Diabetes In Children - An Overview

Diabetes In Children - An Overview

Type 1 and type 2 diabetes are lifelong conditions. You can minimise the long-term risks and complications for your child.

Key points to remember about diabetes in children

Diabetes happens when the level of glucose in the blood is too high.

  • diabetes is a condition where the level of glucose in the blood is too high
  • that's because the body is not using the glucose properly
  • in type 1 diabetes, the main problem is that the insulin-making cells in the pancreas are destroyed and not able to make enough insulin
  • in type 2 diabetes, the main problem is that the body is not able to use the insulin effectively due to resistance to insulin
  • both forms of diabetes are lifelong conditions - once diagnosed as having type 1 or type 2 diabetes, your child will always have it
  • you can minimise the long-term risks and complications for your child

What is diabetes?

Once diagnosed with diabetes, your child will always have it. But, you can minimise the long-term risks and complications for your child.

Diabetes is a condition where the level of glucose in the blood is too high.

Glucose is made from the breakdown of carbohydrates we eat. The glucose is then absorbed from our gut into the blood system. Insulin is a hormone produced by beta cells in the pancreas. Insulin is needed to allow glucose to move from the blood into the body's cells, where it can be used for fuel for energy. Diabetes occurs when the insulin-making cells in the pancreas are unable to make enough insulin or when there is resistance to the effects of insulin.

You might find it helpful to watch the animation about diabetes and the body at the top of the page.

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

In type 1 diabetes, the main problem is that the insulin-making cells in the pancreas are destroyed and not able to make enough insulin. Type 1 diabetes is mainly diagnosed in childhood, and is not caused by being overweight or eating sweet foods.

In type 2 diabetes, the main problem is that the body is not able to use the insulin effectively due to resistance to insulin. The insulin-making cells in the pancreas are able to produce insulin but the insulin is not able to work well because the cells in the body are 'resistant' to its effects. Sometimes, the pancreas becomes exhausted. This leads to not enough insulin production on top of the problem of insulin resistance. Type 2 diabetes often affects older people, especially if they are overweight.

What causes diabetes?

The cause of type 1 diabetes

Type 1 diabetes is caused by a combination of genetic and environmental factors. If a person who has a genetic tendency to develop diabetes comes in to contact with a trigger in the environment, then diabetes may develop.

Many people who have a genetic tendency to develop diabetes do not get diabetes, so researchers are trying to find out more about what the environmental triggers are. These triggers are poorly understood, but may be common things in our environment such as viruses.

If diabetes is triggered, the body's immune system, which normally protects us from infection, begins to attack the insulin-making cells which are called beta cells, in the pancreas. The immune system starts to destroy the beta cells, causing a decrease in insulin production. It can take from a few weeks to a few years for all the beta cells to be destroyed.

Symptoms of diabetes do not occur until more than 90 percent of the beta cells have been destroyed. This means that it is difficult to tell if a person is developing diabetes, until the symptoms of diabetes occur. It is important to remember the following points:

  • you cannot catch diabetes from another person - it is not contagious
  • type 1 diabetes is not caused by eating too much sugar or any other foods
  • there is nothing you could have done differently to prevent your child from getting type 1 diabetes
  • your child cannot grow out of type 1 diabetes - it does not change to type 2 diabetes as they get older

TrialNet - study, prevention, and early treatment of type 1 diabetes

TrialNet is a network of 21 clinical centres working in cooperation with screening sites throughout the United States, Canada, Finland, United Kingdom, Italy, Germany and Australia. This network is dedicated to the study, prevention, and early treatment of type 1 diabetes. You can find information on a number of studies being run by visiting the TrialNet website.

The cause of type 2 diabetes

Type 2 diabetes is the most common form of diabetes (80 to 90 percent of diabetes) and affects mainly older people. But, type 2 diabetes is becoming more common in children and young people throughout the world. The tendency to develop type 2 diabetes is inherited, but it also depends on environmental factors.

The major risk factor for getting type 2 diabetes is being overweight (obesity). Being overweight is often related to lifestyle factors such as not getting enough physical activity and eating too much of certain types of foods such as sugar, fats, and takeaway or 'fast' foods.

It is important to remember the following points:

  • type 2 diabetes is becoming more common in younger populations
  • the risk of getting type 2 diabetes lessens by becoming physically active and eating a healthy diet

How long will diabetes last?

Both forms of diabetes are lifelong 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:

  • keeping blood glucose levels normal as much as possible
  • 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

While type 2 diabetes is a lifelong condition, the symptoms may lessen if the person with diabetes loses weight, becomes physically active and engages in a healthier lifestyle.

What are the signs and symptoms of diabetes?

If your child has any of these signs and symptoms, please go to your family doctor or health professional for advice. 

People with type 1 and type 2 can have the following 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 (type 2)

In type 1, the symptoms generally come on rapidly.

In type 2, the symptoms usually develop gradually. Some children or young people who have symptoms need to go to hospital where they receive a diagnosis of type 2 diabetes and start on insulin. Over time, they may be able to gradually stop having insulin. Many people with type 2 will have no symptoms and are only diagnosed after screening on a routine medical check. 

The development of type 1 diabetes is a medical emergency, and your child will need to go to hospital. 

When should I seek help for my child with diabetes?

If your child displays any of the above signs and symptoms, and you are concerned that they are unwell, please go to your family doctor or health professional for advice. The development of type 1 diabetes is considered a medical emergency, and you will need to go to hospital. If you can't see a doctor for whatever reason, take your child to the nearest emergency department.

How is diabetes diagnosed in my child?

Diabetes is diagnosed by detecting high blood glucose levels in the blood. An initial finger prick blood test can detect high blood glucose levels. But, your child will need a further blood test to confirm it. High glucose values can also be measured in your child's wee (urine). For type 2 diabetes, sometimes your child will need a test called an oral glucose tolerance test. Your child drinks a sweet liquid, and glucose levels in the blood are checked after.  An oral glucose tolerance test is not used for diagnosing type 1 diabetes.

What are the treatments for diabetes?

Effective treatments for type 1 diabetes

Insulin

Children with type 1 diabetes need insulin to replace the insulin that the body cannot make anymore.  Insulin is a hormone which you cannot take as an oral medicine - you must inject it into the layer of fat under the skin.

Healthy diet

A child with type 1 diabates needs to eat a healthy diet, just like a child without diabetes. They need a regular intake of carbohydrates for growth and development.

Physical activity

Physical activity is the best foundation for management of type 1 diabetes. Physical activity is part of a healthy lifestyle.

Matching insulin to carbohydrates and physical activity

The amount of insulin a child with type 1 diabetes needs depends on the amount of carbohydrates they eat and the amount of physical activity they do. This is called matching insulin to carbohydrates and physical activity.

Learning about diabetes

There is a lot to learn about how to care for a child or young person with diabetes.

This learning involves the whole family, extended family, and other people that are involved in the life of a child or young person - school staff, friends, neighbours, sports coaches, etc.

Education and learning about type 1 diabetes is an ongoing process.

Effective treatments for type 2 diabetes

  • make adjustments to lifestyle - healthy eating, an increase in physical activity and weight loss may prevent the need for medical treatment
  • most young people will need medical treatment at some stage, including tablets that help the body to use insulin more effectively, insulin injections or a combination of both
  • medicines do not cure diabetes and most people will have to take medicines for the rest of their lives
  • a child or young person living with diabetes needs a lot of care and assistance with establishing healthy habits to help and support them in living with diabetes

What does caring for a child or young person living with diabetes include?

Monitoring

  • helping with glucose monitoring and administration of medicine depending on your child's age and independence level
  • making appointments with diabetes specialist teams
  • trying to keep your child or young person with diabetes feel as supported as possible

Education

  • reading and learning about the condition
  • teaching your child as much as possible about diabetes, healthy living and healthy eating, (keeping the information right for your child's age)
  • using the skills and knowledge of the healthcare team looking after your child - they can provide educational guidance to you and your child

Transitioning

This is the process of preparing children to move to the next stage of managing their diabetes. As children grow older, so do their levels of knowledge and their ability to take on more responsibility for the management of their diabetes. Support from parents, friends, school and the diabetes team form an essential part of this developmental milestone.

Check the Starship Diabetes Adolescent Transition Programme section of the Starship Child Health website.

  1. 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
  2. Clinical practice guidelines: Type 1 diabetes in children and adolescents. 2005. 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
  3. ISPAD (International Society for Pediatric and Adolescent Diabetes) Clinical Practice Consensus Guidelines 2014 https://www.ispad.org/?page=ISPADClinicalPract [Accessed 4/12/2018] 
  4. APEG national evidence-based guidelines for type 1 diabetes in children, adolescents and adults. November 2011. Copies available for download at https://apeg.org.au/ or https://diabetessociety.com.au/Index.asp
  5. The American Diabetes Association website: http://www.diabetes.org/

The content on this page has been approved by the Clinical Network for Children and Young People with Diabetes, Paediatric Society of New Zealand. 

Images
The following images have been purchased from Dreamstime:
© Robhainer | Dreamstime.com - Sick Child
© Rolmat | Dreamstime.com - Boeing Airplane Photo
© Designua | Dreamstime.com - Complications Of Diabetes Mellitus Photo

This page last reviewed 10 April 2019.
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