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:
sugar in urine
sudden vision changes
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,
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.
Understanding DIABETES, By H. Peter Chase, MD, published by Children’s Diabetes Foundation at Denver (ISBN 978-098326500-9). An instructional manual for families of children with diabetes.
Urine Test: Microalbumin-to-Creatinine Ratio
What It Is
A microalbumin-to-creatinine ratio urine test involves measuring the amount of a protein called albumin in the urine. The amount of urine albumin is compared with the quantity of a waste product in the urine called cretonne.
The body normally filters out creatinine in the urine at a steady rate, so comparing the ratio of urine albumin with creatinine in the same urine specimen helps determine if the body is excreting albumin at an increased rate. If this is occurring it may be the result of kidney disease.
In most healthy people, the kidneys prevent albumin and other proteins from entering the urine. However, if kidneys are damaged and start to allow proteins to pass from the blood into the urine, the first type of protein to appear in the urine is albumin. This is because albumin molecules are smaller than most other protein molecules.
The consistent presence of small amounts of albumin in the urine is called microalbuminuria and is associated with early-stage kidney disease. Once there are larger amounts of albumin in the urine it is called macroalbuminuria and it could indicate more severe kidney disease.
Why It's Done
The microalbumin-to-creatinine ratio test is most commonly used to screen for kidney problems in teens with diabetes. It also might be done on a more regular basis, like once a year, in teens with diabetes to help in early identification of kidney disease.
It also can be used to monitor kidney function in kids and teens already diagnosed with kidney disease or taking medications that can affect the kidneys. The test can also help detect kidney complications from hypertension and autoimmune diseases.
Your child might need to temporarily stop taking specific drugs that could interfere with test results. Be sure to review all your child's medications with your doctor.
Your child will be asked to urinate (pee) into a clean sample cup in the doctor's office or at home. Collecting the specimen should only take a few minutes. If your child isn't potty trained and can't urinate into a cup, a catheter (a narrow, soft tube) may need to be inserted into the bladder to obtain the urine specimen.
A urine collection bag with adhesive tape on one end might instead be used to collect a sample from an infant. If you're doing the collection at home, you'll clean your baby's genital area and then attach the bag around the urinary opening. Once the bag is in place, you'll secure it with the attached tape. You can put a diaper on your baby once you've attached the bag. Remove the collection bag after your baby has urinated into it, usually within an hour. Deliver this specimen to your lab.
Sometimes, a doctor will want to test urine collected over a period of time ranging from 4 to 24 hours. After each urination, you or your child will pour the specimen from the sample cup into a larger container. Be careful not to touch the inside of the container. During the testing period, all the urine should be collected, even if it is just a small amount.
For specimens collected at home, follow any storage and transportation instructions the lab gives you. At the lab, the technician will determine the quantity of albumin in the urine and compare it with the amount of creatinine in the urine.
What to Expect
Because the test involves normal urination, there shouldn't be any discomfort as long as your child can provide a urine specimen. It's important to keep the area around the urinary opening clean before the test.
Getting the Results
The results of the microalbumin-to-creatinine test will be available in 1-3 days. It's important to know that children sometimes pass albumin in their urine even though they have no kidney damage.
If the test shows abnormal results, further tests will be ordered to determine if there's an illness and, if so, help diagnose it. Talk to your doctor about the meaning of the specific test results.
No risks are associated with the urine microalbumin-to-creatinine ratio test. Infants may occasionally experience skin irritation from the adhesive tape on the collection bag. If a catheterized specimen is required it may cause temporary discomfort.
You can discuss any questions you have about this procedure with your doctor.
Helping Your Child
The urine microalbumin-to-creatinine ratio test is painless. Explaining in simple terms how the test will be conducted and why it's being done, can help ease any fear. Make sure your child understands that there should be no foreign matter, such as toilet paper or hair, in the sample.
If You Have Questions
If you have questions about the microalbumin-to-creatinine ratio test, speak with your doctor.