The morning we found out: signs of Type 1 we almost missed

It started the way a lot of scary things start — slowly, and then all at once.

Audrey was five. She'd been a little off for maybe two or three weeks. Tired in a way that felt bigger than a growth spurt. Drinking a lot of water — like, a lot — and then making endless trips to the bathroom. We'd been chalking it up to a bug she couldn't shake, or maybe just the weird energy swings that come with being five years old in the middle of summer.

My wife caught it first. She's a former nurse, and something in her clinical brain quietly flagged what her mom brain was trying to explain away. Lethargy. Constant thirst. Peeing constantly. She didn't catastrophize. She just said: we need to go get her checked out.

I thought we were going to the family doc to "just check on things."

We were not just checking on things.

Higher than the meter could measure

The doctor did a finger stick. Then she looked at the meter. Then she looked at us.

Audrey's blood sugar was higher than the meter could read. It just said HI — meaning the number was above the top of the scale. We found out later she was already beginning to slip into diabetic ketoacidosis, or DKA, which is a life-threatening emergency that happens when the body, unable to use sugar for fuel, starts breaking down fat and flooding the blood with acids called ketones.

We went straight to Children's Hospital Colorado. We didn't go home first. We didn't pack a bag.

We stayed overnight. The team there was incredible — and eventually, we were referred to the Barbara Davis Center for Diabetes at CU Anschutz, which has been amazing in treating Audrey and helping our whole family actually understand what Type 1 diabetes is and what it isn't.

What it isn't, by the way, is anything we did wrong.

Type 1 is an autoimmune disease. Audrey's immune system attacked the beta cells in her pancreas — the cells that produce insulin. It wasn't caused by diet, or sugar, or anything a parent could have controlled. It just happened. And it happened faster than we realized.

Why the signs are so easy to miss

Here's the thing that keeps me up at night when I talk to other parents: the symptoms of Type 1 diabetes in kids look exactly like about fifteen other totally normal things.

Tired? Kids are tired. Drinking a lot of water? It was summer. Needing to pee constantly? Probably just drinking a lot. Losing a little weight? Probably just a growth thing.

Each symptom on its own is easy to explain away. Together, they're a pattern — and most parents don't know to look for the pattern. I didn't. My wife, with a clinical background, almost didn't.

That's not a parenting failure. It's a knowledge gap. And the only way to close it is to talk about it more, louder, and more honestly.

The symptoms to actually know

There's a framework called the "4 T's" that a lot of organizations use to make symptoms easier to remember. I wish I'd known it before that morning. Here's what to watch for, in plain language:

• Toilet — frequent urination. Going to the bathroom way more than usual. In younger kids, this can mean suddenly wetting the bed again after being dry for months, or diapers that are constantly soaked. Older kids might be asking to leave class multiple times a day.
• Thirsty — extreme thirst. An unquenchable thirst that doesn't go away no matter how much they drink. When blood sugar is very high, the kidneys try to flush the extra sugar out, which pulls a lot of fluid with it — hence the constant drinking and the constant bathroom trips. They're connected.
• Tired — deep, persistent fatigue. Not normal kid tiredness. Lethargy. Reduced engagement. A kid who seems like they're running on empty even after a full night of sleep. Without working insulin, the body can't convert food into energy, and it shows.
• Thinner — unexplained weight loss. Losing weight despite eating normally, or even eating more than usual. Because the body can't access the fuel from carbs, it starts burning fat and muscle instead. Audrey had lost weight we hadn't even clocked because it happened gradually.

Beyond the 4 T's, organizations like Breakthrough T1D list a few others worth knowing: dry mouth, itchy skin from dehydration, blurry vision, increased appetite (the body is literally starving for fuel even with food going in), and mood swings or irritability from blood sugar swings.

None of these require all symptoms to be present. Audrey had three of the four T's clearly. That was enough.

When to stop waiting and get a finger-stick today

I want to be direct here: if you are reading this post and thinking, "that actually sounds like my kid right now," don't wait for the next available appointment.

Call your pediatrician today and say: I'm concerned my child may have Type 1 diabetes, I'd like a blood glucose test. A simple finger-stick can give you an answer in about 10 seconds. A random blood sugar level of 200 mg/dL or higher, according to the Mayo Clinic, is the primary screening threshold for Type 1 in children.

I'm not saying this to frighten you. I'm saying it because a 10-second test is all that stood between us and knowing, and we almost let another few days go by.

What DKA looks like — and why you don't wait

Diabetic ketoacidosis is where things get dangerous quickly. It happens when there's not enough insulin to let sugar into the cells, so the body burns fat for fuel instead, producing ketones. When ketones build up in the blood, the blood becomes acidic — and that is a medical emergency.

Signs of DKA include:

• Nausea, vomiting, or stomach pain
• Rapid, labored breathing
• Fruity or sweet smell on the breath (this one surprised me — I didn't know this was a thing)
• Extreme exhaustion or confusion
• Flushed face

If your child is showing multiple of these signs — especially the vomiting, the fruity breath, or the confusion — that is a 911 call or an ER visit, not a "let's see how they feel in the morning" situation. DKA can become life-threatening within hours.

Audrey was close. I don't say that for drama. I say it because that morning we went to the family doc instead of waiting one more day is a morning I think about a lot.

What happened after — and where Audrey is now

We left Children's Hospital the next day knowing almost nothing about Type 1. We couldn't have told you the difference between a basal rate and a bolus. We definitely couldn't have told you what the carbs were in the dinner we were about to make.

That learning curve was steep. The first 30 days were some of the hardest of our lives — not because anything went terribly wrong, but because there was just so much to absorb, all at once, while also parenting a five-year-old who was scared and confused. If you're in that window right now, I wrote about those first 30 days — what to expect and what actually helped us get through it.

Audrey is seven now. She is, genuinely, thriving. She wears her CGM like it's just part of her — because for her, it is. She's become a representative for the Barbara Davis Center and the Children's Diabetes Foundation, and she's been featured in CDF press. The kid who couldn't tell us she was thirsty now talks to other families about what life with T1D actually looks like.

We still count carbs at every single meal. We still think about her blood sugar before birthday parties, before gym class, before sleepovers. We've gotten faster at all of it — smarter tools help — but it never fully goes on autopilot.

If you're newly navigating this and want to understand what the tech side of T1D management looks like, we also broke down pumps, pens, CGMs, and apps in plain language for parents who are still figuring out what any of it means.

And if you're still in the "is this something I should worry about?" phase — please, go get the finger-stick. Talk to your pediatrician. Ask the question. The answer takes 10 seconds and the peace of mind — either way — is worth it.

Your care team will guide you on everything that comes next. That part we can't do for you. But knowing what to look for — that's something any parent can have.

We're building CarbCue for families like ours — a simple iOS app that uses a photo of a meal to help estimate carbs, so one small part of this very large job gets a little easier. If that sounds useful, join the waitlist and we'll let you know when it's ready. We're building it for Audrey, but honestly, we're building it for your kid too.