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Diabetes is a very serious metabolic disor­der that prevents the normal breakdown and use of food, especially sugars (carbohydrates) by the body. It can damage the heart, blood vessels, kidneys, and neuro­logical system and can cause a progressive loss of vision over many years.

In children, diabetes is caused by inade­quate production of the hormone insulin by the pancreas. When that happens, the body is unable to properly metabolize sug­ars, which build up in the bloodstream; these sugars cannot be used by the body and are excreted in the urine. This leads to the major symptoms of diabetes: increased urination, thirst, and increased appetite, as well as weight loss.

While diabetes can begin at any age, there are peak periods at about ages five to six and then again at ages eleven to thir­teen. The first sign is often an increase in the frequency and amount of urination. However, the other cardinal symptoms must be present as well for the diagnosis of diabetes: Your child will complain of being thirsty and tired, she will begin to lose weight, and her appetite will increase. If these symptoms are not noticed early in their course, some children may require hospitalization by the time a diagnosis is made in order to receive treatment with intravenous insulin and fluids to stabilize their condition.

Although there is no cure for diabetes, children with this disease can lead a nearly normal childhood and adolescence if their disorder is kept under control. It is essen­tial to control diabetes properly in order to avoid complications. Regular insulin injections—usually two per day, just before breakfast and dinner—can keep blood sugar levels within a normal range and re­duce the likelihood of symptoms. A diet high in complex carbohydrates with re­strictions on refined sugar is important too. A child with diabetes may need to be reminded that insulin shots alone cannot control diabetes; she also has to pay atten­tion to her diet, following the doctor's nutritional guidelines. At least thirty minutes of exercise a day can help your child man­age her disease as well.

By working with your children in their middle years, you can help them gradually begin to take responsibility for caring for their disorder. They can start giving them­selves insulin injections. They can also check the sugar in their blood at least twice a day, using simple, chemically treated test strips. By attending summer camps for dia­betic children, they can see how other chil­dren with this illness have become more self-reliant in caring for the disease.

However, you need to oversee these self-care tasks to make certain your child is fol­lowing your doctor's guidelines. If your child takes too much insulin, she can expe­rience insulin shock, with symptoms that include clammy or tingling sensations, trembling, a rapid heartbeat, and a loss of consciousness. Conversely, if she takes too little insulin, the major symptoms of dia­betes (weight loss, increased urination, thirst, and appetite) can return.

When a youngster does not assume self-care responsibilities in the middle years, you may find it even more difficult to intro­duce this concept during adolescence, when the desire for independence often overrules common sense. If your youngster develops good habits before her teenage years arrive, however, she has a much bet­ter chance of an easier young adulthood.

For more information about childhood diabetes, ask your doctor or contact the Ju­venile Diabetes Foundation, 432 Park Av­enue South, New York, New York 10016. In many communities, parent groups are available in which the parents of children with diabetes can meet to discuss their common concerns. Ask your pediatrician to recommend a book or two that can fur­ther familiarize you with diabetes; one of the best, which can be read by both par­ents and children, is An Instructional Aid on Insulin-Dependent Diabetes Mellitus by Luther B. Travis, M.D. (American Diabetes Association, Texas Affiliate, 8140 North Mopac, Austin, Texas 78759).

Last Updated
Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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