Caring for Children with Diabetes

Helping a child travel well through life with diabetes takes a team approach, including clinicians, diabetes educators, dietitians, and in some cases, counselors or psychologists. Family is an integral part of that care team, responsible for the day-to-day management of the child's blood glucose and general health.

Type 1 Diabetes in Children

Because type 1 diabetes is usually diagnosed in children, teens, and young adults, it used to be known as “juvenile diabetes.” In this chronic condition, the pancreas stops producing a hormone known as insulin. Insulin’s job is to break down the carbohydrates you eat and turn them into glucose, or “blood sugar.” The glucose travels through the bloodstream, providing energy and nourishment. Without insulin to let glucose into the cells, the body is literally starving for energy. Meanwhile, excess glucose can’t be broken down, so it accumulates in the bloodstream where it can cause serious damage. Because people with type 1 diabetes must take insulin injections to survive, the disease is sometimes called “insulin-dependent” diabetes.

The care regimen for a child with type 1 diabetes requires attention to detail and a constant attention to blood sugar levels and insulin administration. The daily routine may include as many as six to eight injections of insulin and eight to twelve finger sticks to check blood glucose. On days when a child is especially active, an extra nighttime blood glucose test may be required, and parents may have to set their alarm for a 2:00 am reading. Parents need to count carbohydrates at all meals and snacks to determine insulin doses. For the child’s safety, parents must reach out to relatives, teachers, day care providers, friends, and babysitters and educate them about what to do to prevent a medical emergency.

Symptoms of Type 1 Diabetes

Once the pancreas stops producing insulin, the symptoms of type 1 come on very rapidly. These include:

  • Increased thirst
  • Frequent urination
  • Extreme hunger
  • Unintended weight loss
  • Irritability and other mood changes
  • Fatigue and weakness
  • Bedwetting (in children who no longer wet the bed during the night)
  • Blurred vision

Consult your doctor right away if your child develops any of these symptoms.

Type 2 Diabetes in Children

Type 2 diabetes begins with a process called “insulin resistance”. Insulin is a hormone produced by the pancreas, a large organ behind the stomach. Normally, insulin breaks down the carbohydrates you eat and turns them into glucose, or “blood sugar”. The glucose then travels through the bloodstream, providing energy and nourishment. Type 2 diabetes develops when the body starts to “resist” the insulin it produces and stops carrying glucose into the body’s cells. The pancreas tries to compensate for the added demand for insulin by making more. Over time, the pancreas can no longer keep up with the body’s increased need for insulin. Excess sugar accumulates in the bloodstream and begins to cause long-term damage.

While type 2 diabetes remains very rare in children, the condition is on the rise. In the years between 2001 and 2009, SEARCH for Diabetes in Youth, a national study sponsored by the Center for Disease Control, found a 21% increase in type 2 diabetes in children and teens ages 10-19. Experts agree that the most important factor behind this increase is childhood obesity: children diagnosed with type 2 diabetes are invariably overweight.

Getting the child or teen to lose weight and adopt healthier habits is essential. In general, kids with type 2 diabetes need to:

  • Eat a healthy, balanced diet that will help them lose weight and manage their blood sugar while providing the nutrients they need to grow.
  • Get regular exercise.
  • Take medication as prescribed.
  • Monitor blood glucose as recommended by their physician.
  • In addition, the child must be closely monitored for other conditions associated with type 2 diabetes, including obesity, high blood pressure, or abnormal blood lipid (fat) levels.

SOURCES

  1. ADA: http://www.diabetes.org/diabetes-basics/type-1/
  2. GNM Healthcare: http://www.gnmhealthcare.com/pdf/03-2008/03/1534466_Prediabetesandtype2diabet.pdf