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Childhood Diabetes

Angela Oswalt Morelli , MSW, edited by Mark Dombeck, Ph.D.

Diabetes is a serious metabolic disorder in which the body becomes unable to efficiently make use of blood sugars (glucose) and carbohydrates which are the body's primary source of fuel. There are two main types of diabetes, known as Type I (one) and Type II (two), respectively. Both types of diabetes have to do with the improper functioning of the hormone Insulin, which normally facilitates the movement of glucose from the blood into the body's cells where it is used for energy.

diabetes street signIn Type I diabetes, cells of the pancreas produce little or no insulin. In Type II diabetes, insulin is produced by the pancreas, but the body's cells nevertheless are still not able to get access to the glucose they need to produce energy. When this occurs, the body steps up production of insulin in an attempt to compensate. In both cases, abnormally high levels of blood sugar accumulate in the blood resulting in hyperglycemia, or high blood sugar.

The exact cause of Type I diabetes is unknown. Genetics, viruses, and auto-immune problems may play a role in developing this disease. The causes of Type II diabetes are better understood. Poor diet, obesity (particularly excess body weight around the waist), and a lack of exercise in combination with vulnerabilities due to heredity factors all contribute to the onset of Type II diabetes.

In the past, children's diabetes was almost always of the Type I variety; so much so that Type I diabetes was know as "juvenile onset diabetes". Type II diabetes was called "adult onset diabetes", because it was commonly observed only in adults. Today these labels are quite out of date as as increasing numbers of youth and adolescents are being diagnosed with Type II diabetes.

Children with uncontrolled diabetes experience increased thirst and urinate frequently as their bodies struggle to eliminate excess glucose. As well, shifts in blood sugar concentration are associated with moodiness. Extreme hunger and weight loss are also observed as children's growing bodies are not able to access the fuel in the foods they consume.

Diabetes is a serious medical condition that can result in disability if not properly treated. Untreated diabetes can cause damage to vision, kidneys, the heart, blood vessels, and the neurological system. Chronic diabetes can cause people to lose their vision or the use of their limbs. In its most severe (untreated) form, diabetes can be life-threatening. Luckily, diabetes is a treatable condition. Children and adults who properly manage their diabetes and follow their doctors' instructions can lead a full, normal life.

Diabetes management requires close nutritional monitoring. Children with diabetes need to adhere to a diet that eliminates or restricts consumption of refined sugar (found in fruit juice, cookies, cake, soda, candy, etc). In addition, many children with diabetes need to read labels and tightly control the amount of carbohydrate they consume each day. Controlling carbohydrate intake is necessary so that children eat only what their bodies can process.

As well, children with diabetes need to monitor their blood sugar levels using pretreated strips and a small finger prick device. Should their blood sugar levels get too high, symptoms described in the introduction of this section (e.g., increased thirst, urination, mood changes, etc.) will return. If blood sugar levels get too low, children can experience dizziness, trembling, rapid heartbeat, tingling sensations, or a loss of consciousness.

Managing diabetes is all about regulating blood sugar levels so that they remain reasonably even and do not become too high or low. To this end, children with diabetes may need to give themselves insulin shots once or twice a day in response to the rise and fall of their blood sugar levels. The process of insulin injection can be automated in some cases through the option of a surgically implanted insulin pump which meters out smaller, more frequent doses of insulin throughout the day in response to blood sugar levels. Insulin is prescribed, monitored, and adjusted only with a doctor's guidance. If too little insulin is given, the diabetes symptoms will return. If too much is given, the body can experience insulin shock, where blood sugar levels get too low.

Many things can affect children's blood sugar levels, including diet and food choices, exercise and activity (or lack thereof), and stress levels. Caregivers should work closely with the doctor, school nurse, and other responsible individuals (e.g., coaches, child care providers, etc.) to make sure that everyone involved with children's care are knowledgable about their condition and able to provide care appropriately.

As children with diabetes progress through middle childhood and become more responsible for self-care, they can and should be encouraged to take on more responsibility for managing their own diabetes care. Children who learn to monitor and control their disease independently early on are more apt to stick to their treatment regimen during the difficult adolescent years.