weight gain or weight loss
• Fatigue, irritability, decreasing school performance
• Recurrent skin infections

Diagnostic difficulties at onset

• Young infants with hidden symptoms
• Hyperventilation misdiagnosed as pneumonia
• Abdominal pain or vomiting misdiagnosed as abdominal ‘migraine’ or appendicitis
• Enuresis or polyuria misdiagnosed as urinary infection
• Polydipsia misdiagnosed as habit or psychogenic drinking