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Pediatric Diabetes Type 1

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Type 1 diabetes used to be known as insulin-dependent diabetes or juvenile diabetes. In this type, the pancreas doesn’t produce insulin. Without insulin, your child can’t convert sugar, starch and other food into energy.

This condition can occur at any age. Usually it is first diagnosed in children, teens or young adults.

The cause of type 1 diabetes isn’t known. Doctors think it is an autoimmune disorder. This means that the body sees the pancreas as an invader and attacks it. Sometimes an infection causes the body to attack the beta cells that make insulin by mistake.

Unlike type 2 diabetes, this type can’t be prevented. Most people who develop type 1 diabetes are of normal weight and are healthy before it starts. Exercise and diet are not helpful in reversing type 1 diabetes. Both, however, are important in treating it.

At Children’s Health℠, we work closely with both you and your primary care provider so that everyone involved has the information they need to create the best outcomes for your child. 

Tests & Diagnosis

Tests & Diagnosis

Symptoms are the first things your child’s doctor will assess in making a diagnosis. There are also tests for type 1 diabetes that may be used to make a diagnosis:

  • Blood glucose tests (also called blood sugar tests) take a sample of blood to see how much glucose is present. This test can be done after your child has not eaten anything for 8 hours or more (fasting) or at any time of the day (random)
  • Glucose tolerance tests mimic what happens in your child’s body after she eats. At the start, a baseline blood sample is taken. Your child will be given a drink containing a set amount of glucose (usually 75 grams). For the next three hours, another blood sample will be taken every 30 to 60 minutes
  • Hemoglobin A1c (Hgb A1c) tests give an indication of your child’s average blood sugar over the past three months. It may be used in the diagnosis of type 1 diabetes. More often it is a way to track how well your child’s blood sugar has been controlled during treatment
  • Urine glucose tests are done because if the level of sugar in the blood is high it may “spill over” into the urine. This is known as glycosuria

One of the ways to tell if your child’s diabetes is type 1 or type 2 is for a doctor to test for autoantibodies to certain types of cells or hormones:

  • Antibodies may target glutamic acid decarboxylase (GAD) found in the cells of the pancreas that produce insulin
  • Insulin autoantibodies may attack the insulin itself, making it unusable. These can be seen before other symptoms show up and help identify children who may be at increased risk for type 1 diabetes later on
  • Islet cell antibodies attack the pancreatic islet cells that produce insulin

Not every child needs all these tests. Your physician will tell you exactly what the next steps are. Each year, the endocrinology specialists at Children’s Health see more than 12,000 pediatric patients for type 1 diabetes and other endocrine-related conditions. We have the skill and resources necessary to provide comprehensive and compassionate care for your child too. 

Treatments

Treatments

The main treatment for type 1 diabetes is to replace the insulin your child’s body needs. This is usually done using one of three methods:  

  • Insulin syringes are tubes with very fine needles. The outside is marked with lines that show how many units of insulin you are drawing up. There are various doses of  insulin available, so make sure that the syringe being used goes with the kind of  insulin that has been prescribed.

  • Insulin pens actually look like large pens. They use insulin cartridges and disposable needles. You use the dial on the side to find the dose. It is displayed in the pen’s  window as a double check.

  • Insulin pumps are attached to a catheter. The catheter is put into the abdomen, usually around the waist. Some pumps can also measure the amount of glucose in  the blood and automatically adjust the dose as needed.

An important part of the diabetes treatment and control process is keeping close track of  your child’s blood glucose levels. Usually you or your child will prick a finger for a drop of  blood. The blood is placed on a special test strip, which then goes into a meter. After a short  time, the meter tells how much sugar is in the blood.    

The doctor may ask you or your child to write down the time and results to help the  healthcare team know how well your child is doing. Many meters will now record this  automatically and some may even “phone home” directly to the doctor’s office. You, your  child and your child’s doctor should set up a plan on what should be done if the blood sugar  is too high or too low.     

Exercise     

Regular exercise works to control the amount of sugar and helps burn extra calories and fat  to help your child get to, and to maintain, a healthy weight. Since exercise can change blood  sugar, talk to your child’s doctor before starting a program. Some changes may have to be  made in the treatment plan before, during and after physical activity.     

Diet     

Diet is another important part of the care for type 1 diabetes, as different foods will have  different impacts on blood sugar. The American Diabetes Association and the American  Dietetic Association have information on planning healthy meals.     

Children’s Medical Center uses a multidisciplinary approach to caring for your child. This  allows us to offer our patients care from multiple specialists and experts, in a single  appointment, at one location. If your child has symptoms of a type 1 diabetes, contact us.  We provide the comprehensive and individualized care necessary to put your child back on  the path to a healthy life. 

Symptoms

Symptoms  

Most of the symptoms seen before diagnosis are related to having too much sugar in the blood stream. These symptoms include 

  • Constantly being very thirsty
  • Feeling very hungry  
  • Being tired all the time  
  • Having blurry eyesight  
  • Having numbness or tingling in your feet  
  • Losing a lot of weight without trying  
  • Urinating often

Symptoms, if untreated    

If the diabetes continues undiagnosed and is not treated, other symptoms can occur later:  

  • Deep, very rapid breathing  
  • Dryness in your child’s skin or mouth  
  • Flushed, red face  
  • A fruity odor to your child’s breath  
  • Nausea or vomiting  
  • Severe stomach pain
  • Difficulty thinking clearly, having a hard time waking up, or even a coma 
FAQs

FAQs

What is type 1 diabetes?

In type 1 diabetes the pancreas completely stops producing any insulin, the hormone needed to change the glucose (sugar) found in foods into energy.  

How is type 1 diabetes different from type 2?

Type 1 diabetes is different because the only treatment available is the use of insulin. Type 2 may be treated with insulin, but other medications and even diet alone can also be used.  

What causes type 1 diabetes?

The cause of type 1 diabetes is still unknown. The possible causes doctors and researchers are looking at include genetics and environmental factors such as viruses.  

Who gets type 1 diabetes?

You can have type 1 diabetes at any point in your life if the pancreas stops producing insulin. Most people are diagnosed in childhood or when they are young adults.  

How is type 1 diabetes treated?

People with type 1 diabetes can neveruse pills. Insulin therapy tries to mimic the way the pancreas would produce and distribute its own insulin, if it were able. The goal is to use insulin, close monitoring of blood sugar levels and diet to keep blood sugars as close to normal as possible.  

What kind of complications are people with diabetes likely to have?

Too much sugar in the blood disrupts the normal environment of your child’s body. If left untreated, it can lead to heart attacks, strokes, blindness, kidney failure, removal of a body part because of blood vessel problems and nerve damage with pain.

Tight control helps decrease the chances that your child will experience complications from high glucose levels.

Can type 1 diabetes be prevented?

There is no way to prevent type 1 diabetes. However, most of the complications can be prevented with close control of your blood sugars. 

What are the symptoms I should watch for that tell me my child’s blood sugar levels aren’t right? 

The warning signs can be different from one person to the next.  Warning signs of high or low blood sugar (hyperglycemia or hypoglycemia, respectively) vary. Symptoms of low blood sugar can include feeling shaky, blurred speech, headache, sweating, tiredness, dizziness, hunger and changes in behavior. If untreated, they can lead to loss of consciousness and seizures.

Symptoms of high blood sugar include increased thirst, increased appetite, increased urine,  tiredness and blurred vision. If left untreated, this can lead to ketoacidosis -- a life-threatening  condition with symptoms that may include extreme thirst, rapid shallow breathing, nausea,  vomiting, abdominal pain and even a fruity odor to your child’s breath. 

Resources

Resources

For more information on Type 1 diabetes, please visit these sites: 

For information specifically relating to the disease and how you can help your child (includes audio and Spanish versions), go to KidsHealth

This page has more facts and information about Type 1 diabetes: JDRF  

For tips on understanding how Type 1 diabetes affects your child, psychologically as well as physically, see JDRF

More ideas for parents and children about life, school and family communication are offered here: American Diabetes Association

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