Relapse in Childhood or Adolescence

This is the part of the transient diagnosis that families are sometimes not told clearly, and it matters more than almost anything else in this category.

Diabetes returns in possibly half or more of children who had the transient form. When it comes back, it is usually permanent. In one series, the average age at which it returned was 14 — right around puberty, when hormone changes increase the body's demand for insulin.

Knowing this in advance is entirely to your child's advantage. A family who is watching will catch it early, in clinic, with a routine test. A family who was told the condition was cured may not recognise it until their teenager is seriously unwell.

What to watch for, from later childhood onwards:

• Passing urine often, especially getting up at night.
• Constant thirst.
• Losing weight without trying.
• Unusual tiredness, or a drop in school performance.
• Blurred vision, or infections that keep returning.

The practical protection is simple: keep an annual HbA1c from around age eight to ten, keep the genetic report, and make sure any new doctor knows the history. Tell your child too, at an age they can absorb it — they need to carry this into adulthood themselves.

Relapsed diabetes is treated on its merits and does not always mean injections. Reported responses include changes to diet, tablets, or insulin, depending on the child.

Watch without living in it. A yearly test and a habit of noticing is the whole task.