The awareness, testing, and management of type 1 and type 2 diabetes continues to improve. The early detection of juvenile-onset diabetes plays a critical role in managing the condition, and improving a child’s chances of a high-quality life.
What Is Diabetes?
Diabetes mellitus is a chronic medical condition in which the pancreas cannot make the hormone insulin (type 1), or the body cannot properly use the insulin (type 2). Insulin allows glucose, a source of fuel used by cells, to pass from the bloodstream into cells. Abnormal levels of blood glucose from untreated diabetes will damage multiple organs over time, particularly the heart and blood vessels (heart attacks, strokes), and other organs including the kidney (kidney failure) and eyes (blindness). Over time untreated diabetes will damage the nervous system and affect brain functions.
The Different Forms of Diabetes
Diabetes is divided into two different forms: type 1 and type 2 diabetes. Both types of diabetes can develop at any age. Children are more likely to be diagnosed with type 1 diabetes.
What Is Type 1 Diabetes?
Type 1 diabetes develops when the individual’s pancreas does not produce enough of a special hormone called insulin. This essentially prevents their body from being able to use the sugar known as glucose. The digestive process converts carbohydrates, proteins and fats into glucose to be used as a source of energy by many organs, especially the brain. In the absence of insulin, glucose builds up in the bloodstream. When the excess sugar is excreted from the body in the kidney, it takes large amounts of water with it leading to one of the most severe presenting signs of diabetes – dehydration. It also explains how the disease got its name, diabetes mellitus, or “sweet urine”.
High blood glucose levels cause complications for the kidneys, the heart, and other organs. Chronic dehydration caused by frequent urination can cause other health complications over time.
What Are Symptoms of Juvenile Type 1 Diabetes?
A first symptom of juvenile-onset type 1 diabetes is an increase in how often a child urinates (polyuria). Bedwetting may be present, even in a child who has been completely potty trained. Other key symptoms of type 1 diabetes in a child include:
- Being very thirsty and increased drinking of fluids (polydipsia)
- An increased appetite despite increased eating (polyphagia)
- Losing weight
- Constantly feeling tired
Children with type 1 diabetes are most often diagnosed around the ages of 5 or 6 years, with another peak diagnosis window in the 11 to 13 year age range.
It’s important to note that high blood sugar levels and dehydration caused by uncontrolled diabetes are dangerous and might cause children to need intravenous insulin and fluids in a pediatric emergency room or critical care unit. Low blood insulin levels also lead to a condition known as ketoacidosis caused by effects on fat metabolism. Ketoacidosis is very serious and can lead to coma and shock if not treated promptly.
What Is Type 2 Diabetes?
In the past, Type 2 diabetes was mistakenly referred to as “adult onset diabetes” because it was uncommon in children. Unfortunately, with increasing rates of childhood obesity, a shocking number of children are being diagnosed with type 2 diabetes at an earlier age.
Unlike type 1 diabetes, children diagnosed with juvenile-onset type 2 diabetes often have a family member with diabetes. There is a high correlation between being overweight or obese and type 2 diabetes. This is because obesity leads to a condition known as insulin resistance. Unlike type 1 diabetes, patients with type 2 diabetes have plenty of insulin. Their body fails to recognize it, and acts like it is not there. Diabetes can develop as a complication of pregnancy. Both the mothers and their infants with this condition are at increased risk of developing type 2 diabetes later on.
What Are Common Symptoms of Juvenile Onset Type 2 Diabetes?
Many of the symptoms of juvenile-onset type 2 diabetes are similar to type 1 diabetes, though because they have some insulin that works, the symptoms develop more gradually. Dehydration and ketoacidosis are less common, though still occur.
Managing Blood Sugar to Control Diabetes
It’s important to understand that even though there currently is no cure for diabetes, a child who is diagnosed with diabetes can still lead a very normal life as long as their blood sugar is properly managed.
The first step is frequent blood sugar monitoring. Measuring blood sugar levels multiple times per day by finger stick or digital glucose monitoring device provides the information needed to make informed decisions about insulin treatment to control blood sugar. Insulin then can be delivered by injection or by pump several times a day to maintain glucose levels close to the normal range.
By keeping blood sugars within a normal range, your child ultimately lowers the risk of acute and long-term health problems that can occur over time with mismanagement.
Maintaining a healthy diet, and exercising frequently to stay active are the next important step in controlling glucose. Your child should get at least 30 minutes of exercise each day to help maintain a healthy quality of life. Healthy eating helps minimize wide variations in blood sugar and makes management with insulin easier.
These are all habits that your child will need to maintain for the rest of their lives. Instilling good practices when they are young, will help them learn to effectively manage their blood sugar and other diabetes symptoms later in life.
What Can Parents Do to Help A Child With Diabetes?
The amount of help and support your child needs from you to manage their diabetes will undoubtedly change as they get older, and become more independent.
The younger the child, the more dependent they are on their parents to make the food, exercise and testing decisions they need to control blood glucose. Parents of very young children administer their insulin injections or make changes to insulin pumps when needed.
Children over the age of 7 typically have the fine motor skills to administer their insulin injections under your adult supervision, though not all are ready to do so
By the age of 7 or 8, your child may also be capable of learning how to check their blood sugar several times per day. This usually involves simple, chemically treated test strips and a blood sugar meter. There are also new technologies that affix a glucose monitor to the skin. It then sends active information to a smartphone app, letting them and you monitor their blood glucose levels.
Many children are capable of independently monitoring their own blood glucose levels, and administering their own insulin by the age of 13. Careful monitoring is still wise. If your child accidentally takes too much insulin, their blood sugar can dip too low, causing hypoglycemia. This can cause trembling, a rapid heartbeat, nausea, fatigue, weakness, and even loss of consciousness.
Developing good diabetes management habits in childhood can have a significantly positive impact on your child’s management habits as they get older. Many communities also have active parent groups that share and discuss common concerns. You might want to ask your pediatrician for a recommendation.
