Misdiagnosis of Type 1 Diabetes
R. Paul Wadwa, MD, Professor of Pediatrics at the BDC • April 2, 2026
Originally Published: November 30, 2017
Original Author: Shideh Majidi, MD, Assistant Professor, Pediatric Endocrinology at the BDC
TL;DR:
Type 1 diabetes is often misdiagnosed because its early symptoms—like frequent urination, extreme thirst, fatigue, and nausea—overlap with common illnesses such as the flu, UTIs, and viral infections. In Colorado, over half of newly diagnosed children present in diabetic ketoacidosis (DKA), a serious and preventable complication. Recognizing the warning signs early and asking for simple testing can help ensure a timely and accurate diagnosis.
Early Warning Signs of Type 1 Diabetes in Children and Teens
Thousands of youths are diagnosed with type 1 diabetes every year and in Colorado, over 50% of Colorado children with newly diagnosed diabetes present in Diabetes Ketoacidosis (DKA). Symptoms of type 1 diabetes include extreme thirst, frequent urination (including urinating at night or bedwetting) and increased appetite. Other symptoms may include weight loss, lack of energy and blurry vision.
Why Type 1 Diabetes Is Often Misdiagnosed
The symptoms of diabetes are often seen in other, more common illnesses. Therefore, a diagnosis of type 1 diabetes can be easily missed or misdiagnosed. Type 1 diabetes is commonly confused with urinary tract infection, stomach flu, strep throat, or other viral infections (such as mononucleosis), as these conditions all have symptoms that overlap with diabetes..
Common Conditions Mistaken for Type 1 Diabetes
- Stomach flu (gastroenteritis): The stomach flu may cause stomach ache, nausea, vomiting, and dehydration. Healthcare providers often recommend people with the stomach flu to drink fluids to help prevent dehydration so if someone says they have been drinking well and going to the bathroom a lot, it can be seen as a “good” sign.
- Urinary Tract Infection (UTI): Frequent urination is a symptom of a UTI and people with UTIs can also have stomach pain, nausea, and vomiting.
- Mononucleosis (“mono”): Mono is viral illness (caused by Epstein-Barr virus, or EBV) that leads to chronic fatigue, sore throat, and swollen glands. Someone with new, undiagnosed type 1 diabetes can be tired and have low energy before extreme thirst and/or frequent urination are appreciated.
When Illness Masks Type 1 Diabetes Symptoms
People with undiagnosed type 1 diabetes can also have infectious illnesses at the same time, such as a common cold or strep throat, that can mask the symptoms of diabetes. When people have a cold or strep throat, they often feel fatigued, and may have stomach pain or nausea.
When to Ask Your Doctor to Test for Type 1 Diabetes
If you are worried that you or your child has diabetes and have been misdiagnosed, talk to your doctor about your concerns. Make sure to tell your doctor if you are having increased urination (including waking up overnight to go to the bathroom) and increased thirst, as these are the classic symptoms of diabetes. Ask your doctor if you should be tested for diabetes. Most doctor’s offices can test a urine sample for glucose and ketones, which can help to diagnose or rule out diabetes.
