Type 1 Diabetes: What Is It?

What Is Diabetes?

Diabetes is a disease that affects how the body uses glucose, the main type of sugar in the blood.

What Happens in Diabetes?

Our bodies break down the foods we eat into glucose and other nutrients we need, which are then absorbed into the bloodstream from the gastrointestinal tract. The glucose level in the blood rises after a meal and triggers the pancreas to make the hormone insulin and release it into the bloodstream. But in people with diabetes, the body either can't make or can't respond to insulin properly.

Insulin works like a key that opens the doors to cells and lets the glucose in. Without insulin, glucose can't get into the cells (the doors are "locked" and there is no key) and so it stays in the bloodstream. As a result, the level of sugar in the blood remains higher than normal. High blood sugar levels are a problem because they can cause a number of health problems.

What Is Type 1 Diabetes?

The two types of diabetes are type 1 and type 2. Both make blood sugar levels higher than normal but they do so in different ways.

In type 1 diabetes, the pancreas loses its ability to make insulin because the body's immune system attacks and destroys the cells that produce insulin. No one knows exactly why this happens, but scientists think it has something to do with genes. But just getting the genes for diabetes isn't usually enough. A person probably would then have to be exposed to something else — like a virus — to get type 1 diabetes.

In type 2 diabetes, the pancreas still makes insulin but the body doesn't respond to it normally. Glucose is less able to enter the cells and do its job of supplying energy (a problem called insulin resistance). This raises the blood sugar level, so the pancreas works hard to make even more insulin. Eventually, this strain can make the pancreas unable to produce enough insulin to keep blood sugar levels normal.

Who Gets Type 1 Diabetes?

Type 1 diabetes can't be prevented, and there is no real way to predict who will get it. Nothing that either a parent or the child did caused the disease.

Once a person has type 1 diabetes, it does not go away and requires lifelong treatment. Kids and teens with type 1 diabetes depend on daily insulin injections or an insulin pump to control their blood glucose levels.

What Are the Signs & Symptoms of Type 1 Diabetes?

A person can have diabetes without knowing it because the symptoms aren't always obvious and they can take a long time to develop. Type 1 diabetes may come on gradually or suddenly.

But kids or teens who develop type 1 diabetes may:

• Need to pee a lot. The kidneys respond to high levels of glucose in the blood by flushing out the extra glucose in urine (pee). Kids with high blood sugar levels need to pee more often and make more pee.
• Drink a lot of liquids. Because they're peeing so often and losing so much fluid, they can become very thirsty and drink a lot in an attempt to keep the levels of body water normal.
• Feel tired often. This is because the body can't use glucose for energy properly.
• Lose weight (or not gain weight as they grow). Kids and teens with type 1 diabetes may have an increased appetite, but often lose weight because the body breaks down muscle and stored fat in an attempt to provide fuel to the hungry cells.

In some cases, other symptoms can be the signal that something is wrong. Sometimes the first sign of diabetes is bedwetting in a child who has been dry at night. Diabetes also should be suspected if a girl who hasn't started puberty yet gets a vaginal yeast infection.

How Is Type 1 Diabetes Diagnosed?

Doctors can say for sure if a person has diabetes by testing blood samples for glucose. When high blood sugars show that a child has diabetes, other blood tests are usually done to help doctors find out if the child has type 1 or type 2 diabetes, because management and treatment of the diabetes may differ based on type.

If diabetes is suspected or confirmed, the doctor may refer your child to a pediatric endocrinologist, a doctor who specializes in the diagnosis and treatment of kids with diseases of the endocrine system, such as diabetes and growth disorders.

How Is Type 1 Diabetes Treated?

Treatment means good diabetes control to minimize symptoms; prevent health problems; and help kids have normal physical, mental, emotional, and social growth and development. To do this, parents and kids should aim to keep blood sugar levels within the goal range as much as possible.

In general, kids with type 1 diabetes need to:

• take insulin as prescribed
• eat a healthy, balanced diet with accurate carbohydrate counts
• check blood sugar levels as prescribed
• get regular physical activity

Following the treatment plan helps kids stay healthy, but treating diabetes isn't the same as curing it. Right now, there's no cure for diabetes, so kids with type 1 diabetes will need treatment for the rest of their lives. But with proper care, they should look and feel healthy and go on to live long, productive lives, just like other kids.

What Problems Can Happen With Type 1 Diabetes?

If early symptoms of diabetes are missed and treatment isn't started, chemicals called ketones can build up in the blood and cause stomach pain, nausea, vomiting, fruity-smelling breath, breathing problems, and even loss of consciousness. Sometimes these symptoms are mistaken for the flu or appendicitis. Doctors call this serious condition diabetic ketoacidosis, or DKA.

Diabetes also can cause long-term complications in some people, including heart disease, stroke, vision impairment, and kidney damage. It also can cause other problems throughout the body in the blood vessels, nerves, and gums. While these problems don't usually show up in kids or teens who've had type 1 diabetes for only a few years, they can affect them in adulthood, particularly if their diabetes isn't well controlled.

There's good news, though — proper treatment can stop or control these diabetes symptoms and reduce the risk of long-term problems.

What's New in the Treatment of Type 1 Diabetes?

Doctors and researchers are developing new equipment and treatments to help kids cope with the special problems of growing up with diabetes.

Some kids and teens are already using devices that make blood glucose testing and insulin injections easier, less painful, and more effective. One of these is the insulin pump, a mechanical device that can deliver insulin more like the pancreas does. There's also been progress toward the development of a wearable or implantable "artificial pancreas." This consists of an insulin pump linked to a device that measures the person's blood glucose level continuously.

Doctors and scientists are investigating a potential cure for diabetes. This involves transplanting insulin-producing cells into the body of a person with diabetes. Researchers are also testing ways to stop diabetes before it starts. For example, scientists are studying whether diabetes can be prevented in those who may have inherited an increased risk for the disease.

How Can I Help My Child?

Parents can help their kids lead happier, healthier lives by giving constant encouragement, learning what they can about diabetes, and making sure their children eat properly, exercise, and stay on top of blood sugar control every day.

Kids and teens with diabetes need to monitor and control their glucose levels. They need to:

• check blood sugar levels a few times a day by testing a small blood sample
• give themselves insulin injections, have an adult give them injections, or use an insulin pump
• eat a balanced, healthy diet and pay special attention to the amounts of sugars and starches in the food they eat and the timing of their meals
• get regular exercise to help control blood sugar levels and help avoid some of the long-term health problems that diabetes can cause, like heart disease
• work closely with their doctor and diabetes health care team to get the best possible diabetes control
• be watched for signs of complications and other diabetes-related health problems

Living with diabetes is a challenge for anyone, but kids and teens often have special issues to deal with. Young kids might not understand why they need blood tests and medicines. They might be scared, angry, and uncooperative.

Teens may feel different from their peers and want a more carefree lifestyle than their diabetes allows. Even when they faithfully follow their treatment schedule, they might feel frustrated if the natural body changes of puberty make their diabetes somewhat harder to control.

Having a child with diabetes may seem overwhelming at times, but you're not alone. If you have questions or problems, reach out to the diabetes health care team — they can help with medical issues, and are there to support and help you and your child.