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Diabetes (brief)


Disclaimer: This fact sheet is for educational use only. Please consult your doctor or other health professional to make sure this information is right for your child.

What is diabetes?

Insulin is a hormone that is needed to convert sugar, starches and other food into the energy needed for daily life. It is produced by the pancreas. Diabetes occurs when the pancreas is unable to make enough insulin or when there is resistance to the effects of insulin.
 

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What is the difference between type 1 and type 2 diabetes?

In type 1 diabetes, the main problem is insulin deficiency. The pancreas is unable to make enough insulin.
 
Type 1 used to be known as insulin dependent diabetes.
 
In type 2 diabetes, the main problem is resistance to insulin. The pancreas produces insulin but the insulin is not able to work. The cells in the body are resistant to its effects. 
 
Type 2 used to be known as non insulin dependent diabetes.
 
Sometimes insulin deficiency and insulin resistance are both present.
 

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What causes diabetes?

Diabetes is caused by a combination of genetic and environmental factors. If a person who has inherited a tendency to develop diabetes comes in to contact with a trigger in the environment, then diabetes may develop. However, many people who are at risk do not get diabetes. Researchers are trying to find out more about what triggers diabetes.
 
Symptoms of type 1 diabetes do not occur until more than 90 per cent of the insulin producing cells have been destroyed. The use of blood tests that might predict developing type 1 diabetes is not recommended as there is no treatment that can stop diabetes developing.
 

It is important to remember:

  • type 1 diabetes is not caused by sugar or any other foods
  • there is nothing you can do to prevent developing type 1 diabetes
  • diabetes cannot be caught from another person
  • your child cannot grow out of type 1 diabetes. It does not change to type 2 diabetes as they grow older 
Type 2 diabetes is the most common form. It usually affects older people but there is concern about the worldwide increase in type 2 diabetes in young adults and teenagers.
 
The major risk factor for getting type 2 diabetes is obesity (being overweight). This is often related to lifestyle factors - not getting enough physical activity and eating too much of certain types of foods such as sugar, fats and fast food. 
 
It is important to remember:
  • the risk of getting type 2 diabetes can be reduced by eating healthily and being physically active

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How long will the condition last?

Both forms of diabetes are life long conditions. Once diagnosed as having type 1 or type 2 diabetes, your child will always have it.
 
Long term risks and complications can be minimised by:
  • participating in your child’s care and ongoing good health
  • learning as much as you can about diabetes
  • having good medical care
  • providing good family support
  • having a healthy lifestyle

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What are the signs and symptoms?

Both type 1 and type 2 diabetes can present with any of these symptoms:

  • excessive thirst and drinking
  • frequent passing of urine
  • weight loss
  • tiredness
  • mood changes
  • bed wetting
  • hunger
  • fungal infections
  • dark skin pigmentation in certain areas on the body (in type 2 diabetes)
In type 1 diabetes, the symptoms generally come on rapidly. 
 
In type 2 diabetes, the symptoms usually develop gradually. Many people with type 2 diabetes will have no symptoms and are only diagnosed after screening on a routine medical check.
 

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When should I seek help?

If your child displays any of the above signs and symptoms and especially if you are concerned that he or she is unwell, see your family doctor. If you can’t see a doctor for what ever reason, and your child is unwell, take your child to the nearest emergency department.
 

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How is diabetes diagnosed?

In most cases the diagnosis of diabetes is simple. If symptoms suggest diabetes, your doctor will request a urine test to check if it contains glucose (sugar) and / or ketones.
 
Under normal circumstances there should not be any glucose in the urine. Glucose only spills over into the urine when the blood glucose is high. A high glucose level on a blood test confirms the diagnosis. 
 
Occasionally, in type 2 diabetes, the diagnosis may be unclear and a diabetes specialist may recommend a more detailed blood test called a glucose tolerance test. 
 

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What treatments are required?

Type 1 diabetes: key points for effective treatments

  • insulin therapy is required to replace the insulin that the body cannot make
  • a healthy food plan and a regular intake of carbohydrates is needed to balance insulin and activity levels
  • physical activity is part of a healthy lifestyle
  • education and knowledge - there is a lot to learn about diabetes. This learning involves the whole family and is an ongoing process

Type 2 diabetes: key points for effective treatment

  • adjustments to lifestyle - many people do well with healthy eating, an increase in physical activity and weight loss. They may not require medical treatment for a number of years
  • most people will require additional measures at some stage. These may include tablets, insulin or a combination of both

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What are the possible complications that go with diabetes?

Key points to remember:

  • the risk of diabetes complications may be minimised by having good long-term blood glucose control
  • regular health screening is important for early detection and treatment of complications
  • smoking increases the risk of complications

Complications can include:

  • Eye problems. Retinopathy occurs when there is damage to the retina. The retina is the thin layer of tissue at the back of the eye. It contains small blood vessels and nerve endings for vision. Other diabetes related eye conditions are cataracts and blurred vision. Regular screening will help to minimise any damage.
  • Kidney problems. The kidneys act as a filter for the body. Waste passes into the urine and is removed from the body. Nephropathy refers to kidney damage. People who are most at risk of developing this condition have had poor diabetes control over a long period of time. Regular checking for protein in the urine (microalbumiuria) will help to recognise and minimise any kidney damage associated with diabetes.
  • Nerve problems. Neuropathy refers to nerve damage associated with diabetes. Good control and regular screening are the best ways of minimising this problem.
  • Vascular (blood vessel) disease increases the risk of heart attacks and strokes. A person with type 2 diabetes has an increased risk of getting vascular disease at an early age.
  • Foot problems, due to decreased blood flow or nerve problems, are unlikely to occur in children or young people. However feet need to be well cared to prevent problems in later life. Podiatrists (people who treat foot disorders) can help.

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Where can I go for more information and support?

On this website
 
DNZ (Diabetes New Zealand)
DNZ is a nationwide organisation with 41 diabetes societies throughout NZ. For information about educational resources, diabetes products and membership, contact:
 
Diabetes Supplies Ltd. (for resources and products)
Address: Freepost DNZ, PO Box 54, Oamaru
Call free on 0800 DIABETES (0800 342 238)
Fax: 64 3 434 5281
Email: mailto:info@diabetes.org.nz
Website: http://www.diabetes.org.nz/
 
Diabetes New Zealand National Office (for membership enquiries)
Address: PO Box 12 441, Thorndon, Wellington
For membership enquiries call free on 0800 369 636
Email: membership@diabetes.org.nz
 
DYNZ (Diabetes Youth New Zealand)
DYNZ represents children and young people with diabetes who are under 25 years of age.
 
See the DYNZ website for the contact details of your nearest Diabetes Youth group. 
TrialNet (recruiting for participants in diabetes studies)
TrialNet is a network dedicated to the study, prevention and early treatment of type 1 diabetes. It is a network of 18 clinical centers working in cooperation with screening sites throughout the United States, Canada, Finland, United Kingdom, Italy, Germany, Australia, and New Zealand. The local site for Australia is based in Melbourne and you can find information on a number of studies being run. There are links to centres in New Zealand that are recruiting for participants in a natural history of type 1 diabetes study.
 

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Acknowledgements

Fact sheet produced in collaboration with the Starship Diabetes Service.
Starship logo

 

 
 
 
 
Sources used in the preparation of this fact sheet:
 
“Caring for Diabetes in Children and Adolescents: A parent’s manual”. 2002. The New Zealand Edition. Editors: G. Ambler, V Barron, E Ambler, F Cameron. 
 
Clinical Practice Guidelines: Type 1 Diabetes in Children and Adolescents. Prepared by APEG (Australasian Paediatric Endocrine Group) for the Department of Health and Ageing. Approved by NHMRC (National Health and Medical Research Council). Australian Government. 2005. 
 
 
The American Diabetes Association Website: http://diabetes.org/home.jsp
 

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Endorsement

This fact sheet was endorsed by PSNZ - 14/08/2009

Copyright

Fact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation.
© The Paediatric Society of New Zealand and Starship Foundation 2005 - 2012


The Paediatric Society of New Zealand
http://www.paediatrics.org.nz 		Starship Foundation
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