Most of the food we consume is turned into glucose (sugar) in order for our bodies to use for energy. The pancreas (an organ near the stomach) creates a hormone called insulin to help the glucose enter the cells of your body.
If you suffer from diabetes, your body either doesn’t produce enough insulin or cannot effectively use the insulin produced, causing sugar to build up in the blood.
There are two main types of diabetes; type 1 and type 2. Type 1 diabetes requires insulin as treatment and is typically developed during childhood. Type 2 diabetes is more common than type 1 and generally affects people over the age of 45 who are overweight.
Type 1 Diabetes
Type 1 diabetes in children is a condition where the body cannot produce insulin. If your child is diagnosed with type 1 diabetes, they will receive treatment from a paediatric diabetes care team until they reach the age of 18. They will be helped to manage their condition and taught how to test blood glucose levels and control their diet.
There is no cure for type 1 diabetes in children; however, it can be managed. Advances in monitoring blood sugar and insulin delivery have improved quality of life and blood sugar management for children with diabetes.
Type 2 Diabetes
Type 2 diabetes typically occurs more frequently in adults; however, cases are rising in children. Type 2 diabetes is a chronic condition that affects the way the body processes sugar (glucose). It occurs when the body becomes resistant to insulin or when the pancreas stops producing enough insulin, resulting in a build-up of sugar in the bloodstream, leading to symptoms of high blood sugar.
Causes of Type 1 Diabetes
In children and adults, the exact cause of type 1 diabetes is unknown. In most people with type 1 diabetes, the body’s immune system wrongly destroys insulin-producing (islet) cells in the pancreas. Your child can produce little to no insulin once the islet cells of the pancreas have been destroyed.
Insulin moves glucose from the bloodstream to the body’s cells, but without enough insulin it builds up in your child’s bloodstream, which if left untreated, can cause life-threatening complications. Possible causes include:
- Family history
- Anyone with a parent or sibling that has type 1 diabetes is at a slightly increased risk of developing the disease.
- Genetics
- Certain genes are linked, with an increased risk of type 1 diabetes
- Viruses
- Exposure to certain viruses may result in the autoimmune destruction of the islet cells.
Causes of Type 2 Diabetes
Type 2 diabetes occurs when the body becomes resistant to insulin or when the pancreas stops producing enough, resulting in a build-up of sugar in the bloodstream, leading to symptoms of high blood sugar. The exact cause of type 2 diabetes in children is unclear; however, it is apparent that certain factors increase the risk of the developing the condition. These include:
Weight
Being overweight or obese is a risk factor for type 2 diabetes in children. Excess fatty tissue, particularly around the abdomen can cause the cells in the body to become resistant to insulin.
Inactivity
Inactivity goes hand in hand with weight gain. If your child is not getting enough exercise, the greater their risk of developing type 2 diabetes. Physical activity and exercise helps your child control their weight as it uses glucose as energy and makes your child’s cells more responsive to insulin.
Family History
If a parent or sibling had previously developed the disease, the risk of type 2 diabetes is increased.
Age and Gender
Many children develop type 2 diabetes in their early teens, with girls more likely to develop type 2 diabetes than boys do.
Birth Weight and Gestational Diabetes
Low birth weight and being born to a mother who had gestational diabetes during pregnancy are both linked to a higher chance of developing type 2 diabetes.
Pre-term Birth
Babies born prematurely are at a higher risk of developing type 2 diabetes.
Symptoms of Childhood Diabetes
Signs and symptoms of type 1 diabetes in children typically develop quickly, and may include:
- Increased or excessive thirst
- Mood swings
- Nausea/vomiting
- Frequent urination with possible bed-wetting
- Increased hunger
- Unplanned weight loss
- Excessive fatigue – feeling more tired than usual
- Irritability, including touchiness or behavioural changes
- Fruity-smelling breath
Type 2 in children may develop so gradually that the signs and symptoms are barely noticeable and difficult to detect. In some cases, children may not show any symptoms. If you suspect your child has diabetes, keep an eye out for the following symptoms:
- Skin infections including tingling or dry skin and slow healing sores
- Irritability
- Increased or excessive thirst
- A frequent urge to urinate
- Nausea and vomiting
- Blurred vision
- Darkened areas of skin
- Genital itching or thrush
Diabetes UK encourage people to be aware of the 4 T’s in children:
Toilet
Using the bathroom frequently. Infants will have heavier diapers, or bedwetting after being dry for some time.
Thirst
Drinking more fluids than usual but being unable to quench thirst.
Tiredness
Feeling more tired than usual.
Thinner
Increased weight loss.
Diagnosing Childhood Diabetes
A diagnosis of childhood diabetes generally requires abnormal test results from two tests taken on separate days. There are a number of blood tests available to diagnose diabetes, including:
Random blood sugar test
A sample of blood is taken at a random time. Regardless of when your child last ate, a blood sugar level of 200mg per decilitre or over indicates diabetes.
Fasting blood sugar test
After fasting for 8 hours or overnight, a blood sample is taken from your child. A fasting blood sugar level of 126mg per decilitre or higher indicates type 2 diabetes.
A1C test
An AC1 test indicates your child’s average blood sugar level over the past three months. An A1C level of 6.5% or higher on two different tests indicates type 2 diabetes.
Oral glucose tolerance test
A blood sample is taken after your child drinks a sugary solution and fasts for at least 8 hours or overnight. Over the next few hours, his or her blood sugar levels will be checked several times. A blood sugar level of 200mg or higher typically indicates that your child has type 2 diabetes.
If the blood testing indicates diabetes, your doctor is likely to recommend further tests to differentiate between type 1 and type 2 as different treatment and management techniques are used depending on the type. These additional tests may include:
- Blood tests to check for antibodies that are common in type 1 diabetes
- Urine or blood tests to check for the presence of ketones indicating type 1 diabetes
If diabetes is suspected or diagnosed, the doctor may refer your child to a Paediatric Endocrinologist, a doctor who focuses on the diagnosis and treatment of children with diseases of the endocrine system, such as diabetes and growth disorders.
Following the diagnosis, your child will need regular follow-up appointments to check their A1C levels and guarantee good diabetes management. The doctor will also periodically check your child’s growth, blood pressure, cholesterol levels, liver and kidney function, risk of polycystic ovary syndrome and obtrusive sleep apnoea, along with annual eye examinations.
Treatment of Type 1 Diabetes
Treatment goals for children with type 1 diabetes are to control the condition in a way that allows them to have normal physical and emotional growth and development, along with helping to prevent long and short-term health conditions. In order to do this, parents and children must aim to keep blood sugar levels within their goal range as much as possible.
Generally, children with type 1 diabetes need to:
- Take insulin as prescribed
- Maintain a healthy, balanced diet with precise carbohydrate counts
- Manage blood sugar levels as directed
- Take part in regular physical activity
There is currently no cure for diabetes; children with type 1 diabetes will require treatment for the rest of their lives. Following the recommended treatment plan helps children look and feel healthy, allowing them to live long, productive lives.
Taking Insulin
Children and teens who live with type 1 diabetes must take insulin as part of their treatment plan to help manage their blood sugar levels. Taking prescribed insulin allows them to use the glucose in their blood for energy.
Insulin cannot be taken orally as a pill, as the acids and digestive fluids in the stomach and intestines can break down and destroy insulin if it is swallowed. The only effective way to get insulin into the body is through injections with a needle or with an insulin pump. Unless they are using an insulin pump, most children will require two or more injections every day to keep blood sugar levels under control. Typically, two different types of insulin are needed to manage blood sugar levels both after eating and between meals.
The types of insulin used and number of daily injections a child requires will depend on the diabetes management plan. Insulin needs to be adjusted to handle the rise in blood sugar that occurs following meals, along with providing the right amount of insulin the body needs between meals and overnight.
Insulin injections are typically injected into the fatty layer under the skin of the abdomen, hips, buttocks, arms or thighs. This is virtually painless. Your healthcare team or doctor will teach you when and how to give the insulin, as well as the best injection sites, based on your child’s weight, age and activity patterns.
Treatment of Type 2 Diabetes
Treatment goals for children with type 2 diabetes is to manage the condition in a way that helps them have normal physical and emotional growth and development, and prevents short and long-term health complications. To maintain this, parents and children should aim to keep blood sugar levels as close to normal as possible. It is also vital to manage and treat other conditions that are associated with type 2 diabetes, such as obesity, high blood pressure or abnormal blood cholesterol levels.
In general, children with type 2 diabetes need to:
- Maintain a healthy, balanced diet and follow a recommended meal plan
- Take part in regular exercise
- Take medication as prescribed
- Regularly monitor blood sugar levels
Helping children with type 2 diabetes change to healthier habits is a significant part of treatment. Due to the fact that the majority of children are overweight when they are diagnosed, it is important to encourage healthy eating and physical activity to stop further weight gain and encourage weight loss.
Outlook
Across the world, occurrences of diabetes are rising, and consequently so is diabetes in children. Unfortunately, it is impossible to prevent type 1 diabetes, however steps can be taken to lower the risk of developing type 2 diabetes such as maintaining a healthy weight, staying active and limiting the intake of foods that are high in sugar and fat.
If you are concerned that your child has developed diabetes, speak to your doctor for a referral to One Ashford Hospital. Our Paediatric Consultants are highly experienced in diagnosing and treating children with diabetes, with our medical team and paediatric nursing staff offering support in a caring manner at all times.
To make an appointment to see a Consultant Paediatric Consultant, please contact the reservations team on 01233 364 036 or email ashford.info@onehealthcare.co.uk
One Ashford Hospital is located in Kent and is ideal for private, insured and NHS patients located in Ashford, Dover, Canterbury, Folkestone, Maidstone and all nearby areas.
Why Choose One Ashford Hospital
• Access to leading Consultants within 48 hours*
• 0% and low interest finance options**
• Competitive fixed-price packages
• Modern purpose-built hospital
• Fast access to diagnostics including MRI, X-Ray and Ultrasound
• Private, spacious, ensuite rooms
• Specialist Physiotherapy and nursing teams
• Little waiting time for surgery
• Calm, dignified experience
*Dependent on Consultant availability
**Terms and conditions apply
One Ashford
One Hatfield