Diabetes In Children: Symptoms, Types And Diagnosis

Diabetes In Children Symptoms, Types And Diagnosis

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We commonly relate diabetes to adults. It is not easy to relate the condition with a child. But unfortunately, diabetes in children is a reality and leads to challenges similar to those faced by adults.

Children have a long life and diabetes could be a hindrance to leading a normal life. So, how do parents manage diabetes in children? What are the warning signs of childhood diabetes? In this post, MomJunction gives you all that information. Read on.

What Is Diabetes?

Diabetes, also called diabetes mellitus, is a condition where your pancreas produces very little or no insulin. Inadequate or no insulin makes it difficult for the body to extract energy from food.

Our body breaks down food into a simpler sugar called glucose for the cells to use as energy. But the glucose can enter the cells only in the presence of the insulin hormone. Insufficient insulin or the lack of it makes it impossible for glucose to enter the cells. As a result, the cells do not get energy while the glucose accumulates in the bloodstream (1).

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What Are The Types Of Diabetes In Children?

There are two types of diabetes, just like in adults:

  1. Type 1 diabetes: This autoimmune disease causes the pancreas to make little to no insulin. It mostly affects children and hence is also called juvenile diabetes (2). Type 1 diabetes is a chronic problem. According to the American Diabetes Association, about 1.25 million children and adults in the US have type 1 diabetes (3).
  1. Type 2 diabetes: The pancreas does not produce adequate insulin or the body’s cells are unable to use insulin correctly to allow glucose (4). Type 2 is the most common form of diabetes and accounts for 90-95% cases of diabetes mellitus (5). Type 2 diabetes is often triggered by a preventable condition like obesity.

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What Causes Diabetes In Children?

The exact reasons are not known (6). However, medical experts believe that type 1 diabetes occurs due to genetic factors since it is an autoimmune disease. The immune system cells attack and destroy the pancreatic cells responsible for the production of insulin. The faulty genes are usually triggered by factors such as environment and lifestyle.

The cause of type 2 diabetes is also unknown. It often seems to run in families, thus suggesting faulty genes at work. However, it takes a preventable factor, such as obesity, to trigger the faulty gene.
Let’s see more about such triggering factors in the next section.

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What Are The Risk Factors For Diabetes In Children?

The following are the common factors that increase the child’s susceptibility to diabetes (5):

  • Family history
  • If the mother had diabetes (gestational diabetes) during pregnancy
  • The child was born overweight
  • Belonging to certain ethnic groups such as African, Pacific Islander, and Asian
  • Being overweight or obese is one of the most common causes of type 2 diabetes in children. (Childhood obesity may seem unreal, but according to the US Centers for Disease Control and Prevention, one out of five school-going children in the country is obese (7)
  • Injury or damage to the pancreas either through an accident or due to an infection
  • Having another autoimmune or genetic disease. For example, children with genetic disorder cystic fibrosis are at risk of developing diabetes (6)

If your child has a few of the above risk factors, and not keeping well, then you might want to check for the symptoms of diabetes.

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What Are The Symptoms Of Diabetes In Children?

A child with diabetes will display the following signs (1):

  1. Increased urination. Your child will visit the toilet more frequently. Older children may wet the bed at night despite being toilet-trained.
  1. Increase in appetite but with no gain in weight.
  1. Increased thirst.
  1. Trouble with eyesight. The child would complain about blurred vision.
  1. Drowsiness and frequent tiredness.
  1. Mood swings and irritability.
  1. Itchy or dry skin.
  1. Tingling sensation in the hands and feet.
  1. Repeated episodes of nausea and vomiting.
  1.  Dark, ring-like patches on the skin around creases and folds in the areas like nape (back of the neck), underarms, elbow and knee folds. The darkening of the skin is called acanthosis nigricans (AN), and could be an indicator of diabetes (8).

The symptoms of type 1 and 2 diabetes are similar and may not immediately be a red flag. It is when the symptoms sustain for a long time that the situation can be concerning. Take your child to the doctor if you suspect diabetes.

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How Is Diabetes Diagnosed?

Doctors use the following diagnostic measures to detect diabetes:

  1. Blood test: It includes a suite of tests. The primary tests are random glucose test and a fasting glucose test. Oral glucose tolerance test is a variation of the fasting glucose test that checks blood glucose levels after consumption of a sugary drink at the doctor’s clinic. Another test is the hemoglobin A1C test that shows the average amount of glucose in the hemoglobin for the past three months. Other compounds, such as the levels of c-peptide and antibodies in the body, are also checked during the blood tests.
  1. Urine test: A child with diabetes will have higher than normal levels of glucose in the urine.

Doctors determine type 1 or 2 diabetes depending on the levels and values of different compounds checked in the blood test. If the child’s blood sugar is higher than usual but not high enough to be diabetic, then they are in the pre-diabetes stage.

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Can Diabetes Be Treated In Children?

There is no cure for diabetes. Multiple organizations have been trying to find a cure for the condition through cell therapy, countering the immune system, or inducing insulin production, but they are just in the early stages of development (9).

However, diabetes can be effectively managed through medicines and lifestyle changes.

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How To Manage Diabetes In Children?

Both types of diabetes can be managed by controlling the blood sugar and not letting it fluctuate. Here are the various ways to manage a child’s diabetes (10):

1. Monitor the blood sugar:

  • Check the child’s blood sugar periodically as per the schedule suggested by the doctor.
  • You may also have regular appointments with the doctor to check the child’s blood sugar and other parameters like insulin levels through a laboratory test.
  • The monitoring of blood sugar helps in detecting any sudden increase or decrease of blood sugar.

2. Insulin injection:

  • If the doctor has prescribed insulin injections to the child, then use them at intervals as advised. These injections may be self-administered by the child or by the parent in the case of younger children.
  • The insulin injection is a specialized syringe with a thin, small needle, which makes it nearly pain-free. It is given either on the upper arm, the front of the thigh, or the lower belly.
  • There is also an alternative option called an insulin pump, which gradually releases insulin within the body at various time intervals throughout the day. An insulin pump is a small digital device that attaches to
  • your belt. A tiny tube delivers the insulin through a small needle taped to the belly. The main pump module that sits on the belt monitors the blood sugar and releases relevant quantities of insulin into the body.
  • The pump mimics the pancreas in its way of delivering insulin in small doses over a period. However, insulin pumps need to be programmed/calibrated periodically and are also expensive when compared to single-use insulin injections.

3. Diet management:

  • The diet will determine the blood sugar and also the amount of insulin your child needs.
  • Your child’s food plan should consist of food low in fat and carbohydrates but rich in other nutrients like proteins.
  • Talk to a dietician for a personal diet plan for your child.

4. Physical activity:

  • Physical activity helps regulate the use of blood sugar while also making the body efficient at using insulin.
  • Regular exercise is important for children with type 2 diabetes. If the child is obese or overweight, then they must lose weight through exercise.
  • The American Academy of Pediatrics states that a child should be active for at least one hour every day. Children can do moderate to vigorous exercises suitable for their age. Parents can be part of the activity to encourage the child.

There is no single diabetes management plan, as it may vary depending on the age of the child, type of diabetes, and their overall health. Your child’s doctor and dietician can help you achieve the right diabetes management plan custom-made for your child. However, some dietary best practices work for all children with diabetes.

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What To Feed A Child With Diabetes?

Here is a general list of foods to eat and foods to avoid for a child with diabetes (11):

Foods to eatFoods to avoid
Five servings of fruits and vegetablesSugary drinks, including fruit juices
High-fiber, whole-grains such as whole-grain cerealHighly processed grains with low fiber and high carbohydrate content
Naturally sweet food like sweet potatoes as a dessertCandies and high sugar desserts; food items with refined simple sugars
Lean meat like chicken and fishRed meat like beef
Low-fat healthy oils like olive oil and sunflower oilOils and fat with high trans fat content
Food cooked using fat-free methods such as baking, steaming, and boilingFoods high in butter and other fats
Low-fat milk and dairy productsWhole milk and dairy products with high fat and sugar content

A healthy diet prevents a surge in blood sugar.

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What Are The Complications Of Diabetes In Children?

Chronic high blood sugar affects nearly all organ systems in the body. Here are the likely complications of poorly managed diabetes:

  1. Gangrene, which causes the death of the tissue usually around the extremities like the arms and legs.
  1. Circulatory system problems like a stroke.
  1. Problems with vision, including impaired vision and blindness.
  1. Kidney problems.
  1. Complications in the functioning of the heart. Extreme cases can cause heart failure.
  1. Hypoglycemia – extreme low blood sugar — due to an over-dosage of insulin injection.

Complications of diabetes only occur when you make no efforts to control blood sugar. Proper management of diabetes helps prevent such issues.

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Can You Prevent Diabetes In Children?

Type 1 diabetes is difficult to prevent as it is genetic. The risk of type 2 diabetes can be minimized through healthy lifestyle practices. Here is what can be done to reduce a child’s risk of having diabetes:

  1. Adequate physical activity: Physical activity helps keep the body weight under control. Being overweight and obese is the most significant risk factor in causing type 2 diabetes. Encourage your child to exercise at least one hour a day. They need not have to do all the exercises at once but break it down to four 15-minute sessions (12).
  1. Healthy balanced diet: Remove soda and sugary drinks from the child’s menu. Give them fruit for in-between snacks. You need not eliminate sugar from the child’s diet. Desserts are okay to have but in a small serving and no more than once a day. A balanced diet is essential to maintain a healthy body weight and for the child to get all the essential nutrients
  1. Change the feeding habits: Do not let your child eat while watching TV. It can make them eat more than usual. Also, serve small portions of a meal at a time to prevent overeating. Do not force the kid to finish what is on their plates. If a child says they are full, then do not insist on them eating more.

Diabetes is a lifelong condition, but it need not be an impairment to your child’s growth. Help them manage their condition by making careful health choices. You may be supportive by controlling the child’s diet and replacing unhealthy food with healthy ones.

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Have something to share about diabetes in children? Do let us know in the comment section below.

References:

1. Diabetes Mellitus: An Overview; Cleveland Clinic
2. Type 1 Diabetes; University of Virginia
3. Statistics About Diabetes; American Diabetes Association
4. Type 2 Diabetes; University of Rochester
5. What is Type 2 Diabetes?; University of California
6. Childhood Obesity Facts; Centers for Disease Control and Prevention
7. What are the Types of Diabetes?; Yale School of Medicine
8. Acanthosis Nigricans; American Academy of Dermatology
9. The future of diabetes treatment: Is a cure possible? Labiotech.eu
10. Diabetes Mellitus: An Overview: Management and Treatment; Cleveland Clinic
11. Type 2 Diabetes: Tips for Healthy Living; American Academy of Pediatrics
12. Prevent Type 2 Diabetes in Kids; Centers for Disease Control and Prevention

 

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Rohit Garoo

Rohit Garoo took writing as a profession right after finishing his MBA in Marketing. Earlier he graduated with a Bachelor’s degree in Botany & Zoology from the autonomous St. Xavier’s College in Mumbai. Rohit has also done a Stanford University certification course on breastfeeding. This botanist-zoologist turned writer excels at life sciences, and at MomJunction he writes everything about pediatrics and maternal care. In between writing and being overly curious, he spends time cooking, reading, and playing video games. LinkedIn profile – linkedin.com/in/rohit-garoo-263115aa
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