Fourteen-year-old Zara Holland-Martin from Rayleigh loves singing, listening to music and dancing ballet and contemporary.
In August 2025, at 13 years old, she became critically ill and developed diabetic ketoacidosis (DKA). This is a serious complication of type 1 diabetes when the body does not have enough insulin.
At one stage, her family were told to prepare for the worst. Thankfully, Zara recovered, thanks to the medical and support teams who cared for her.
Now, Zara and her mum, Mandy, raise awareness about type 1 diabetes and DKA. They bring other type 1 diabetes families together offering advice, guidance and shared experiences. This helps children and young people with type 1 diabetes meet others with the same condition.
The lead up to hospital admission
In the months before Zara became seriously ill, the signs of her undiagnosed type 1 appeared slowly. She complained about stomach pains, backaches and felt tired all the time. She was always thirsty, needed to use the toilet more frequently and suffered from dizziness. The family visited their GP practice, but the symptoms were initially thought to be related to other causes.
In early August 2025, Zara’s situation escalated during a family weekend away. Zara was visibly thinner and mentioned her clothes felt loose and big. She had to keep stopping on family outings due to exhaustion. Mandy says:
She then developed an unquenchable thirst, drinking massive amounts of fluids and using the toilet constantly. Due to the warm weather, I mistakenly thought she just needed to keep hydrated. That evening she was sick a lot.
Two days later, Zara was too exhausted to leave the car during our trip and asked to go home. When we arrived home, she was sick repeatedly and told me she couldn’t breathe. She had deep, rapid and laboured breathing. We checked her heart rate, which was 178bpm, and took her straight to Southend Hospital.
Emergency response
When they arrived at A&E, Zara was immediately triaged and diagnosed with type 1 diabetes and diabetic ketoacidosis (DKA). Within 15 minutes, 17 staff members were around her bed. Hospital staff activated the Paediatric and Neonatal Decision Assessment (PANDA) protocol. A specialist team from Addenbrooke’s Hospital in Cambridge then guided her care via phone every 15 minutes.
Mandy continues:
While the medical team were asking me questions, they told me that they were wiring Zara up to a defibrillator in case her heart stopped. It was at this point that staff told me to call my family to come to the hospital, prepare for the worst, and say my goodbyes because she was not expected to live.
Zara was moved to the adult intensive care unit where she was monitored constantly. Staff told the family that cases like Zara’s are uncommon.
Making progress
She slowly began to get better. Although she was still very fragile, she continued to improve and was moved to paediatric care. Mandy says:
During her week in hospital, I remember the diabetes nurses visiting to give her a ‘Rufus Bear’ (an educational stuffed bear for type 1 diabetes children) and fitting her very first Continuous Glucose Monitor on her arm to track her glucose levels automatically.
A terrifying experience
“It is hard to comprehend how quickly life changed in just a few days.
Mandy explains
Our experience felt like a catastrophic plane crash rather than a managed emergency landing. Her siblings are still adjusting to the emotional turmoil of what they saw.
Zara doesn’t remember much of the time in intensive care but has vivid memories of certain moments and those who she formed the closest bonds with.
I live with a heavy sense of guilt that I failed her by not recognising the signs.
I had absolutely no idea what the 4Ts were, what the signs of type 1 diabetes look like or how life-threatening DKA can be.
Know the 4Ts
- Toilet – going to the toilet more often, bedwetting by a previously dry child or heavier nappies in babies
- Thirsty – being constantly thirsty and not being able to quench it
- Tired – feeling very tired and having no energy
- Thinner – losing weight or looking thinner than normal
Living with type 1 diabetes
Zara now manages her diabetes well and uses a glucose monitor and insulin pump. Before eating, Zara enters the carbohydrates in her food into her device, which automatically calculates and delivers the insulin she needs. Mandy says:
This technology has given her back her independence, confidence, and freedom to live like any other teenager.
I support her by helping calculate her meal carbohydrates to ensure accuracy. Managing this condition is hard work, and celebrating her resilience is what she responds to best.
Zara’s friends and family are very supportive and understand that she needs insulin to stay alive. They look out for her, have learnt the signs and symptoms and remind her to check her levels. The community diabetes nurses have worked with her school to provide training support.
Making a difference and a note of gratitude
Mandy says:
We want to ensure other parents recognise the signs. No family should ever have to endure the trauma we went through.
We also know that other families have not been as fortunate as us. Tragically, there are parents who have lost their children to DKA from undiagnosed type 1 diabetes.
We, as a whole family, cannot thank the medical and support teams enough for all their care, compassion, attention, and support.
Our diabetes team is brilliant. They completely understand the lifestyle changes and the profound effect this diagnosis has on the family. We truly couldn’t be supported by anyone better.
Before she became ill, Zara wanted to be a lawyer. However, after going through this experience, she now wants to become a paediatric nurse so she can care for children, just like the team who saved her.
Why early diagnosis matters
More than one in four children and young people with newly diagnosed type 1 diabetes are admitted to hospital with DKA. These figures were reported in the National Paediatric Diabetes Audit Report on Care and Outcomes 2024/25, published by the Royal College of Paediatrics and Child Health.