Living with diabetes: Watch out for the 4Ts – tiredness, thirst, thin and toilet

Laura Cleverly
disney reuters 300x225 Living with diabetes: Watch out for the 4Ts   tiredness, thirst, thin and toilet


Disneyland Paris is the place where dreams come true – this was what my family and I were told on arrival at our long-awaited holiday. I was 16-years-old at the time and had just completed my GCSEs. After a long, hard struggle to get through my exams I definitely needed a break. I’d lost a stone in weight in just a few weeks and felt broken in every way through tiredness. I’d spent most nights guzzling water and going to the toilet. I had no idea why this was happening to me, no one did.

At the time my only dream, or desperate wish if you’d like, was that I could rest. I was so tired from the journey to Disneyland, although I’d slept the whole way there I was still exhausted. Other than sleep I also wished for fluids. Anything and everything that I could get my hands on, I would drink instantly, never quenching my thirst. I always asked for more.

The symptoms that I was displaying were put down to stress from exams: even a health care professional mistook the signs telling me I had food poisoning, although my mother had suggested diabetes to him. Little did I know that my body was slowly giving up due to undiagnosed Type 1 diabetes.

While on holiday I felt awful, I was thirsty, thin, unhappy and on the last day I wanted nothing more than to go home. I hid my physical pain well, not wanting to spoil anyone’s fun, until the last day when I collapsed a total of three times. Doctors were called, tablets were prescribed, signs were dismissed and my family were left to cope alone.

Hours before we were due to leave (I have fantastic timing) pains set in. Excruciating pains shot through my stomach, I’d never felt anything like it before. Along with the pain, I experienced terrible confusion as my vision seemed to be failing. I couldn’t see any colour, everything was a dull grey and seemed to be slipping away from me. I couldn’t breathe speak or stand. I clung to my mum as I doubled over in pain, desperate for it to end. I would have done anything to make it stop.

I passed out as the paramedics arrived and I was airlifted to hospital, missing the only helicopter ride I’ve ever been on. I was told by my family that with one simple blood glucose test the mystery had been solved. There and then, within seconds, my family were told that I had Type 1 diabetes and that I was in diabetic ketoacidosis (DKA). This meant that because my body had stopped producing insulin and it had started using fat a fuel instead. As the fat was broken down acidic ketones were building up in my blood in such high levels that they were effectively poisoning me.

I spent days in intensive care and was then moved to a ward, scared and angry. I know that my diabetes couldn’t have been prevented, there is no way to prevent Type 1 diabetes, but the way that I was diagnosed could have been. A basic knowledge of the signs and symptoms could have avoided a misdiagnosis. I could have spent that holiday the way most people do, with dreams coming true. Who knows?

Sadly, I have heard stories of misdiagnosis before: signs being missed and emergency situations occurring which aren’t necessary. This doesn’t only cause physical consequences, but could potentially cause long term emotional effects for those involved. It isn’t always the case though and I also know of many people who have had a quick, efficient diagnosis and treatment.

As part of World Diabetes Day, charity Diabetes UK has launched a campaign to raise awareness of the most common signs of Type 1 diabetes. The symptoms are known as the ‘4 Ts’: Tiredness, Thirst, Thinner and Toilet. If you are feeling constantly tired, even after rest, it could be a warning sign. You should also be wary of an unquenchable thirst, frequently going to the toilet and losing weight in a short period of time.

The test for Type 1 diabetes is simple, all it takes is a finger prick that could put someone’s mind at rest and could also save a life. These four symptoms are the ones that really stood out for me in the weeks running up to my diagnosis and I wish they had been spotted sooner.

An in-depth specialist understanding of diabetes is not necessary but knowing the 4 Ts is all it takes. If you recognise any of these signs in yourself or a child then go to your doctor and insist on a test for Type 1 diabetes. Being Type 1 aware could prevent situations like I was in. It could prevent diabetic ketoacidosis and could be the difference between a diagnosis and a life-threatening situation. I want to make sure that more parents, grandparents and carers are aware of the 4 Ts of diabetes. It really could make a huge difference.

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  • frances smith

    I had a very similar experience as a teenager, quite a long time ago.

    my mother took me to the doctors again and again, and he decided i had anorexia nervosa, or something, and sent me to see a psychiatrist. who sent me away again.

    then one day the doctor i normally saw wasn’t there, so i saw another one, who instantly diagnosed type 1 diabetes.

    its quite scary, that it still happens and so frequently.

    i never trust a doctor now.

  • Latentexistence

    I’d like to add that the signs of Type 2 diabetes and the test are the same so this equally applies to adults.

  • Katy Sutcliffe

    Sadly I think this is a too common experience!
    My daughter, when aged 15 months, was a whisker away from death despite repeated visits to GPs with classic symptoms of diabetes over the course of two days. The final visit resulted in the locum GP saying to me and my husband to ‘go straight to the hospital, take her in your arms and run as fast as you can to the children’s ward they will be waiting for you!’ She hadn’t diagnosed the diabetes – but was aware that my daughter was in a critical condition. Eventually, they tested her blood sugar levels as part of a set of routine tests.

    I’m pleased to report that my daughter is now a happy, healthy 14-year-old, who is remarkably relaxed about and in control of her diabetes.

    As well as a mother of someone with diabetes, I am also a researcher. Through my work have spoken to many families to explore their experiences of living with and managing diabetes. Far too often I have heard stories of diagnosis in which classic symptoms of diabetes have not been recognised by healthcare professionals until a child is really sick – including a case of a GP who refused to accept a diagnosis of diabetes in a very young child.

    This ‘4Ts’ campaign is excellent – we all need to be more aware – including some healthcare professionals!

  • Ruth Raynor

    I booked in with my local GP because I was tired, thirsty and peeing all the time, having some problem with occasional blurring in my eyes and, because of another condition I have I’m at higher risk for diabetes. My GP was really understanding and listened, didn’t dismiss me at all and tested me for a whole load of things straight off the bat, including thyroid function and UTI. Because I was smart enough to book in the morning and not eat breakfast I was able to get a fasting blood sugar test straight away too.

    Results came back fine, but the scare was enough motivation to start re-evaluating my diet and swapping some of the more refined carbohydrates for more vegetables.

  • Sculptor471

    The glucose blood test is not a 100% indicator for Type 2 diabetes. People with Type 2 can apparently show “normal” glucose levels on a random fasting blood test.

    However the Glycated Haemoglobin (Hba1c) test is much more reliable. This indicates the average glucose level over the previous six weeks or so. Usually this requires a full lab blood test. There are pinprick test machines available now – but doctors’ surgeries don’t normally have them.

    My genetic inheritance always posed a risk of developing Type 2 – even with a family body type that always has a good BMI. For a decade there were minor ailments that could have been indicators of diabetes – but the blood tests were always ok.

    It was only when an age related set of blood tests showed a possible diabetic condition that the doctor ordered an Hba1c test for confirmation – which apparently showed a very high count.

    After two years of Metformin pills, a removal of work related stress, and some minor counting of calories – my last three six monthly Hba1c tests have come in at 42, 42, 41 viz 6%. My doctor says no one would guess I was diabetic.

  • Sculptor471

    Without wishing to be a pseudo-doctor – you might consider asking about a non-fasting Glycated Haemoglobin (Hba1c) test. This indicates the average glucose levels over a period of about six weeks. It is used as the diabetes confirmation test – but usually only after a fasting blood test raises any suspicions.

    I had a genetic disposition – with possible symptoms for about a decade. However my BMI was good and the fasting blood tests were always ok. When I finally failed one – then the confirmatory Hba1c test showed my Type 2 diabetes was quite severe.

  • Jack stokes

    Metformine kills 60% of patients in under 10yrs.
    LCP, Liverpool Carers Pathway, See the similarity?

  • Jack stokes

    Metformine kills 60% within 10yrs by Cadiovascular Disease, it was withdrawn in 1964 after 10yrs for that reason, then released again in 1994 for lack of anything better.
    The French manufacturers synthetic formulation is based upon the herb Goats Rue, a safer option.
    A google search reveals most of the top diabetic drugs kill either by the same method or worse still, cancer. For myself, I discovered Rawfoods and a sugar free diet, plus low carbs keeps me well.

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