What is diabetes?
Type 1 diabetes is a disorder where the body does not make
enough of a hormone called insulin. Type 1 diabetes is also
called insulin-dependent diabetes, childhood diabetes, or
juvenile diabetes.
Type 1 diabetes usually starts in childhood or early
adulthood. It must be treated with insulin shots. With
treatment, blood sugar levels can be controlled.
Type 1 diabetes should not be confused with type 2 diabetes
(non-insulin dependent diabetes). People with type 2
diabetes can still produce insulin in regular amounts and
receive different treatments. Type 2 diabetes is becoming
more common in children ages 10 to 18 years old.
What is insulin?
Insulin is a hormone produced by an organ in your body
called the pancreas. When food is digested, the body breaks
down much of the food into sugar (glucose). Blood carries
the sugar to the body's cells for energy. Insulin helps the
sugar enter the cells and controls the level of sugar in the
blood.
When there is not enough insulin in the body, the amount of
sugar in the blood can reach very high levels. Too much
sugar in the body can cause many serious problems. If the
problems are not treated, they can be life-threatening.
What causes type 1 diabetes?
In type 1 diabetes, destruction of cells in the pancreas
causes the pancreas to make very little insulin. Often it
is not known why the cells are destroyed. One possible
cause is that the body's own immune system destroys the
cells. Also, diabetes tends to run in families.
How is it diagnosed?
Some of the signs that your child may have diabetes include:
urinating a lot
drinking a lot of fluids
losing weight.
If you think your child has diabetes, call your health care
provider. If you want to test for diabetes at home, you can
buy a simple urine test called Keto-Diastix at a pharmacy.
Keto-Diastix can be used to check the level of sugar and
other chemicals (ketones) in your child's urine. Call your
child's provider immediately if the test for sugar in the
urine is positive.
What is the treatment?
Education and diet.
When a child is diagnosed with diabetes, there is a lot
the family must learn about the disease. This
education is usually done for 2 or 3 days at a children's
diabetes clinic. Health care providers will teach you
what diabetes is and how to give shots of the proper
amounts of insulin to your child. You will learn how to
test for sugar in the blood and for ketones in the blood
or urine. You will learn how to treat low blood sugar
and other procedures needed to keep your child healthy.
A dietitian will teach you about food management. A
child with diabetes needs to be careful about eating
carbohydrates. Your child will need to eat and snack
consistently from day to day.
For more information see:
Diabetes: Food Management
Control of blood sugar levels.
Home care involves balancing diet, exercise, and stress
with insulin. Children with type 1 diabetes must get
insulin shots. The dosage of insulin in the shots is
not always the same. The dose must be adjusted
according to the food the child eats and the level of
sugar in the child's blood at the time of the shot. If
a child gets too much insulin, low blood sugar could
result. Just as prevention of high blood sugar is
important, prevention of low blood sugar is also very
important.
Most families use a home meter to measure the level of
sugar in their child's blood 3 or 4 times each day.
After your child is around 7 to 10 years old, he can
learn how to test his own blood sugar. Families also
learn how to give the insulin shots. Children can learn
to do their own shots when they are 10 or 11 years old.
Measuring blood sugar and giving insulin shots at home
allows you to adjust the treatment as needed for the
best blood sugar control.
Blood sugar levels measured when a child has not eaten
for at least 2 hours and 2 hours after meals should be
kept in the following ranges:
Children under the age of 5 years: 100 to 200 mg/dL
(5.5 to 11.1 mmol/L).
Children ages 5 to 11 years: 80 to 180 mg/dL (4.4 to
10.0 mmol/L)
Children over 12 years old: 70 to 150 mg/dL (3.9 to
8.3 mmol/L).
Follow-up visits with your child's health care provider.
Your child's provider will measure the overall blood
sugar control every 3 months with a test called the
hemoglobin A1c (HbA1c). If the HbA1c is kept in a good
range, the risk for eye, kidney, and nerve problems is
greatly reduced.
Ketone tests
Fat breaks down into ketones when not enough insulin is
available. Ketones have acid properties that can make a
person very sick, causing a condition called
ketoacidosis. It is important to keep a method of
measuring ketones at home. You can use the urine ketone
dipstick tests (Ketostix or Keto-Diastix) or a blood
ketone test (Precision Xtra). You need to test for
ketones if a child with diabetes is sick (even vomiting
once), or if the blood sugar is high (for example, above
240 mg/dL, or 13.3 mmol/L).
Checking other family members
Other family members have a 1 in 20 chance (5%) for also
developing diabetes. A blood glucose level test is not
very helpful for predicting diabetes because the test
does not show high glucose levels unless the person
already has diabetes. Fortunately, a test called the
"islet cell antibody" test is now available that can
predict diabetes as much as 10 years before a person
gets diabetes. It is a free test through the
TrialNet/Natural History Study. Call 1-800-425-8361 for
more information (in Denver call 303-315-6397).
When should I call my child's health care provider?
Call immediately if:
Your child's urine tested positive for sugar and he or
she has not yet been diagnosed with diabetes.
Your child with known diabetes frequently has low blood
sugar, particularly if your child loses consciousness or
has seizures.
A urine test shows that there are moderate or large
amounts of ketones in your child's urine or the blood
ketone test is >0.6 mmol/L.
Call during office hours if:
Blood sugar tests at home are constantly above the
desired range for your child's age.
Blood sugars tests at home are frequently (1 or 2 times a
day) below the desired range for your child's age.
Another illness (for example, flu) occurs, which might
upset the diabetes.
If you have other questions about diabetes.
For more information:
A book is available for families who have a family member
with type 1 diabetes. The book explains home care in
detail. It is called "Understanding Diabetes" and costs
$15. You can order the book by writing or calling:
The Guild of Children's Diabetes Foundation
777 Grant Street, Suite 302
Denver, Colorado 80203
303-863-1200
You can also order online at:
http://www.childrensdiabetesfdn.org
