Diabetes is a disease that affects the way the body uses food for energy. There are different types of diabetes. Type 1 diabetes is one of the most common childhood chronic diseases. It affects about 1 in 400 children, adolescents and young adults under 20 years of age.
Currently, once diagnosed, type 1 diabetes is a lifelong disease with no known cure. However, there are very effective treatments for type 1 diabetes.
What causes type 1 diabetes?
Type 1 diabetes happens when the body cannot make enough insulin. Nutrients in food are changed into a form of sugar called glucose. Insulin allows glucose to move from the bloodstream into the cells to be used for energy.
Without insulin,
glucose is "stuck" in the bloodstream. This leads to a high level of glucose in the blood, which can cause damage in the body.
Ordinarily, our bodies produce insulin is produced in special cells (called beta cells) in the pancreas, which is an organ in the belly. But with type 1 diabetes, the immune system gets confused and destroys beta cells as if they were harmful germ that got into the body. This ongoing attack may occur quickly or over a period of years.
Symptoms of type 1 diabetes
The symptoms of type 1 diabetes a child may experience largely result from:
the lack of energy caused by the body not being able to use the nutrients eaten.
the high sugar levels in the bloodstream pulling water from the body into the bloodstream and spilling into the urine, causing
dehydration (lack of fluids).
Type 1 diabetes symptoms in children include:
hunger, at times extreme, associated with weight loss.
increased thirst and increased urination (peeing). This can be missed in infants who are not toilet trained, because parents may not realize that they are in need of more
frequent diaper changes. Also,
"accidents" in a toddler and older children previously toilet trained may be overlooked.
fatigue or feeling tired.
irritability or unusual behavior.
blurry vision (not a common symptom, but this can occur if the sugar is very high).
If untreated, the following symptoms can occur that require immediate medical care:
How is type 1 diabetes diagnosed?
Type 1 diabetes is diagnosed when a child has classic symptoms of diabetes as described above, along with abnormally high blood sugar levels and ketones in the urine. Ketones are acids that build up in the body when there is not enough insulin.
Diabetes can also be diagnosed by a test that shows what the average blood sugar has been in the blood over the previous 3 months. This test is called hemoglobin A1c (HbA1c). A result that is equal to or greater than 6.5% suggests diabetes.
If you are worried that your child may have symptoms of type 1 diabetes:
Bring your child to see their pediatrician right away. The doctor can easily check for sugar in the urine. They can also take a drop of blood from the finger to check the blood sugar level with a glucose meter (a small portable machine).
It may be tempting to borrow a borrow a glucose meter from a relative or friend to check your child's blood sugar, but we advise against this. You may not do it correctly, and the home meter may not be working properly.
Before a child develops full-blown type 1 diabetes, a phase of
prediabetes may be present. This measures differently.
How is type 1 diabetes treated?
Diabetes can be treated by giving back the very hormone that is missing: insulin.
Insulin may be given as several daily injections with small syringes with very thin and short needles that make the injections almost pain-free. Insulin injections are most commonly given in the upper part of the arms, in the front of the thighs, and in the fatty skin of the belly.
Insulin can also be given continuously via a small machine (often referred to as a "pump") that gives insulin through a small plastic tube (called a "catheter"), which can be inserted by the parent or the affected child.
What is an islet transplant?
Islets are clusters of cells in the pancreas. They contain the insulin-producing beta cells that are destroyed with type 1 diabetes.
Pancreatic islet cell transplantation is an experimental treatment for the disease. However, it may only be performed as part of a
clinical trial and it is not without risks.
Managing type 1 diabetes
Treatment for type 1 diabetes is aimed at normalizing blood sugar levels. However, this is not a simple task, and blood sugars must be checked several times daily.
Blood sugar can be measured by obtaining a small drop of blood using a very fine device called a lancet. The drop of blood is then put on a strip and inserted into a home glucose meter. Some people with insulin pumps also wear continuous glucose monitors. These devices measure the levels of sugar in the fatty space under the skin.
A
healthy diet is also very important in type 1 diabetes, and insulin dosing needs to be matched with the amount of sugar (called carbohydrate) taken in. Being
physically active is also key, and insulin often needs to be reduced at times of physical activity.
Can type 1 diabetes be prevented or delayed?
Relatives of people with type 1 diabetes are at higher risk of developing type 1 diabetes, compared with children and young adults who do not have any relatives with type 1 diabetes in their extended family.
Diabetes cannot be predicted with certainty. However, special blood tests are available to measure the risk of diabetes. These tests measure proteins called antibodies that are associated with type 1 diabetes. For people who are found to have those antibodies and who are having some rise in their blood sugar, there is a medication that may be able to delay the onset of type 1 diabetes.
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