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.

Type 1 Diabetes: What Is It?

If you have a child who has been diagnosed with diabetes, you're not alone. Every year in the United States, 13,000 children are diagnosed with type 1 diabetes, and more than 1 million American kids and adults deal with the disease every day.

Diabetes is a chronic condition that needs close attention, but with some practical knowledge, you can become your child's most important ally in learning to live with the disease.

About Diabetes

What Happens in Diabetes?Diabetes is a disease that affects how the body uses glucose, the main type of sugar in the blood. Glucose comes from the foods we eat and is the major source of energy needed to fuel the body's functions.

After you eat a meal, your body breaks down the foods you eat into glucose and other nutrients, which are then absorbed into the bloodstream from the gastrointestinal tract. The glucose level in the blood rises after a meal and triggers the pancreas to make the hormone insulin and release it into the bloodstream. But in people with diabetes, the body either can't make or can't respond to insulin properly.

Insulin works like a key that opens the doors to cells and allows the glucose in. Without insulin, glucose can't get into the cells (the doors are "locked" and there is no key) and so it stays in the bloodstream. As a result, the level of sugar in the blood remains higher than normal. High blood sugar levels are a problem because they can cause a number of health problems.

What Is Type 1 Diabetes?

There are two major types of diabetes: type 1 and type 2. Both type 1 and type 2 diabetes cause blood sugar levels to become higher than normal. However, they cause it in different ways.

Type 1 diabetes (formerly called insulin-dependent diabetes or juvenile diabetes) results when the pancreas loses its ability to make the hormone insulin. In type 1 diabetes, the person's own immune system attacks and destroys the cells in the pancreas that produce insulin. Once those cells are destroyed, they won't ever make insulin again.

Although no one knows for certain why this happens, scientists think it has something to do with genes. But just getting the genes for diabetes isn't usually enough. A person probably would then have to be exposed to something else — like a virus — to get type 1 diabetes.

Type 1 diabetes can't be prevented, and there is no practical way to predict who will get it. There is nothing that either a parent or the child did to cause the disease. Once a person has type 1 diabetes, it does not go away and requires lifelong treatment. Kids and teens with type 1 diabetes depend on daily insulin injections or an insulin pump to control their blood glucose levels.

Type 2 diabetes (formerly called non-insulin-dependent diabetes or adult-onset diabetes) is different from type 1 diabetes. Type 2 diabetes results from the body's inability to respond to insulin normally. Unlike people with type 1 diabetes, most people with type 2 diabetes can still produce insulin, but not enough to meet their body's needs.

Signs and Symptoms of Type 1 Diabetes

A person can have diabetes without knowing it because the symptoms aren't always obvious and they can take a long time to develop. Type 1 diabetes may come on gradually or suddenly.

Parents of a child with typical symptoms of type 1 diabetes may notice that their child:

  • urinates frequently. The kidneys respond to high levels of glucose in the bloodstream by flushing out the extra glucose in urine (pee). A child with diabetes needs to urinate more frequently and in larger volumes.
  • is abnormally thirsty. Because the child is losing so much fluid from peeing so much, he or she becomes very thirsty to help avoid becoming dehydrated. A child who has developed diabetes drinks a lot in an attempt to keep the level of body water normal.
  • loses weight (or fails to gain weight as he or she grows) in spite of a good appetite. Kids and teens who develop type 1 diabetes may have an increased appetite, but often lose weight. This is because the body breaks down muscle and stored fat in an attempt to provide fuel to the hungry cells.
  • often feels tired because the body can't use glucose for energy properly.

But in some cases, other symptoms may be the signal that something is wrong. Sometimes the first sign of diabetes is bedwetting in a child who has been dry at night. The possibility of diabetes should also be suspected if a vaginal yeast infection (also called a Candida infection) occurs in a girl who hasn't started puberty yet.

If these early symptoms of diabetes aren't recognized and treatment isn't started, chemicals called ketones can build up in the child's blood and cause stomach pain, nausea, vomiting, fruity-smelling breath, breathing problems, and even loss of consciousness. Sometimes these symptoms are mistaken for the flu or appendicitis. Doctors call this serious condition diabetic ketoacidosis, or DKA.

In addition to short-term problems like those listed above, diabetes can also cause long-term complications in some people, including heart disease, stroke, vision impairment, and kidney damage. Diabetes can also cause other problems throughout the body in the blood vessels, nerves, and gums. These problems don't usually show up in kids or teens with type 1 diabetes who have had the disease for only a few years. However, they can occur in adulthood in some people with diabetes, particularly those who haven't managed or controlled their diabetes properly.

There's good news, though — proper treatment can stop or control these diabetes symptoms and reduce the risk of long-term problems. Doctors can say for sure if a person has diabetes by testing blood samples for glucose. If you think your child has symptoms of diabetes, talk to your doctor.

If the diagnosis of diabetes is suspected or confirmed, the doctor may refer your child to a pediatric endocrinologist, a doctor who specializes in the diagnosis and treatment of kids with diseases of the endocrine system, such as diabetes and growth disorders.

Living With Type 1 Diabetes

Kids and teens with diabetes need to monitor and control their glucose levels. They need to:

  • check blood sugar levels a few times a day by testing a small blood sample
  • give themselves insulin injections, have an adult give them injections, or use an insulin pump
  • eat a balanced, healthy diet and pay special attention to the amounts of sugars and starches in the food they eat and the timing of their meals
  • get regular exercise to help control blood sugar levels and help avoid some of the long-term health problems that diabetes can cause, like heart disease
  • work closely with their doctor and diabetes health care team to help achieve the best possible control of their diabetes and be monitored for signs of diabetes complications and other health problems that occur more frequently in kids with type 1 diabetes

Living with diabetes is a challenge, no matter what a child's age, but young kids and teens often have special issues to deal with. Young kids may not understand why the blood samples and insulin injections are necessary. They may be scared, angry, and uncooperative.

Teens may feel different from their peers and may want to live a more spontaneous lifestyle than their diabetes allows. Even when they faithfully follow their treatment schedule, teens with diabetes may feel frustrated when the natural adolescent body changes during puberty may make their diabetes somewhat harder to control.

Having a child with diabetes may seem overwhelming at times, but you're not alone. Your child's diabetes care team is not only a great resource for dealing with blood sugar control and medical issues, but also for supporting and helping you and your child cope and live with diabetes.

What's New in the Treatment of Type 1 Diabetes?

Doctors and researchers are developing new equipment and treatments to help kids cope with the special problems of growing up with diabetes.

Some kids and teens are already using devices that make blood glucose testing and insulin injections easier, less painful, and more effective. One of these is the insulin pump, a mechanical device which can be used to deliver insulin more like the pancreas does. There's also been progress toward the development of a wearable or implantable "artificial pancreas." This consists of an insulin pump linked to a device that measures the person's blood glucose level continuously.

Doctors and scientists are also investigating a potential cure for diabetes. This involves transplanting insulin-producing cells into the body of a person with diabetes. Researchers are also testing ways to stop diabetes before it starts. For example, scientists are studying whether diabetes can be prevented in those who may have inherited an increased risk for the disease.

Until scientists have perfected ways to better treat and possibly even prevent or cure diabetes, parents can help their kids lead happier, healthier lives by giving constant encouragement, arming themselves with diabetes information, and making sure their children eat properly, exercise, and stay on top of blood sugar control every day. Doing so will enable their kids to do all the things that other kids do while helping them grow up to be healthy, well-adjusted, productive adults.

Reviewed by: Steven Dowshen, MD
Date reviewed: April 2012