Type 1 diabetes is the most common form of the condition among children and adolescents. A 2009 report from the Centers for Disease Control and Prevention (CDC) revealed that type 1 diabetes prevalence stands at 1.93 in every 1,000 children and adolescents, while type 2 diabetes affects 0.24 in every 1,000.
Since the 1980s, the number of children being diagnosed with type 1 diabetes has gradually crept up at a rate of about 3 to 5 percent per year. That may not sound like much, but it’s startling when you consider that twice as many children are diagnosed with type 1 diabetes today than were diagnosed 20 to 25 years ago. Although the condition can develop at any age, we’re seeing it at younger ages than ever before and more toddlers and preschoolers are being diagnosed.
Experts believe that environmental factors like children’s reduced exposure to germs may be partly to blame (a theory known as the hygiene hypothesis). Reduced exposure to early-childhood infections may also alter certain children’s immune response, leading to the autoimmune attack on the body’s insulin-producing beta cells.
Why some kids get type 1 diabetes is also a mystery. White children and those with a family history of type 1 diabetes are most at risk, but only about 10 percent of those with type 1 diabetes have a family history of the disease.The exact cause of type 1 diabetes is unknown.
Scientists do know that in most people with type 1 diabetes the body’s own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet) cells in the pancreas. Genetics may play a role in this process, and exposure to certain viruses may trigger the disease. Sometimes, a child develops Type 1 diabetes after being exposed to a virus like the ones that cause mono (Epstein-Barr) or hand-foot-mouth disease (which includes viruses such as Coxsackie).
Misconceptions about Type 1 diabetes
Let’s set the record straight about some hurtful untrue comments that many people(adults and children) with type 1 diabetes often hear:
“You must have OD’d on sugar to get type 1 diabetes.”
“Type 1 is like being hit by lightning. It happens sometimes, and it’s not anybody’s fault,” says Steven Griffen, MD, a vice president for JDRF (formerly called the Juvenile Diabetes Research Foundation). “Unfortunately, we don’t know exactly what causes type 1 diabetes, and researchers are still trying to get a clear picture about genetic and environmental factors that may play roles, including exposure to viruses or bacteria that live in your gut.”
One thing we do know, though, is that it’s not brought on by too much sugar.
Diabetes in children: What Are The Signs?
Type 1 diabetes in children, previously called juvenile diabetes, occurs when the pancreas is unable to produce enough of the hormone insulin. Children with the condition will require lifelong insulin injections and blood sugar monitoring, and a change in diet may be needed.
Type 2 diabetes, although less common in very young children, can occur when not enough insulin is produced or it is not working properly. As a result, glucose can accumulate in the bloodstream. The condition can often be managed through a change in diet, increasing exercise and maintaining a healthy weight, although some patients may require diabetes medication – such as metformin – or insulin therapy.
The most common symptoms of both type 1 and type 2 diabetes among children and adolescents include increased thirst and urination, fatigue and weight loss. Some children may also experience increased hunger and blurred vision, while girls with type 1 diabetes may develop a yeast infection.
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Symptoms of type 1 diabetes in children tend to develop rapidly over a period of a few weeks, while type 2 diabetes symptoms develop more slowly.
Parents should take their child to the doctor if they notice any of the above symptoms. But despite an increase in diabetes prevalence among children and adolescents, it seems there is a lack of awareness when it comes to identifying symptoms of the condition.
Although blood tests are the most reliable way to diagnose diabetes, your child’s doctor may first order a glucose urine test because it’s easier to have a child pee into a cup than to draw his/ her blood. If there’s sugar in his/ her urine, a random blood-glucose test (one that doesn’t require fasting) can confirm the diagnosis, usually while you’re still at the doctor’s office. A blood-glucose reading of 200 milligrams per deciliter (mg/dL) or higher indicates your child has diabetes and will need to be given insulin multiple times every day to help her body process glucose. Fortunately, there have been great advancements in managing this lifelong affliction.
After the Diagnosis
If your child has diabetes, it’s critical that his/her blood-sugar levels stay in a safe range. This will be determined by a doctor, but it will be slightly higher than the normal blood-sugar level range of 70mg/dL to 120mg/dL. Levels that drop too low or spike too high can lead to seizures, coma, and even death.
Whenever your child eats or is physically active, you’ll need to take a droplet of blood pricked from her finger and check her sugar level using a handheld blood-glucose meter. To cut down on finger sticks, some families have switched to continuous glucose monitoring systems, devices that constantly check a child’s sugar levels through a sensor inserted into her skin for up to six days at a time. But these readings aren’t as accurate as metered ones, so kids must still endure a few finger pokes each day.
Blood-glucose monitors determine how much insulin your child’s body needs, but they don’t actually dispense insulin. For that, most newly diagnosed children with diabetes need their parents to inject insulin into their stomach, upper arm, outer thigh, or buttocks.
Eventually, many people with diabetes switch to an insulin pump, a pager-size device that straps to the waistband or adheres directly to skin and delivers a steady supply of insulin via a small tube inserted into the skin.
A pump gives kids more freedom, but shots are cheaper, simpler to use, and more likely to be covered by insurance. Children of all ages can use insulin pumps.
Parents must be vigilant about their child’s diet, though it’s a myth that kids with diabetes can’t enjoy cookies or cake. No foods are forbidden. No child should have lots of sweet drinks and treats, and this also goes for children with diabetes.
Carbohydrates are a particular concern because starches (like those found in bread and pasta) and natural sugars (including those in fruits and juices) raise blood-sugar levels faster than sugar does. Parents need to count carbs and adjust their child’s insulin to ensure that their blood-glucose levels don’t spike too high.
Diabetes in Children: Counting Carbs
Carbohydrate counting is a skill that can help you and your child plan his or her meals to manage diabetes and control blood sugar. Carbohydrate counting also can allow your child to eat a variety of foods, just like other kids, and to increase his or her sense of control and confidence in managing diabetes.
Caring for a Child with Diabetes
Testing blood glucose (sugar) and giving insulin may seem overwhelming in the beginning. As you work with your diabetes team you will learn about diabetes and become more confident. It is important that you become comfortable with caring for your child’s diabetes so that you can help your child become comfortable too.
As the caregiver of a child with type 1 diabetes, you will help them with:
Monitoring blood glucose
Having regular meals and snacks
Balancing food, medication and physical activity
Recognizing the signs of low and high blood glucose
Talking To Your Child About Diabetes
The way you talk to your child about diabetes will have a big impact on how they perceive their diabetes and themself. Being positive and supportive will help boost your child’s self-esteem.
Children with Diabetes in School
Students living with diabetes have the right to be full and equal participants in school and all school-related activities without the fear of being excluded, stigmatized, or discriminated against.
School boards should develop and communicate a comprehensive diabetes management policy that includes the roles and responsibilities of the students living with diabetes, their parents/caregivers and school personnel.
Children With Type 2 Diabetes
Years ago, it was rare to hear about a child with type 2 diabetes. Doctors used to think kids only got type 1. It was even called juvenile diabetes for a long time.
Not anymore. Now more and more people younger than 20 have this disease.
When Your Diabetic Child Is Sick
Kids with diabetes get sick once in a while, just like other kids. However, because the effects of illness on the body can raise or lower blood sugar levels in people with diabetes, a few extra precautions are needed to keep blood sugar levels under control.
Diabetes In Children:Dealing With Feelings
When their child is first diagnosed with diabetes, parents might spend a lot of time thinking about the disease’s physical effects. But emotional issues also come with a diabetes diagnosis, and these can affect how kids cope with the physical aspects.
So it’s important for parents to recognize the feelings that kids with diabetes might experience and learn strategies to help them.
Children With Diabetes Need To Have Fun
Having diabetes shouldn’t prevent a child from having fun during special occasions. A little planning and a question or two allows kids with diabetes to participate in just about everything.
On special occasions, such as sporting events, pizza days at school or birthday parties, contact the organizer to find out what food will be served and when, and what physical activities are planned. How the food ‘fits in’ depends on when it’s being served. Meals or snacks can be split as needed to allow your child to eat with the other children. Your diabetes educator can give you some good ideas about how to handle this.
For holidays and celebrations, it’s important to keep as many traditions as possible, but you may need to modify those that involve food. Consider creating new traditions that put the focus on fun and activity, not food.
How Can I Help A Diabetic Child?
It can be difficult, especially at first, but it’s important to resist the urge to lower your expectations or overprotect a child with diabetes. Instead, encourage the same independence that you’d expect from your other kids. With the encouragement and support of their parents, kids with diabetes can take on some responsibilities for managing it — a change that often has a positive, confidence-building effect.
Help kids Find Their Strengths
Is your child a reader, a football player, a son, a daughter, a grandchild, a student, a future doctor, an art lover? He or she also is a person in control of diabetes, but this does not define someone’s life — it’s only a very small part of who your child is.
Focus on Friendships
Encourage your child to have fun with friends, which builds confidence and a sense of belonging. Your child should know that it’s OK to discuss diabetes with friends. Instead of focusing on the one thing that’s different, kids can focus on all the things that they have in common with their peers.
Find ways to cope with Bullying
Sometimes kids pick on peers with diabetes or other health problems. Your child might use the following ways to deal with teasing or bullying:
Act brave, walk away, and ignore the bully. Tell your child to look the bully in the eye and say something like, “I want you to stop right now.” Counsel your child to then walk away and ignore any further taunts. Encourage your child to “walk tall,” head held high (this type of body language sends a message that your child isn’t vulnerable).
Use humor or give the bully a compliment to throw the bully off guard. However, tell your child not to use humor to make fun of the bully.
Use the buddy system. Enlisting the help of friends or a group may help both your child and others stand up to bullies.
Tell an adult. If your child is being bullied, emphasize that it’s very important to tell an adult. Teachers, principals, parents, and lunchroom personnel at school can all help to stop it.
Talk to your child about the fact that people do nothing to deserve diabetes — it just happens. Also, if your child feels like the diabetes is causing problems for you or your family, offer reassurance that there’s no reason to feel guilty. Instead, your child should focus on dealing with his or her own feelings about diabetes, not yours.
Tell friends, Teachers, and Others about your Child’s Diabetes
Ask if your child would like others to know about the diabetes. Kids sometimes find it less embarrassing if they tell friends and classmates that they have diabetes — that way, they don’t have to worry about what their friends will think when they head to the nurse’s office every day. Teachers and care providers also should know about your child’s condition and its management (for instance, if your child takes breaks to test blood sugar or eats snacks at certain times).
Connect with Others Dealing with Diabetes
Finding a support group for kids and families with diabetes can help kids to feel less different. These groups also can boost your confidence as you deal with diabetes and offer advice and tips on managing it. Your child’s diabetes health care team might be able to help you connect with support groups in your area.
Get Help When You Need It
Be sure to keep your child’s diabetes health care team in the loop about any emotional issues — they deal with this all the time and can provide help for your child and advice for you. If your child shows any signs of depression (such as prolonged sadness or irritability, fatigue, appetite changes, or changes in sleeping habits), talk to your child’s doctor or a mental health professional.
Every parent of a child with diabetes must deal with the feelings that surround the disease. Try to keep in mind that for most kids, negative feelings about diabetes pass or change with time as they adjust to living with it.
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