Derry teacher Miss Fox knows the 4Ts of type 1 diabetes

Caolan O’Neill, 6, from Derry

Caolan O’Neill, 6, from Derry was diagnosed with type 1 diabetes last year, after his teacher noticed he was going to the toilet a lot.

Type 1 diabetes cannot be prevented and occurs when the pancreas is no longer able to produce insulin. It is the most common type of diabetes in children and young adults.

Caolan’s mum Amanda explains: “Caolan was quite the typical 5-year-old boy, he was very happy-go-lucky, enjoyed playing with his friends and dreaming of being a YouTuber and he had just started his first term in Primary 1 and was really loving it.”

Caolan attended St Paul’s Primary and Nursery School, Derry and his Primary 1 teacher was Miss Fox.

She said: “I noticed that Caolan was asking to go to the toilet a lot. I started to take note of it, because it wasn’t normal for Caolan. The first day he went to the bathroom five times, the next day he was up to nine and then, on the third day, he was back to normal again, but it wasn’t his normal, so I thought it was time to bring it up with Caolan’s mum and dad.”

Amanda continued: “When Miss Fox raised her concerns with me, I immediately got an appointment with the GP; we were seen within a matter of hours and the GP undertook a finger prick test, which showed that Caolan’s bloods were too high to be read. We then had to take Caolan to our local hospital where the diagnosis was confirmed.”

Every year between 100 and 130 children develop type 1 diabetes in Northern Ireland. 

Dr Bríd Farrell, Assistant Director of Service Development and Screening at the Public Health Agency (PHA), said: “Children can develop type 1 diabetes at any time. We therefore want to raise awareness of the four most common symptoms of type 1 diabetes to make sure all children who develop the condition are diagnosed early.

“We are urging parents to make themselves aware of the symptoms and if you do notice any of them, I would urge you to get your child’s blood sugar checked that day as time can be of the essence.”

Symptoms in children and young people can develop over a few days or weeks and parents and carers should look out for the ‘4Ts’:

  1. Toilet – going to the loo a lot, bed wetting starts unexpectedly;
  2. Thirsty – child being really thirsty;
  3. Tired – feeling more tired than usual;
  4. Thinner – losing weight or looking thinner than normal.

With type 1 diabetes, early diagnosis is important in children, otherwise their condition can deteriorate rapidly with serious consequences such as diabetic ketoacidosis (DKA). DKA occurs when the body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which needs urgent medical attention and hospital admission.

Dr Farrell continued: “If we diagnose type 1 early, we can start early treatment and avoid DKA, and we can also sometimes avoid hospital admission.

“Keeping an eye out for the 4Ts can result in earlier diagnosis of type 1 diabetes. If parents are concerned about a child they should have their blood glucose (sugar) checked either in the GP surgery or local pharmacy.”

Amanda added: “Caolan is now doing great. He still loves doing all the things he did before, still dreams of being a YouTuber and still loves playing with his friends and doing anything related to arts and crafts. He is a true inspiration; he doesn’t let his condition define him. We are very proud of him; he is a true wee superhero.

“We are very thankful that Miss Fox noticed the change in Caolan’s toilet behaviour and that she informed us. Because of her actions we got the diagnosis early, before DKA developed.   

“I would urge all parents, carers, teachers and anyone who works with children and young people, to know the 4Ts and if symptoms are recognised, please inform the parents and they should make an appointment with their GP.”

There are other symptoms aside from the 4Ts that can indicate type 1 diabetes – for further information on the condition, see

DKA is an emergency and needs to be treated in hospital immediately. For further information on the condition, see