Diabetes generally comes in one of two forms: type 1 and type 2. The type of diabetes diagnosed in children is usually type 1, or "insulin-dependent" diabetes. Children with type 1 diabetes lose the ability to make insulin in their pancreas. Type 2 diabetes is found in increasing numbers in youth, which used to be mostly found in adults. Kids with type 2 diabetes do not make enough insulin, or the body is resistant to insulin, and it is mostly due to excess body weight.
Causes
The cause of type 1 diabetes is unknown, though it could be related to genetics. Children with a close relative with type 1 diabetes are at higher risk of developing diabetes. Type 2 diabetes tends to be inherited as well. Certain ethnicities, such as African-Americans, Native Americans and Hispanic Americans have a greater risk of developing type 2 diabetes. Obesity is a major risk factor for developing type 2 diabetes, and with the increasing obesity rate in children, an increasing number of children are being diagnosed with type 2 diabetes, which used to be seen only in adults 45 and older.
Symptoms
Unlike adults, symptoms of diabetes in children often develop quickly over a few weeks, especially in type 1 diabetes. These symptoms include increased thirst and urination. The child may complain of extreme hunger, as the glucose from food is not able to enter cells for energy. Significant weight loss and fatigue are also very common due to lack of energy supply to the body. Type 2 diabetes develops more slowly, with symptoms similar to those of type 1 diabetes. Some female children or adolescents may develop a vaginal yeast infection.
Management
To achieve optimal blood sugar levels, children and adolescents with type 1 diabetes require daily injections of insulin or the use of an insulin pump. Those with type 2 diabetes manage it with diet and exercise, diabetic medication and sometimes insulin. The child will also need to monitor blood sugar several times a day. Checking blood sugar is very important, as the results will help determine the dose of insulin needed to keep his blood sugar levels within an acceptable range. The acceptable range varies with age. In general, it is 100 to 200 mg per deciliter for toddlers and preschoolers, 90 to 180 mg per deciliter for school-age children and 90 to 150 mg per deciliter for adolescents.
Diet
Healthy eating is very important as children need nutrients to grow. However, parents may be concerned that the intake of carbohydrates will increase blood sugar levels. Fast-acting insulin is available that allows parents to give insulin right after a meal based on the amount of carbohydrates consumed. The diabetes team will work with the child and his family to determine an insulin-to-carbohydrate ratio that is appropriate for him.
Exercise
The changing pattern of physical activity in toddlers and children can make it challenging to manage blood sugar levels. It is a good idea to always keep snack foods on hand. Children with diabetes may need to eat snacks before, during or after exercise depending on the intensity and length of exercise. They also need to check blood glucose levels before and after the activity to prevent hypoglycemia. For those with type 2 diabetes, exercise is important to help children control their weight.
