Type 1 Diabetes in Children

Condition

What is type 1 diabetes? 

Type 1 diabetes (T1D) can develop at any age, but most often occurs in children and teens. In T1D, the pancreas produces little to no insulin. The hormone insulin is essential for life because it allows the cells in muscles, fat, and live to absorb glucose (sugar) that is in the blood and use it for energy. 

Previously, T1D in children was known as “juvenile diabetes” or “insulin-dependent diabetes”. 

The exact cause of T1D is not known, but generally, it is an autoimmune disease that results in the body’s inability to produce insulin, leading to abnormally high blood sugar levels. Viruses that generate autoimmune responses to attack pancreatic beta cells (the body’s insulin-producing cells) also increase the risk. 

The rate  of new diagnosis of T1D has increased 2.8 percent to 4 percent per year in recent years and is expected to continue to increase, so education and research are critical to developing new ways to combat T1D. 

What are the symptoms of T1D in children? 

Symptoms of untreated T1D may be similar to other medical conditions. Common symptoms are increased thirst, frequent urination, unintentional weight loss, sweet smelling breath, fatigue, and irritability.

Are there potential complications in T1D? 

If left untreated, T1D can affect multiple organs. This can cause damage to the heart and blood vessels, eyes, nerve, and kidneys, to name a few. In severe cases, long-term complications of T1D can lead to death. 

Other complications that require immediate medical attention are hypoglycemia (low blood sugar levels), hyperglycemia (high blood sugar levels), and diabetic ketoacidosis (excessive ketones in the blood due to insufficient insulin).

Are there prevention methods to protect children from developing T1D?  

Currently, there aren’t any known ways to prevent T1D, but ongoing research is focused on identifying possible therapies for disease prevention in high risk populations. Drugs are also being developed to slow disease progression and prevent further destruction of insulin-producing cells in people living with T1D.

How is T1D diagnosed?  

There are a few tests that can be administered to diagnose T1D. A diagnosis of diabetes can be made if your child’s random or fasting blood sugar levels are elevated. The levels of autoantibodies commonly found in T1D may also be determined, to distinguish type 1 from other types of diabetes. They will also have a glycated hemoglobin (A1c) test which will reflect the average blood sugar level over the last three months. Other blood and urine tests are also available to check for associated conditions.

Additional support after diagnosis is needed. Assisting your child in achieving and maintaining healthy blood sugar levels is extremely important, as well as having regular visits with your child’s diabetes team. The multidisciplinary team may include doctors, diabetes educators, dietitians, and social workers, all of whom are important in educating and supporting you and your child. 

What treatment options are available? 

The primary treatment for children with diabetes is insulin administration. To most optimally give insulin, tasks for the family typically include frequent monitoring of glucose levels (with glucose meters or continuous glucose monitoring), keeping track of carbohydrates, and adjusting insulin doses for different diet choices, activity levels, and illness.

Insulin medications available include rapid-acting insulin, short-acting insulin as well as long- and ultra-long-acting insulin. Consult with your child’s diabetes team to determine which type of insulin medication is appropriate for your child’s needs. 

What insulin delivery options are best suited for children? 

Insulin can be administered by injections given multiple times a day (with a syringe or with a pen-like device), or via insulin pumps. Either delivery option is safe and effective for children. Consult with your child’s diabetes team to determine which mode of insulin delivery is appropriate for your child’s specific needs. 

Supporting your child after a diagnosis

When your child is diagnosed, it may be very concerning and overwhelming, but your diabetes team is there to help. You will learn new skills and incorporate new tasks at home. These may include:

  • how to check your child's blood sugar and understand the results
  • how to calculate and give a dose of insulin
  • how to count carbohydrates and notice the effect of different foods on blood sugar levels
  • how to treat a low blood sugar level
  • understand how exercise, illness, and stress affects blood sugar levels 

It is also important to inform others about your child’s diagnosis. Educate other family members, friends, and school administrators about T1D and how they can help. Having allies and creating a support system is essential to your child’s health. 

Also, try to encourage your child to be open about T1D with their classmates, teachers, and school nurses. This can help them feel more comfortable about their diagnosis and allow others to recognize symptoms of hypoglycemia (low blood sugar). 

Other organizations that may be of support are the American Diabetes Association (ADA), Juvenile Diabetes Research Foundation (JDRF) and Children with Diabetes, who all have web pages that list resources for local support. 

Questions to Ask Your Doctor 

  • What is considered a healthy blood sugar range? 
  • What are the signs of hypoglycemia? 
  • What is diabetic ketoacidosis (DKA) and what are some warning signs? 
  • Can my child's insulin dosage be adjusted? 
  • What are long-term complications of diabetes, and how can we prevent and monitor for them?
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