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Diabetes mellitus type 1 in children

What is it?

Diabetes (di-ah-BE-tez) is also called diabetes mellitus (MEL-i-tus). There are three main types of diabetes. Your child has type 1 diabetes. It may also be called insulin dependent, early onset, or juvenile onset diabetes. Type 1 diabetes happens when your child's pancreas (an organ that lies behind the stomach) does not make insulin. Type 1 diabetes is more common in children or young adults but anyone can have it. It usually starts in late childhood but can happen in early infancy through late adulthood. There is no cure for diabetes but your child can have a long and active life if his diabetes is controlled.

How did my child get type 1 Diabetes?

  • Insulin is a hormone (a special body chemical) made by the pancreas. The pancreas is an organ that lies behind the stomach. Much of the food we eat is turned into sugar in the stomach. This sugar goes into the blood and travels to the cells of your child's body to be used for energy. Insulin acts as a "key" to help sugar enter the cells.
  • With type 1 diabetes, your child's body does not make insulin. This causes sugar to build up in his blood so your child must have insulin shots every day. At a time during the first year after the diagnosis is made, your child may need less insulin. This is called the "honeymoon period." You will give your child his insulin injections until he is old enough to do it himself. Some children can learn to give themselves their own insulin shots around ten years old, with an adult present.

Signs and Symptoms:

The symptoms of hyperglycemia (hi-per-gli-SE-me-ah) or high blood sugar usually come on suddenly. If your child has one or more of the following signs and symptoms, you should take your child to see his caregiver:

  • Blurry vision.
  • Fatigue (feeling very tired).
  • Hungry all of the time.
  • Losing weight without trying.
  • Sores that take a long time to heal.
  • Urinating often or bedwetting even though your child is potty trained.
  • Very thirsty and drinking a lot of liquids.
  • Irritability (grumpy and fussy).
  • Restless, listless (does not seem to care or to pay attention to the teacher) and has trouble at school.

What is hypoglycemia?

Your child may have problems with hypoglycemia (hi-po-gli-SE-me-ah). This is a condition that happens when your child's blood sugar level falls too low. It may be caused by having too much insulin in his blood or your child may not have eaten enough. Ask your child's caregiver for more information about hypoglycemia.

It is very important in young children to treat symptoms of low blood sugar right away. Give your child something to eat or drink that has sugar, such as four ounces (one-half cup) of orange juice, five to six pieces of hard candy, or glucose tablets. If your child is very young, you may need to check his blood sugar more often. This is because your child has not learned to recognize the symptoms of low blood sugar. Very young children may not be able to tell you that they feel different when their blood sugar drops. Following are the signs and symptoms of hypoglycemia:

  • Being confused.
  • Fatigue (feeling very tired).
  • Feeling weak and dizzy.
  • Feeling very hungry.
  • Having a headache and feeling irritable.
  • Having a very fast heartbeat.
  • Looking pale.
  • Trembling and sweating with a cold, clammy feeling.
  • Unconscious (passing out) and going into a coma.

What is ketoacidosis? Ketoacidosis (ke-toe-ah-si-DOE-sis) happens if your child's blood sugar stays too high for too long without being treated. This can cause your child's body to start breaking down body fats for energy rather than using blood sugar. Wastes called ketones are left behind. This may happen when your child is sick or under a lot of stress. It may also happen if your child has eaten too much or has not taken enough insulin. Ketoacidosis can be very serious and needs to be treated right away. Ask your child's caregiver for more information about ketoacidosis.

Following are the signs and symptoms of ketoacidosis:

  • More thirsty than usual.
  • Passing more urine than usual.
  • Acting confused or having trouble thinking clearly.
  • Fatigue (feeling tired).
  • Fast deep breathing at rest.
  • Fruity-smelling breath.
  • Nausea and vomiting (throwing up).
  • Finally, becoming unconscious (coma).

Can diabetes cause other health problems? High blood sugar levels may damage other body tissue and organs over time. Diabetes can even cause death if left untreated. If your child's blood sugar is well controlled, other health problems may not happen.

  • Having uncontrolled diabetes for a long time can damage your child's nerves, veins, and arteries. This can cause damage to his feet and legs. With time, your child may need to have his feet or legs amputated (removed).
  • The buildup of sugar can also damage organs in your child's body. Uncontrolled diabetes can affect your child's eyes, kidneys, and heart.

Wellness Recommendations:

The most important thing you must do is help control your child's blood sugar. Caregivers will work with you and your child to help keep blood sugar levels within a "target range." This means that the blood sugar is not too high or too low. To do this, you have to find the right balance of diabetes medicine, food, and physical activity. Food puts sugar in their body and raises blood sugar levels. Diabetes medicine and physical activity lower blood sugar levels.

You can help control your child's blood sugar by helping him eat the right food. A diabetes nurse or a dietitian will help you learn what your child should eat and how food affects his diabetes. A diet high in fiber is helpful in diabetes.

  • Your child should not drink alcohol.
  • Exercising helps your child's body better use sugar and insulin. This helps keep blood sugar levels under control. It also makes the heart stronger, lowers blood pressure, and helps keep an ideal body weight. Your child may also feel less anxious about his diabetes and feel better about himself if he exercises. Ask caregivers to help plan the best exercise program for your child. Start exercising when your child's caregiver says it is OK.

Medical Care:

Your child may need to take medicine to control his blood sugar. He may need to go into the hospital for more tests and treatments.

Herbs and Supplements:

Before your child takes any herbs or supplements, ask his caregiver if it is OK. Talk to your child's caregiver about how much your child should take. If your child is using this medicine without instructions from his caregiver, follow the directions on the label. Do not give your child more medicine or take it more often than the directions tell you to.

The herbs and supplements listed may or may not help treat your child's condition.

Herbs:

  • Bitter melon (Momordica charantia) may be helpful and has been studied in people with diabetes.
  • Fenugreek (Trigonella foenum-graecum) is helpful for diabetes and has been studied in people.
  • Gymnema (Gymnema sylvestre) may be helpful and has been studied in people with diabetes.
  • Prickly pear cactus (Opuntia fulginosa) may be helpful and has been studied in people with diabetes.
  • Psyllium (Plantago isphagula) may be helpful and has been studied in people with diabetes.

Supplements:

  • Alpha lipoic acid may be helpful for diabetes and has been studied in people.
  • B vitamins (B1 (thiamine), B6 (pyridoxine), and B12 (cyanocobalamin)) may be helpful for diabetes and diabetic nerve problems.
  • Biotin has been used, but has not been studied in people who have diabetes.
  • Chromium may be helpful for diabetes and has been studied in people.
  • Fish oil (DHA, EPA) may be helpful and has been studied in people with diabetes.
  • Glucomannan may be helpful for diabetes and has been studied in people.
  • Guar gum may be helpful for diabetes and has been studied in people.
  • Magnesium may be helpful for diabetes and has been studied in people.
  • Vanadium is helpful for diabetes and has been studied in people.
  • Vitamin E may be helpful for diabetes and has been studied in people.
  • Zinc may be helpful for diabetes and has been studied in people.

Complementary Therapies:

  • Traditional Chinese Medicine (TCM), which combines acupuncture and herbs, has been used to treat diabetes
  • Stress may affect diabetes.

Other ways of treating your symptoms:

Talk to your caregiver if:

You would like medicine to treat your child's diabetes.

Your child's symptoms have not gone away or improved by these self-help measures.

You have questions about what you have read in this document.

Your child has one or more of the following symptoms of high blood sugar:

  • Blurry vision.
  • Fatigue (feeling very tired).
  • Hungry all of the time.
  • Losing weight without trying.
  • Sores that take a long time to heal.
  • Urinating often or bedwetting even though your child is potty trained.
  • Very thirsty and drinking a lot of liquids.
  • Irritability (grumpy and fussy).
  • Restless, listless (does not seem to care or to pay attention to the teacher), and has trouble at school.

SEEK CARE IMMEDIATELY IF:

Your child has trouble thinking clearly.

Your child is feeling worse even though you are following the caregiver's directions.

Your child has signs of advanced ketoacidosis:

  • Confused or trouble thinking clearly.
  • Fast deep breathing at rest.
  • Fruity-smelling breath.
  • Finally, going into a coma.

Care Agreement:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child. You always have the right to refuse treatment.

References:

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Last Updated: 11/4/2014

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