What Is Juvenile Diabetes?
Type 1 diabetes, once known as juvenile diabetes, is primarily diagnosed in children and young adults. Those with this disease have a pancreas that does not produce insulin.
Insulin is the hormone the body needs to transfer glucose from the bloodstream into the tissue cells. The cells use glucose (sugar) as fuel. Without insulin, this glucose builds up in the blood. The cells don’t get the glucose they need for energy, which can cause serious complications if the condition is not treated.
What Causes Juvenile Diabetes?
Type 1 diabetes affects just a small fraction of the population – five percent – mostly whites. While the disease typically is diagnosed in people under age 20, it can occur at any age.
Genetics are suspected in causing type 1 diabetes. However, researchers are also finding that a virus, or other factors in the environment, can trigger a change in the immune system. Suddenly, the immune system attacks the pancreas.
This makes type 1 diabetes an autoimmune disease, as the immune system is attacking the body.
Understanding Juvenile Diabetes Symptoms in Young Children
Rapid weight loss is often the first symptom in children. This occurs because the body is deprived of energy, which causes tissues and fat stores to shrink. However, the child has an intense appetite due to the muscles and organs needing energy.
Symptoms of type 1 diabetes also include:
- Peeing frequently due to the body’s way of getting rid of excess sugar.
- Thirstier than usual. The child becomes dehydrated because excess water goes out with urine.
- A toilet-trained child may start bed-wetting.
- Lack of energy, drowsiness caused by glucose deprivation.
Type 1 diabetes causes skin problems:
- Dry, itchy skin
- Bacterial infections
- Fungal infections
- Genital yeast infections (girls)
- Candidiasis, a type of diaper rash (babies)
How to Help Your Child Manage Their Diabetes
Treatment for type 1 diabetes is lifelong and includes blood sugar monitoring, insulin therapy, healthy eating and regular exercise. As your child grows and changes, so will his or her diabetes treatment plan.
If managing your child's diabetes seems overwhelming, take it one day at a time. Some days you'll manage your child's blood sugar perfectly, and on other days, it may seem as if nothing works well. Don't forget that you're not alone.
You'll work closely with your child's diabetes treatment team — doctor, diabetes educator and dietitian — to keep your child's blood sugar level as close to normal as possible.
Frequent Blood Sugar Monitoring
You must check and record your child’s blood sugar multiple times daily. This is the only way to make sure the level is within the target range and involves skin pricking.
Continuous Glucose Monitoring (CGM)
A fine needle inserted under the skin checks blood glucose level every few minutes. This is helpful for children who don't show warning symptoms of hypoglycemia.
Insulin treatments include rapid-acting insulin, short-acting insulin, intermediate-acting insulin, and long-acting insulin. The doctor will prescribe a mix of insulin types to use every 24-hour period depending on your child's age and needs.
Insulin Delivery Options
- Fine needle and syringe. This method allows for different types of insulin to be mixed in a single injection, reducing the number of injections.
- Insulin pen. The device looks like an ink pen, with a cartridge filled with insulin. Mixed insulin preparations are available in pen form, but these mixtures aren't for children.
- Insulin pump. This is a small device the person wears. A catheter inserted under the abdomen skin allows the insulin to travel into the body.
Healthy eating and regular exercise are important in keeping blood sugar levels under control. Your child’s dietitian will likely advise lots of fruits and vegetables, whole grains, fewer animal products and sweets.
It’s critical for a parent to learn what a high-fat or high-sugar food does to the child’s blood sugar. As time passes, you’ll learn more about the effects of your child’s favorite foods, and how to compensate.
Physical activity should be part of your child’s daily routine. Physical activity lowers blood sugar and can affect blood sugar for up to 12 hours later. You may need to check blood sugar more often when the child starts a new activity. Adjust meals or insulin doses to compensate for the activity.
Red Flag Signs of Trouble
Even with constant monitoring, there can be problems. Low blood sugar, high blood sugar, and ketoacidosis require immediate care. If not treated, they can cause seizures and coma (loss of consciousness).
Hypoglycemia (Low Blood Sugar)
Teach your child the signs of low blood sugar. These include:
- Pale complexion
- A headache
If your child has a low blood sugar reading:
- Give fruit juice, glucose tablets, hard candy, regular (not diet) soda or another source of sugar.
- Retest the blood sugar in about 15 minutes to make sure it has gone up into the normal range.
- If blood sugar level is still low, give more sugar and then retest in another 15 minutes.
If not treated, your child could lose consciousness. This requires an emergency injection of a hormone that stimulates the release of sugar into the blood (glucagon). Make sure you and your child always carry a source of fast-acting sugar. Talk to your doctor about this.
Hyperglycemia (High Blood Sugar)
Hyperglycemia or high blood sugar can occur when the child overeats, eats the wrong foods and doesn’t take enough insulin.
Signs of high blood sugar:
- Increased thirst
- Frequent urination
If you suspect hyperglycemia:
- Check your child's blood sugar
- You may need to give an extra dose of insulin if blood sugar is above your child's target range
- Wait 15 minutes, and then recheck your child's blood sugar
- Adjust your child's meal plan or medications to prevent high blood sugar in the future
Severe lack of insulin causes your child's body to produce ketones. Excess ketones build up in your child's blood and are spilled in the urine, a condition known as diabetic ketoacidosis (DKA). Untreated DKA can be life-threatening.
Signs of DKA include:
- Thirst or parched mouth
- Increased urination
- Flushed skin
- Nausea, vomiting or belly pain
If you suspect DKA, use an over-the-counter ketone test to check your child's urine for excess ketones. If the ketone levels are high, call your child's doctor or get emergency care.
As this is a serious disease, your child will need help following the 24/7 treatment plan. This will require some significant lifestyle changes, but over time they will seem normal. By carefully controlling type 1 diabetes, you reduce your child’s risk of very serious complications.
Always stay positive. The habits you teach your child today can help ensure a happy, healthy, active life.