Diabetes is one of the most diagnosed chronic diseases in children in the United States. An estimated 125,000 children under the age of 19 are diabetic, and each year more than 15,000 more are diagnosed. Treatment of diabetes involves a lifetime regimen of blood sugar self-testing and a closely monitored diet. Some children require insulin; for others, diet alone is sufficient.
Significance
Diabetes is serious and can even be life-threatening. It is caused by the body's inability to properly make and use insulin, which the body uses to change food (particularly sugars and starches) into the energy it requires. Early diagnosis is of the utmost importance in properly managing this disease and limiting its effects on a child. Diabetes is not curable, but it can be treated with a lifestyle regimen of diet, exercise and balancing the body's insulin levels with or without medication. The key to managing diabetes is to keep the blood sugar as level as possible.
Types
In type 1 diabetes the body makes insufficient amounts of insulin or no insulin at all. It's a disease of the immune system that commonly begins in childhood or the early teen years. The disease has a genetic component and tends to run in families. Caucasian children have the highest incidence of type 1 diabetes. Children who are diagnosed with type 1 diabetes must take daily insulin shots.
In type 2 diabetes, the cause is the same: The body cannot produce or correctly use the insulin needed to turn food into energy. This type is usually diagnosed in children between the ages of 12 and 14; more girls are diagnosed than boys. This type of diabetes has seen a continual rise in the number of cases since 1994.
Warning
The warning signs of type 1 diabetes can be difficult to spot because they can mimic many other illnesses. Sometimes the first symptoms can look a lot like a virus or the flu. The most important symptoms that are always present include excessive thirst (polydipsia), excessive urination (polyuria) and unexplained weight loss. These symptoms are usually the most visible. Sometimes there are other symptoms, including dehydration that occurs even when the child has had plenty of fluids, vomiting, confusion, bed-wetting in a child who previously had no problems with it, lethargy, yeast infections (vaginal yeast infections or thrush, which is yeast in the mouth and/or throat), flu-like symptoms and an odd, fruity smell on the breath. In some cases there will be difficulty with labored, heavy breathing; stupor and unconsciousness can also occur.
Excessive thirst and urination are also warning signs of type 2 diabetes. Beyond that, the symptoms differ. Children with type 2 diabetes often exhibit numbness or tingling in their hands and/or feet and itchiness. They can also have exhaustion, excessive hunger, blurry vision and irritability. Sores and cuts will heal slowly, and children can have high blood pressure even at a young age. Acanthosis nigricans, dark and velvety-looking patches on the skin in the armpits or around the neck, can also be present.
Expert Insight
Childhood obesity and a sedentary lifestyle have caused a rise in the incidence of type 2 diabetes in children. Type 2 diabetes is increasing at a rate of 3 percent per year; for children under 5 the rate is as high as 5 percent per year. More than half the children diagnosed with type 2 diabetes will develop complications within 15 years. Studies have proved that a weight loss of 7 to 10 percent of a child's body weight, combined with a moderate exercise program, can prevent the onset of type 2 diabetes. (Statistics courtesy of the Juvenile Diabetes Foundation.)
Considerations
One of the most important keys in managing childhood diabetes is family support and involvement. The regimented diet and blood sugar testing are very difficult for a child to manage without a lot of adult intervention. The second key is to involve the child's school nurse and teachers to make sure they're educated enough to be on the lookout for any signs of trouble. It's important to treat the diabetic child as normally as possible, being careful to curtail only activities his doctor has specified. It's difficult for parents to accept that their child has this type of illness, and they have to be careful not to overprotect him out of their own fears. With good communication, testing, diet, exercise and support, children with diabetes can experience a full and rewarding childhood. For more information, see the website listed below.
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