According to the American Diabetes Association, diabetes is a group of diseases characterized by high blood glucose, or sugar levels, resulting from defects in the body's ability to produce and/or use insulin. Normally, when we eat carbohydrates from sugar or starches, they are broken down in the stomach to sugar. This sugar is then absorbed into the blood, which carries the sugar throughout the body to give tissues the energy they need. As we eat and our blood glucose level rises, our body responds by producing insulin. Insulin acts like a key to open doors, called receptors, on cells to let the sugar inside. When the body cannot make or use enough insulin, the sugar can't get inside the cells the way it should. It builds up in the blood, causing hyperglycemia.
Type 1 Diabetes
In young children, the most common type of diabetes is type 1 diabetes --- formerly known as juvenile onset or insulin-dependent diabetes. In type 1 diabetes, the islet cells of the pancreas no longer produce insulin. The insulin has to be replaced using shots or an insulin pump. According to MayoClinic.com, the exact cause of type 1 diabetes is unknown. In most cases, the body's immune system mistakenly destroys the insulin-producing islet cells. Genetics may play a role, as well as exposure to certain viruses. There is no known way to prevent type 1 diabetes.
Symptoms
When blood glucose becomes high, excess sugar is excreted in the urine, taking a lot of fluid with it; fluid is also pulled from body tissues. This leads to excessive thirst and frequent urination. Because the body's tissues aren't receiving the energy they need, they signal the brain that they need food. This causes extreme hunger. Also, the sugar is being excreted in the urine instead of being absorbed into the cells. This leads to weight loss. Changes in fluid in the lens of the eye can cause blurred vision. Your child may experience fatigue, irritability or unusual behavior. In girls, the first symptom may be a genital yeast infection. Symptoms usually develop quickly, over a period of weeks.
Preparing for an Appointment
If your child has any of the symptoms of diabetes, which include increased thirst, frequent urination, extreme hunger, weight loss, blurred vision or fatigue, you should talk to his doctor. After an initial diagnosis of diabetes, your child may be sent straight to the hospital. Hospital staff will stabilize his blood sugar level and begin teaching you and your child about insulin, nutrition and more. A team that includes a pediatric endocrinologist, a diabetes educator and a registered dietitian will probably manage your child's ongoing diabetes care. MayoClinic.com recommends preparing for any appointments by writing down any concerns that you want to discuss, writing down questions you have, bringing paper and pen to record important information, and bringing a family member or friend to help you remember things.
Tests and Diagnosis
Usually, type 1 diabetes is diagnosed by checking a random blood glucose level. A blood glucose reading greater than 200 mg/dl, even if your child has just eaten, indicates diabetes. The doctor may follow up with tests for autoantibodies to determine whether the diabetes is type 1 or type 2. The presence of ketones in the urine suggests type 1 diabetes. The doctor may also do a fasting blood sugar test in which a blood glucose reading greater than 126 mg/dl on two separate tests indicates diabetes, while 100-125 mg/dl is considered pre-diabetes. The glycated hemoglobin, or A1C, test indicates average blood sugar over 2 to 3 months. It can be used to diagnose diabetes, which is indicated by a result of 6.5 percent or higher on two separate tests. It can also monitor how well the blood sugar is being managed.
Treatment
There is no cure for diabetes; however, with education and good management of blood sugar levels, your child can lead a long, healthy life. Treatment includes a combination of medication, blood sugar monitoring, healthy nutrition and regular exercise. Because the pancreas can no longer make insulin, it must be replaced via injections or an insulin pump. Your child will still need a healthy diet that includes plenty of whole grains, fruits and vegetables, but eating consistent amounts of these carbohydrate foods helps to stabilize blood sugar. It is also important for your child to be physically active. The diabetes team specializes in helping you and your child put all of these factors together for overall health and optimal blood sugar control.
Type 2 Diabetes
In type 2 diabetes, the pancreas is still producing insulin, but the cells resist it; this is called insulin resistance. Sugar can't get inside the cells and builds up in the blood. Although type 2 diabetes is usually diagnosed in adults aged 40 years or older, 2010 information from the Centers for Disease Control and Prevention indicates a rise in children being diagnosed with type 2 diabetes over the last two decades; these children are usually over the age of 10. Obesity and inadequate physical activity are major contributors. Symptoms are similar to those for type 1 and include increased urination, thirst and hunger; weight loss; fatigue; and blurred vision. In addition, slow-healing sores or frequent infections can be a sign of type 2 diabetes. Some children may have areas of darkened skin in folds and creases, usually the armpits and neck. Talk to your doctor if your child has signs or symptoms of type 2 diabetes.
