Diabetes in children can be Type 1 or Type 2 diabetes, but diabetes type 1 is the most common form of childhood diabetes: 90-95% of children under 16 have type 1 diabetes. Every year 13,000 U.S. children are diagnosed with type 1 diabetes, which is 35 kids every day.
About 2 million teens, 1 in 6 overweight teenagers have elevated blood sugar levels that are not yet in diabetic range. These teenagers are at high risk of getting diabetes in the future.
What is diabetes in children?
Most often diabetes in children is called Type 1 diabetes, but it has previously been called:
- Juvenile-onset diabetes
- Childhood diabetes
- Insulin-dependent diabetes (IDDM)
Type 1 diabetes is caused because the pancreas cannot produce insulin. It is an autoimmune disease, where the body attacks its own cells and thus the cells that make insulin in the pancreas are destroyed.
How common is diabetes in children?
Childhood diabetes is not common, however, over the last 30 years, the number of cases of diabetes in children has tripled. In the US and Europe, diabetes type 2 has now been diagnosed in young people, which is likely related to the increase in obesity among children and young people. However, type 1 diabetes in children are the majority of new diagnoses and cases, and this is perplexing.
What causes childhood diabetes?
It is not known what the causes of diabetes in children may be; however, it is thought that it is a combination of genetics, environmental triggers and autoimmune factors. It is interesting to note that most of the children who are diagnosed with type 1 diabetes did not have a family history of diabetes.
What are the symptoms of diabetes in children?
The main symptoms of diabetes in children are the same as symptoms of type 1 diabetes for adults. Symptoms can come on quickly or over a few weeks. Type 2 diabetes symptoms usually come on very slowly.
Some of the symptoms may be:
- excessive thirst
- unexplained weight loss
- excessive fatigue and tiredness
- frequent urination
- Blurry vision or changes in vision
- Fruity, sweet-smelling breath
- Heavy, troubled breathing
- Loss of consciousness or seeming “out of it”
Symptoms of diabetes that are more typical for children are:
- tummy pains
- irritability, anxiety and behavior problems
- It is possible for a child to experience diabetic acidosis prior to a diagnosis, so it is important to know their symptoms.
If your child is having unexplained stomach pains and history of illness for more than a couple weeks, consider that it may be diabetes. A blood lab test may need to be done to confirm. If your child is diagnosed with diabetes, find a specialist for childhood diabetes.
What is the treatment for diabetes in children?
Diabetes type 1 means that a person is dependent on insulin; this is true for most children with type 1 diabetes. Establishing a insulin routine for your child will be very important, and your doctor and health care diabetes team will support you and your child.
- Most children now have regimens that include receiving a slow-acting insulin injection at night and frequent doses of fast acting insulin during the day (or an insulin pump).
- Young and small children may not need an insulin injection at night, but will likely need it as they grow up.
- Continuous insulin pumps are very helpful for children and more children are using them. They take time to get used to and there are safety guidelines, but are much easier than continuous interruption to have blood sugars checked and receiving frequent insulin shots.
In the first year of diagnosis, your child may need only small doses of insulin because the body is still able to produce enough insulin –this is sometimes called ‘the honeymoon period’. Working together with your child to maintain very good blood sugar control, avoiding hypoglycemia and keeping a good insulin treatment schedule is important for preventing future complications for your child.
What can parents do to help with treatment of diabetes in children?
Your child needs your support and involvement in control and management of diabetes. It can be very difficult for a child to be ‘different’ and to think about responsibilities that other kids don’t have to worry about.
There are 4 important parts that parents can help their child mange, delay and/or deter diabetes in childhood:
- Making Healthy food choices
- 3 main meals with structured meal times so that the whole family eats together and 2-3 healthy snacks to prevent drops and spikes in blood sugar levels. Eat a healthy, balanced diet high in fiber, vegetables, fruits and whole grains. Minimize sweets and white flours and sugars and eat low glycemic foods. Whole foods are best in appropriate portion sizes.
- Once you and your child know how your child’s body responds to various foods and insulin, you can add some sweets in moderation with the appropriate amount of insulin.
- You can work with a dietician/nutritionist to design a nutrition plan that fits your child and your family’s lifestyle. Discuss with your dietitian how much your child should eat based on age and weight.
- Maintaining + Losing weight
- Work with your child’s doctor and/or a dietitian to assess your child’s nutritional needs and weight. If your child needs to be on a diet, work closely with your health care professionals. Be sure that your child continues to get the nutrients they need. Oftentimes, increasing activity is adequate for children.
- Being active
- Exercise and physical exercise are so important to help keep blood glucose levels stable as well as prevent weight gain that will only complicate diabetes.
- Kids should spend 60 minutes every day being active. Limit TV, video games and computer time during the day and encourage active play.
- It can help to get your entire family out doing activities together –bike rides, hikes, etc.
- Working with your child’s plan of care
Living with diabetes can be very stressful for the individual and the entire family, so be sure you have backup support available from social services, your health professionals team and/or extended family.
Learning as much about diabetes and its treatment as you can learn to help your child and family. Your health professional team will help you and your child adjust to, understand and maintain the treatment plan for your child.
Doing these 8 things is a start for managing and treating diabetes for your child:
- Insulin is usually injected into fatty tissue of the abdomen or thighs. Learn to administer insulin shots and take every opportunity to practice so that you will feel more comfortable with it faster.
- Be familiar with symptoms of low blood sugar and diabetic acidosis and know how to treat them.
- Be sure some source of glucose is quickly available in the event of an emergency: juice, snacks, glucose tabs, etc.
- Routinely check blood sugar levels and when your child is old enough, teach them how.
- As soon as your child is old enough (~age 9 is normal), teach them how to self-administer insulin shots to help facilitate independence and responsibility.
- Work closely with your child’s doctor to be sure you are managing the diabetes well. If your child ever becomes sick, be sure to monitor blood sugars closely and visit the doctor in the event that the diabetes medications need to be adjusted.
- Be sure the school and your child’s friends know the symptoms of hypoglycemia and what they should do if there is an emergency.
- Learn what resources are available for help and support, such as your local diabetes association.
Long-term management of diabetes in children
The younger a child is when they develop diabetes, the longer they will live with the risk of complications of diabetes affecting their eyes, heart, kidneys, etc. It is essential that a child receive the best management they can while they are young, because not only does it help establish good habits, but it also minimizes the potential complications they may have into adulthood. Regular check-ups for late state complications will start around the age of 9, and after that this checkup will be done yearly.
Remember that you are your child’s most important influence.
If you eat healthily and make exercise a priority for yourself and your family, then your child will imitate your excellent example.