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Diabetes is a chronic condition that affects millions of people in the United States, and the number of children being diagnosed with diabetes is rising every year. Early detection and management of diabetes is crucial; specialized diabetes care save your child’s life.Diabetes can affect anyone. The disease impacts all of the body’s main organs and how the body uses energy. There are several types of diabetes with various causes and risk factors. However, all types of diabetes involve an excess of blood sugar, or glucose, in the body. This can lead to serious health issues.The two most common types of diabetes are Type 1 and Type 2.Type 1 diabetes is less common. It is an autoimmune reaction that prevents the body from making insulin. This form of diabetes often has a sudden onset of symptoms, can appear at any age and is not a preventable condition.While just 5% to 10% of people are diagnosed with Type 1 diabetes, Type 2 diabetes is much more common, especially among children. Type 2 diabetes, which limits the body’s ability to use insulin, develops over a long period of time but can be prevented by adhering to a healthy lifestyle. At Wendy Novak Diabetes Institute, the team with Norton Children’s Endocrinology, affiliated with UofL School of Medicine, offers diabetes care for children and young adults up to age 26. We are committed to providing high-quality diabetes care and support for the entire family.
Type 1 diabetes is a condition in which the body no longer makes insulin, an important hormone that is required to live. Children with Type 1 diabetes need insulin to survive, but their body no longer produces it. It is known as an insulin-dependent form of diabetes. Therefore, in order to replace the body’s missing insulin, an insulin pump or insulin injections are necessary. Ongoing diabetes care will be needed for the remainder of your child’s life.
Type 1 diabetes is not related to diet or lifestyle habits; it is an autoimmune disease, where a child’s immune system destroys the cells that create insulin (islet cells) in the pancreas. The destruction of these cells prevents the production of insulin.
Although there is no known cause of Type 1 diabetes, there are several risk factors:
Symptoms of Type 1 diabetes can develop suddenly and rapidly, and can include:
Type 1 diabetes can be diagnosed through blood tests.
A1C (glycated hemoglobin) test: This blood test shows a child’s average blood sugar levels over the past three months. Two A1C tests resulting in 6.5% or higher indicate diabetes.
Blood sugar test: A random blood sugar test, which involves a blood draw at any time, can test for diabetes. A fasting blood sugar test, which involves a blood draw after the child has fasted overnight (for at least 8 hours), can also reveal the presence of diabetes.
Autoimmune testing: A diabetes autoantibody blood panel can test for the presence of antibodies that cause diabetes. This blood test can detect specific autoantibody markers that differentiate Type 1 diabetes from other types of diabetes.
Some people are diagnosed with diabetes after a visit to a hospital emergency department due to symptoms of diabetic ketoacidosis (DKA). This severe complication of diabetes is more common among people with Type 1 diabetes. DKA is caused by low insulin levels combined with high blood sugar levels, which causes ketones in the liver to reach dangerous levels. DKA also can occur when people with existing diabetes do not manage their blood sugar levels, such as during an illness, or they miss a dose of insulin. DKA can be prevented through proper diabetes management.
Type 1 diabetes cannot be cured, but it can be managed with treatments that can improve your child’s quality of life and reduce the risk of other serious health issues as a result of diabetes. Your child’s diabetes care team will help your child and family adjust to a new lifestyle with this condition.
Lifelong insulin therapy is required for patients with Type 1 diabetes. Insulin therapy may include regular insulin injections or getting an insulin pump.
Regular blood sugar monitoring is a crucial part of diabetes management. Frequent testing ensures your child’s blood sugar levels are in a healthy range. It allows you to see how certain foods, medicine and exercise impact blood sugar levels to avoid serious health complications.
Fingerstick tests with a blood sugar meter (glucometer) or using a blood sugar sensor embedded under the skin are common ways to monitor blood sugar levels.
Healthy eating and regular exercise also are components of a successful diabetes care plan. Even with good nutrition and exercise monitoring of blood sugar levels and insulin dosages is needed.
Type 1 diabetes can be an overwhelming diagnosis for your child and family, with abrupt life changes involving administering insulin, managing blood sugar and counting carbs. The team at Wendy Novak Diabetes Institute supports families through these new routines, including education from diabetes educators and dietitians, support from social workers and take-home resources, including a comprehensive diabetes manual with detailed instructions for diabetes management.
In the U.S., the 90% to 95% of adults with diabetes have Type 2, and the condition is becoming more common among children, teens and young people due to childhood obesity. Healthy lifestyle choices, including regular physical activity and eating nutritious meals, can help prevent or even reverse Type 2 diabetes.
It is unclear why some children develop Type 2 diabetes and others don’t. Risk factors include:
Other health conditions: Type 2 diabetes often is associated with metabolic syndrome and polycystic ovary syndrome (PCOS).
Symptoms of Type 2 diabetes can appear slowly over time, allowing it to go unnoticed by caregivers. Some children may experience:
Type 2 diabetes can be diagnosed through blood tests.
Blood sugar tests: A random blood sugar test, which involves a blood draw at any time, can test for diabetes. A fasting blood sugar test, which involves a blood draw after the child has fasted overnight (for at least 8 hours), can also reveal the presence of diabetes.
Oral glucose tolerance test: For this test, the child fasts overnight and visits their provider for a blood test in the morning. Before the initial blood draw, they will drink a sugary drink, and their blood sugar levels will be monitored over two hours.
Management of Type 2 diabetes requires a personalized diabetes care plan, and can involve healthy lifestyle modifications and medications for some patients. Treatment options may include:
Healthy diet: Your child and family should incorporate healthy meals and snacks into your daily eating. This involves avoiding foods that are processed and high in fat. Instead, incorporate more fruits, vegetables, lean proteins and fiber. Drink more water instead of juices or sugary drinks.
Exercise: Your child should get 30 to 60 minutes of moderate exercise every day. Make physical activities fun, encourage trying new activities, and lean toward the types of exercises they enjoy.
Blood sugar monitoring: Your child’s provider will educate you on how often to check your child’s blood sugar levels. This can help you ensure they are in a healthy range and know when to make modifications.
Insulin or other diabetes medications: Some children may require medications to manage their diabetes, such as insulin injections or oral medication. Your child’s provider will help determine the best course of action based on your child’s diabetes care needs.
Early intervention and ongoing monitoring are important to prevent health complications. Regular appointments with your child’s diabetes care team are crucial for managing their condition, including dealing with symptoms, giving medications, checking blood sugar levels, participating in physical activities, eating meals, offering support and more.
Neonatal diabetes is a rare form of diabetes in which a baby does not produce enough insulin, which causes their blood sugar levels to be too elevated. Symptoms usually appear within the first six months of a baby’s life. This condition differs from Type 1 diabetes in that symptoms appear much earlier in life, and it is caused by a specific genetic mutation, which often is inherited.For half of all babies diagnosed with neonatal diabetes, the condition can last a lifetime. For others, the condition may disappear but reoccur later in life, which is called transient neonatal diabetes.
If your baby is showing signs of neonatal diabetes, do not ignore them and see your child’s pediatrician for testing. If your child is suspected to have neonatal diabetes, you will be referred to a pediatric endocrinologist.
Treatment options include insulin therapy or certain oral medications, based on the baby’s condition.
MODY (maturity-onset diabetes of the young) refers to a variety of different types of diabetes that can appear in children and teens. Although MODY can mimic symptoms of Type 2 diabetes, these types of diabetes are caused by different kinds of genetic mutations. MODY usually is an inherited condition that runs in families across multiple generations.
MODY symptoms may be mild and appear gradually over time. Symptoms may include:
A blood sugar test can confirm the presence of diabetes. To officially diagnose MODY, genetic testing is needed confirm the presence of any genetic mutations that are associated with the condition.
Insulin therapy, oral medications and healthy lifestyle modifications, such as diet and exercise, may be used to treat MODY. However, treatment options can vary based on the specific genetic mutation causing the MODY diagnosis. This is where personalized diabetes care and genetic counseling is the best course of action for anyone diagnosed with MODY.
Some children may develop diabetes as a result of other health conditions. These conditions may result from various genetic, autoimmune or medical factors.
Secondary diabetes can occur as a result of another underlying medical condition or factor. Among children, secondary diabetes can be caused by various medical conditions (e.g., cystic fibrosis), hormonal disorders (e.g., Cushing’s syndrome, acromegaly), and certain medications (e.g., corticosteroids). Managing the underlying condition or discontinuing the medication may help improve blood sugar control.
Below are other conditions that can cause secondary diabetes.
Certain pancreatic disorders or abnormalities, such as pancreatitis or congenital anomalies of the pancreas, can affect insulin production and lead to diabetes in children. Treatment may involve managing the underlying pancreatic condition and using insulin therapy.
Some genetic syndromes, like Down syndrome and Prader-Willi syndrome, are associated with an increased risk of developing diabetes. Careful monitoring and early intervention are crucial in these cases.