Diabetes

Finding out your child has a condition like diabetes can be overwhelming. And, although it’s a disease that will always be part of your child’s life, getting help sooner rather than later is key to successfully managing the disease so your child can live a childhood unrestricted by the condition.

When children are diagnosed with Type 1 or Type 2 diabetes, it means there’s too much glucose — the body’s main source of energy for cells — in their bloodstream. Although glucose is found naturally in child’s body, it also comes from the food they eat. Too much or too little glucose in the blood can cause serious health problems.

Both types of diabetes can occur at any age, but kids with Type 1 diabetes make no insulin, and kids with Type 2 make insulin, but it doesn't work as well as it should.

Insulin is a hormone found in the pancreas that allows sugar to get into cells of the body so that sugar can be used as energy.

 
Symptoms of Children with Diabetes
Some of the most common signs and symptoms of children with diabetes include:
  • extreme thirst
  • frequent urination
  • drowiness, lethargy
  • sugar in urine
  • sudden vision changes
  • increased appetite
  • sudden weight loss
  • fruity or sweet-like odor on breath
  • heavy or labored breathing
 
Diagnosing Children With Diabetes

Children diagnosed with Type 1 diabetes are typically diagnosed after presenting with symptoms such as unexplained weight loss, excessive urination, or excessive thirst. Children are diagnosed with Type 2 diabetes typically through a urine sample during a routine examination and symptoms are less dramatic.

Some lab tests that may be used to diagnose diabetes include:
  • fasting plasma test (FPG): a blood test that measures blood glucose in someone who has fasted for at least 8 hours
  • oral glucose tolerance test (OGTT): this test is given to someone who has fasted for 8 hours and then is asked to drink a glucose-containing beverage
  • random plasma glucose test: this blood glucose test is done without regard to fasting
 
Nutrition Tips for Children with Diabetes

At Nemours, our registered dietitians are part of your child’s diabetes care team. Nutrition is an important part of proper diabetes management. It’s not only about counting carbohydrates; it’s about healthy eating habits that are enjoyable.

Developing a Healthy Meal Plan

Healthy food choices should be encouraged for all family members. A registered dietitian at Nemours can help plan a healthy meal plan for your child with diabetes. Just as your child grows and develops, so must your child’s meal plan.

A healthy meal plan includes certain types of carbohydrates (carbs), lean protein, and fat and can be used for children with diabetes and without.

Carbohydrates are found in foods such as bread/starch, fruit, milk, and sweets. Eating carbs makes blood sugar levels rise, but that doesn’t mean that people with diabetes should avoid them — the body needs carbs. Since they affect blood sugar levels, it’s recommended children with diabetes track how many carbs they eat.

Follow these tips for healthy nutrition:

Choose healthy carbs that provide fiber, vitamins, and other nutrients,
such as:

  • whole wheat/grains instead of white bread, white pasta, or white rice
  • fresh fruit instead of fruit juices
  • fat-free or 1% milk instead of whole or 2% milk
  • light ice cream instead of full fat ice cream
  • limit desserts like cake, cookies, and candy, to special occasions

Choose protein from lean meats (cuts of beef and pork that end in “loin” or skinless chicken/turkey), egg whites, reduced-fat cheese, nuts, tofu, and beans.

Avoid foods high in saturated fats and trans fats, as these can raise heart-damaging cholesterol in the body. Choose heart-healthy fats, such as olive oil, canola oil, peanuts, and avocado. Remember that all fats are high in calories, so watch your portion sizes if you are trying to lose or maintain weight.

Drink mainly water instead of regular soda, fruit punch, sweet tea, and other sugary drinks. It’s OK to have calorie-free “diet” drinks occasionally.

Watch your portion sizes! Eating too much of even healthy foods can lead to excessive weight gain.

Diabetes Control: Why It's Important

You've probably heard your child's doctor talk a lot about "diabetes control," which usually refers to how close the blood sugar, or glucose, is kept to the desired range. What does this mean and why is it important?

What Happens in Diabetes?

When Diabetes Isn't Under Control

Too much or not enough sugar in the bloodstream can lead to short-term problems that must be treated right away, like hypoglycemia, hyperglycemia, or diabetic ketoacidosis.

Too much sugar in the bloodstream also can cause long-term damage to the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems.

These problems don't usually affect kids or teens with diabetes who've had the disease for only a few years. But they can occur in adults with diabetes, particularly if they haven't managed or controlled their diabetes properly.

Kids with diabetes who don't control their blood sugar levels may also have problems with growth and development and can even experience a delay in the onset of puberty.

Also important is avoiding frequent and/or severe episodes of hypoglycemia (low blood sugar), which can interfere with participation in school and other activities, making it hard for kids to cope with their diabetes and achieve a healthy, happy childhood and adulthood.

Controlling diabetes means keeping blood sugar levels as close to normal as possible. It's a three-way balancing act: Your child's medications (such as insulin), food, and activity level all need to be balanced to keep blood sugar levels under control. If any one of these is off, blood sugar levels will be, too.

In general, poorly controlled blood sugar levels can be due to any of the following:

  • not taking medications as prescribed
  • not following the meal plan (like eating too much or not enough food without adjusting medications)
  • not getting regular exercise or not making the necessary adjustments in the diabetes treatment plan when there is a significant change in physical activity level
  • illness or stress
  • not monitoring blood sugar levels closely enough so that changes can be recognized and addressed promptly

The Benefits of Good Control

The complications associated with diabetes can seem frightening, but the good news is that studies have shown that people with diabetes who keep their blood sugar levels as close to normal as possible have a much lower likelihood of developing diabetes complications.

One large study showed that people with type 1 diabetes who checked blood sugar levels four or more times a day — and adjusted the amounts of insulin and other diabetes medicines, diet, and exercise based on their readings — had a reduced risk of developing eye disease, kidney problems, nerve damage, and high cholesterol levels (a major risk factor for heart disease).

How to Know if Diabetes Is Under Control

How do you find out if your child's diabetes is under control? First, the diabetes health care team will tell you what the blood sugar levels should be (the "target" range), which is based on factors such as your child's age and medical condition.

Day to day, the only way to know if the blood sugar levels are close to your child's target range is to measure them several times a day with a glucose meter. The diabetes health care team will recommend how and when to test based on your child's treatment plan. Checking regularly and keeping an organized and accurate record of the results will ensure that the health care team has the information needed to adjust your child's diabetes management plan.

Besides daily checks with a glucose meter (to measure the current blood sugar level), you might also use the glycosylated hemoglobin test, which shows blood sugar levels over a longer period. The HbA1C test will give you and the health care team information about your child's blood glucose control during the 2 to 3 months before the test.

Helping Your Child Control Diabetes

Helping your child achieve good blood sugar control can be challenging. Here are some tips:

  • Make sure your child takes insulin or other diabetes medicines as prescribed.
  • Provide meals and snacks that fit into your child's meal plan.
  • Encourage your child to engage in regular physical activity.
  • Check blood sugar levels often and make changes in the treatment plan with guidance from the diabetes health care team.
  • Make sure your child gets regular medical checkups.
  • Learn as much as possible about diabetes.

Working with the diabetes health care team will help you better understand and manage the challenges of diabetes and help your child avoid many of the problems associated with it.

Reviewed by: Steven Dowshen, MD
Date reviewed: April 2011