Having successfully parented their two daughters through to adulthood, Stacy and Joe Crescitelli thought that they had teenagers sussed out. So when their third child, Henry, began growing at a fast pace, sleeping more and thinning out, they didn't think much of it.
But rather than normal teenage hormones, Henry was fighting something much more sinister - Type 1 diabetes.
Stacy Crescitelli wants to warn other parents about the symptoms of Type 1 diabetes so that others don't make the same mistake.
Speaking to TODAY parents, 46-year-old Crescitelli said that the first thing she noticed was that Henry had grown around four or five inches.
"His body was changing. He has always been kind of a solid boy with a large frame — never one of those reed thin, gangly boys — but suddenly, he was becoming one.
"Of course, we thought he was simply 'leaning out,'" she said.
Although Henry continued to lose weight and began to sleep more, it wasn't until he suffered a sudden bout of vertigo that "terrified him and mystified us," that the Crescitelli's realised there was something wrong.
"One minute he was in the kitchen getting water, and the next he was asking me to help him to the couch because he couldn't walk or focus his eyes," Crescitelli recalls.
The vertigo signalled the beginning of new symptoms: frequent, though not daily, headaches, dizziness, and stomach aches. Then, Henry began to complain that his legs ached.
"We assured him that this was normal when someone was growing rapidly and that he could try to stretch and maybe not sleep with the giant family dog so he could have more room at night," said Crescitelli.
Eventually, with his weight plummeting and his sleep increasing more and more, the Crescitellis realised that there was something off with their son.
"My husband and I suspected maybe he was depressed, until one night Joe just looked at me and we both kind of knew that something now was very wrong," said Crescitelli.
They called their nurse practitioner, Pat Chicon, and took Henry in for blood work and a urine test.
Henry was diagnosed with Type 1 diabetes. He was in full-blown diabetic ketoacidosis and had to be admitted to the Children's Hospital of Pennsylvania for four days until he was stabilised.
Type 1 diabetes, an autoimmune disease that causes the body's immune system to attack and destroy the insulin producing cells in the pancreas.
Dr. Nirali Pate is a paediatric emergency medicine physician at Akron Children's Hospital in Ohio. He said that it can be "tough" to recognise the signs and symptoms of Type I diabetes in a teenager.
Dr. Patel said the symptoms of Type 1 diabetes usually include some of the symptoms the Crescitellis saw in Henry, including weight loss and increased fatigue, nausea and abdominal pain, and blurry vision.
But symptoms also usually include increased thirst and hunger, increased urination, and signs of dehydration, like cracked lips, sunken eyes, and pale skin. "Since Henry is a teen, I wasn't tracking his urination or thirst," said Crescitelli.
Crescitelli said she didn't realise that even though teenagers grow taller, they should not lose weight during growth spurts. Henry's other symptoms were only significant once they became part of a pattern.
"Recognition is especially difficult given that most parents would find [the symptoms for Type 1 diabetes] somewhat typical for today's teen," explained Dr. Patel.
"However, it is the appearance of multiple symptoms — symptoms that are out of proportion relative to the teen's baseline behaviour or the emergence of new behaviours — that should alert parents that there may be an underlying medical issue."