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Diabetes Mellitus Type 1 in Children

GENERAL INFORMATION:

What is diabetes mellitus type 1? Diabetes mellitus is a disease affecting how your child's body makes insulin and how it uses glucose (sugar). Insulin is a hormone that helps the body use sugar by allowing the sugar to enter body cells. The four types of diabetes are type 1, type 2, other specific types, and gestational diabetes. With type 1 diabetes, your child's body does not make enough insulin, causing high blood sugar levels. Type 1 diabetes is also called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes.

What causes diabetes mellitus type 1? Type 1 diabetes may be an autoimmune disease. An autoimmune disease is a condition where your child's defense system attacks some of his own cells. Normally, when your child's blood glucose level increases, the pancreas (an organ that lies behind the stomach) makes insulin. In type 1 diabetes, the cells in the pancreas that make insulin are destroyed. Diabetes may also be inherited as it runs in families.

What are the signs and symptoms of diabetes mellitus type 1? Your child may have any of the following:

• Frequent urination.
  
  
• Hungry most of the time.
  
  
• More thirsty than usual.
  
  
• Losing weight without trying.
  
  
• Blurred vision (eyesight).

How is diabetes mellitus type 1 diagnosed? Type 1 diabetes is diagnosed with blood sugar tests. Caregivers will test your child's blood sugar twice to be sure that he has diabetes. A positive blood sugar result should be repeated the next day. Your child may have any of the following blood sugar tests:

• Casual plasma glucose: This may be the first blood sugar test done if your child has symptoms of diabetes. Your child may have diabetes if his blood sugar is 200 mg/dl (milligrams per deciliter) or higher.
  
  
• Fasting plasma glucose: After your child has fasted (no food or liquid) for eight hours, his blood sugar will be checked. Your child may have diabetes if his blood sugar is 126 mg/dl or higher.
  
  
• Oral glucose tolerance test (OGTT): Your child's blood will be drawn two or more times during this test. After fasting, the first sample of blood will be taken. Your child will then be given a glucose drink. Two hours after drinking the liquid, the second sample of blood will be taken. A blood sugar result of 200 mg/dl or higher may mean your child has diabetes.

How is diabetes mellitus type 1 treated? Type 1 diabetes can be treated and controlled most of the time. The goal is to keep your child's blood sugar at normal levels. This can be done by correctly giving your child his insulin daily. Eating the right foods and exercising are also very important in controlling diabetes. You will learn how to check your child's blood sugar at home. You may have to check your child's blood sugar level three or more times daily.

How do I check my child's blood sugar levels? Your child's caregiver will teach you how to use a glucose monitor. This is a small device that tells how much sugar is in your child's blood. The monitor uses a small drop of blood from a prick on your child's finger. Record your child's blood sugar results in a diary each time you check it. Bring the diary with you when you see your child's caregiver.

What other health problems can diabetes mellitus type 1 cause? 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. The buildup of sugar can also damage organs in your child's body. Uncontrolled diabetes can affect your child's eyes, kidneys, and heart.

How can diabetes mellitus type 1 be controlled?

• Diet: A diabetes nurse or a dietitian will help you learn what your child needs to eat and how food affects his diabetes. Caregivers may suggest the following:
  
  
  • Your child's caregiver may suggest that you keep track of the amount of carbohydrate your child eats. Eating too much carbohydrate at one time can cause your child's blood sugar to rise to a very high level. Carbohydrates are found in starches (bread, cereal, starchy vegetables, and beans), fruit, fruit juice, milk, and yogurt. Sweets, such as candy, desserts, or regular soda also contain carbohydrates.
    
    
  • Choose foods for your child that are low in fat, saturated fat, and cholesterol. Lean cuts of meat, fish, and skinless poultry (chicken and turkey), and low fat milk are good examples. If your child is a baby or toddler under two years, you do not have to limit the fat in his diet as long as you choose healthy foods.
    
    
  • Your child should not skip meals. Make sure your child eats the same amount of food for his meals and snacks about the same time every day.
    
    
  • Your dietitian or caregiver will help you find a meal plan and schedule that works best for your child. Young children with diabetes can go through fussy eating phases just like other children. Continue to offer a variety of healthy foods along with your child's favorite foods during these times. Talk to your diabetes nurse or dietician if you have questions or are concerned about your child's eating habits.
  
  
• Exercise: Controlling your child's weight by exercising can change the amount of insulin his body needs. Try to get him to be active at least 30 minutes every day. Playing can be a very good exercise. Work with your child's caregiver to plan the best exercise program for your child

Where can I find support and more information? Having a child with type 1 diabetes is life-changing for you and your family. Accepting that your child has diabetes may be hard. School age children want to be like their friends. Your child may feel different because he has to take insulin, test his blood, and follow a meal plan. If your child is a teenager, doing these things make the normal troubles of adolescence even more difficult. Talk to your child's caregiver about how to help your child. You and your child may want to join a support group which is a group of people who also have type 1 diabetes. Contact the following for more information:

• American Association of Diabetes Educators
  American Association of Diabetes Educators
  100 West Monroe Street, Suite 400
  Chicago, IL 60603-1901
  Phone: 1-800-338-3633
  Web Address: http://www.aadenet.org
  

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria, VA 22311
  Phone: 1-800-342-2383
  Web Address: http://www.diabetes.org
  

• Juvenile Diabetes Research Foundation International
  120 Wall Street
  New York, NY 10005-4001
  Phone: 1-800-533-2873
  Web Address: http://www.jdf.org
  

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.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

References and sources