Blog: Know the 4Ts of Type 1 Diabetes; it could save a child's life

As someone who works in an Early Years setting, you could spot the early signs of Type 1 Diabetes in children. Nobody knows what causes Type 1 diabetes, but the signs and symptoms can develop very quickly. If it is not identified and treated quickly, children can become seriously unwell with diabetic ketoacidosis (DKA). This can be life-threatening.

picture shows young girl being shown how to check her insulin levels

Around 1,400 children and young people in Wales have Type 1 diabetes, but 1 in 4 are not diagnosed until they are in DKA.

Diabetes UK Cymru's Know Type 1 campaign aims to raise awareness of the common symptoms of the condition, to make sure children are diagnosed sooner, and more safely.

Being diagnosed with Type 1 diabetes doesn't have to be an emergency infographic

Type 1 diabetes is a serious, lifelong condition where blood glucose levels are too high because the body cannot produce a hormone called insulin. This controls the amount of sugar (glucose) in the blood.

Type 1 diabetes is an autoimmune condition and is not connected to someone's lifestyle. It's not to do with being overweight and it isn't currently preventable.

The condition must be carefully managed day-to-day. It is treated by daily insulin doses, taken either by injections or via an insulin pump. People with Type 1 diabetes also need to check their blood glucose levels are not too low or high by using a testing device several times a day.

If a child is going to the toilet a lot (or a baby has heavier nappies), has increased thirst which they can't quench, is more tired than usual or is losing weight (getting thinner), it could be a sign they have undiagnosed Type 1 diabetes.

These symptoms are easy to mistake for a viral infection or other illness. But don't delay: Type 1 diabetes can be fatal if left untreated.

Type 1 diabetes has four common symptoms which you can look out for. We call them the 4Ts:

It's important to bear in mind that a child may not be experiencing all of these symptoms at once. If a child shows any of the 4Ts, Diabetes UK Cymru advises you to tell their parents or carer to take the child to a doctor immediately for a finger-prick test.

Raising awareness of the symptoms, and being vigilant, can put a stop to children needlessly becoming seriously unwell.

Picture is of Peter Baldwin whose case study is talked about in the article

Diabetes UK Cymru launched the Know Type 1 campaign in 2017 alongside the Baldwin family from Cardiff. Their son, Peter, passed away aged 13 due to undiagnosed Type 1 diabetes in January 2015.

Despite showing typical symptoms like being tired, getting thinner and needing the toilet, Peter was not diagnosed with Type 1 diabetes until he was seriously ill with DKA. Peter had a chest infection at the time, making the symptoms harder to identify, but a simple finger-prick blood test could have shown he had Type 1 sooner.

Beth, Stuart, and Peter's sister, Lia, now 13, have campaigned tirelessly to increase awareness of the early symptoms of the condition. They have fundraised almost £70,000 for Diabetes UK Cymru since Peter passed away and, through their media work and campaigning, they have raised vital, lifesaving awareness. One video Beth filmed with BBC Wales has since been seen by over 1 million people1. Diabetes UK Cymru has also delivered Know Type 1 training to more than 400 GP's, and sent information packs to 1400 schools, 400 GP surgeries, and all of Wales AM's and MP's.

The charity supported the Baldwin family's petition to the Welsh Government's Petitions Committee on Early Diagnosis. After many months of consultation and evidence-gathering, the Committee published a report in July 2018 which made an almost unprecedented 10 recommendations for improving early diagnosis of Type 1 diabetes. Several of these initiatives have already been introduced, and we are continuing to work alongside the family, and Welsh Government, to ensure their implementation continues.

Most importantly, several parents contacted Diabetes UK Cymru after seeing media coverage of the campaign. They directly credited Peter's story, and Know Type 1, for their child's safe diagnosis.Beth said,

“People generally know the symptoms of many other life-threatening conditions. When it comes to conditions like meningitis, people know to look out for spots on the skin and to put a glass on the rash. But people don't know what to look out for with Type 1 diabetes and it's vital that they do.

“Losing a child is something that no family should have to go through. Now it's our mission to make sure that everyone – whether they are parents, healthcare professionals, childcare providers, teachers - keeps the 4Ts of Type 1 diabetes at the front of their minds.

The Know Type 1 campaign is Peter's legacy. It's all about helping as many other families as we can. Being able to recognise the symptoms, get a quick diagnosis, and early treatment could save a child's life.”

With your help, we can make sure children are diagnosed safely, before they are in DKA, and save lives.


1 Peter Baldwin: Type 1 diabetes test backed after boy's death

Diabetes UK Cymru can provide you with a range of resources to help you, your staff and parents of children at your nursery understand more and raise greater awareness of the symptoms of Type 1 diabetes (the 4Ts). These are available in English and Welsh.

You could:

  • Display posters in your staff room or entrance area
  • Give our leaflets to parents
  • Use our Know Type 1 stickers as part of a talk or lesson for parents and/or staff
  • Include a message about the 4Ts in your newsletter
  • Share the campaign on your website or social media using #KnowType1
  • Follow us on Facebook, Twitter and Instagram at @diabetesukcymru

You can order resources by contacting us on [email protected] or 02920 668276.

We would also be happy to come and speak to your staff or deliver a training and awareness session – just get in touch.

We also have resources to help you support children who have Type 1 diabetes. Order a free Make the Grade pack at

This article was originally published in smalltalk, (winter 2019), pg 23 - 25 and has been reproduced for #DiabetesWeek2024 (Monday 10 - Sunday 16 June)

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