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Diabetes: Type 1

What is diabetes?

Diabetes is a problem with the way the body uses digested food for energy. When your child eats, his or her body changes the food into sugar. Blood carries the sugar to the body’s cells, where it is used for energy. When your child has diabetes, sugar cannot get into the cells and stays in the blood instead. This causes high blood sugar. Too much sugar in the blood can damage your child’s blood vessels and organs.

Type 1 diabetes usually starts in childhood or early adulthood. It is also called type 1 diabetes mellitus or juvenile diabetes.

What is the cause?

Your child’s body needs insulin to move sugar from the bloodstream into the cells. Type 1 diabetes happens when the body does not have enough insulin. Without insulin, the level of sugar in the blood gets too high.

Normally, insulin is made by the pancreas gland. Type 1 diabetes happens when most or all of the insulin-producing cells in the pancreas have been injured or destroyed and the pancreas stops making insulin. Usually the exact cause of the damage to the pancreas is not known. Sometimes the diabetes may happen because of a viral infection or because the pancreas has been injured. Or it may result from an immune system disorder, which is when the body sees part of itself as foreign and attacks it.

What are the symptoms?

Symptoms may start suddenly or they may develop over days to weeks. Symptoms vary widely from person to person. Symptoms may include:

  • Urinating a lot
  • Increased thirst
  • Blurry vision
  • Dry mouth
  • Tiredness
  • Increased hunger
  • Unexpected weight loss
  • Fruity-smelling breath

If diabetes is not diagnosed and treated, your child’s blood sugar could get so high that it causes your child to go into a coma and die.

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Three tests may be done to check the level of sugar in the blood and diagnose type 1 diabetes:

  • A fasting plasma glucose test (FPG), also called a fasting blood sugar (FBS)
  • A1C test
  • Random blood sugar test (RBS)

For the FPG test a sample of your child’s blood is tested in the morning before your child has eaten anything. If this test shows a fasting blood sugar of 126 milligrams per deciliter (mg/dL), your child may have diabetes. Two FBG tests may be needed to confirm the diagnosis.

The A1C test checks your child’s average blood sugar over the past 2 to 3 months. If the A1C is 6.5% or higher, your child has diabetes.

Your child may also have a blood sugar test at a random time. If a random blood sugar test is over 200 mg/dL, it very likely means your child has diabetes.

When type 1 diabetes is suspected, your child may have tests to check for antibodies to insulin or the pancreas cells that make insulin.

How is it treated?

  • Education and diet

    When a child is diagnosed with diabetes, there is a lot the family must learn about the disease. This education is usually done for 2 or 3 days at a children's diabetes clinic.

    Children with type 1 diabetes must get insulin shots. Healthcare providers will teach you what diabetes is and how to give shots of the proper amounts of insulin to your child. You will learn how to test for sugar in the blood and for ketones in the blood or urine. You will learn how to treat low blood sugar and other procedures needed to keep your child healthy.

    A dietitian will teach you about the right diet for your child. A child with diabetes needs to be careful about eating carbohydrates and should eat and snack the same way each day.

  • Control of blood sugar levels

    Home care involves balancing diet, exercise, and stress with insulin to keep the blood sugar at a normal level. The dosage of insulin in the shots is not always the same. The dose must be adjusted according to the food your child eats and the level of sugar in the child's blood at the time of the shot. If a child gets too much insulin, the blood sugar could get too low. Just as prevention of high blood sugar is important, prevention of low blood sugar is also very important.

    Most families use a small machine called a blood glucose meter, or glucometer, to measure the level of sugar in their child's blood 3 or 4 times each day. When children are 7 to 10 years old, they can learn how to test blood sugar themselves. Children can also learn to give themselves shots of insulin when they are 10 or 11 years old. Measuring blood sugar and giving insulin shots at home allows you or your child to adjust the treatment as needed for the best blood sugar control.

    Blood sugar levels that are measured when a child has not eaten for at least 8 hours (fasting), or 2 hours after meals, should be kept in the following ranges:

    • Children under the age of 5 years: 100 to 200 mg/dL
    • Children ages 5 to 11 years: 70 to 180 mg/dL
    • Children over 12 years old: 70 to 150 g/dL
  • Follow-up visits with your child's healthcare provider

    Your child's provider will check the overall blood sugar control every 3 months with an A1C test. If the A1C is kept in a good range, your child will have a lower risk for eye, kidney, heart, and nerve problems later in life. Children over 13 years of age who have had diabetes for 5 years or longer should also have annual eye exams and kidney tests.

  • Ketone tests

    Fat breaks down into ketones when not enough insulin is available. Ketones can cause a problem called ketoacidosis and make your child very sick. It’s important to have a way to measure ketones at home. You can use urine ketone dipstick tests or a blood ketone test. You need to test for ketones if your child is sick (even if he or she has vomited just once, for example) or if the blood sugar is high (for example, above 240 mg/dL).

How can I take care of my child?

Follow your child’s healthcare provider's instructions. Ask your provider:

  • How and when you will hear your child’s test results
  • How long it will take for your child to recover
  • What activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.

You can get more information about diabetes from:

Developed by RelayHealth.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2013-02-11
Last reviewed: 2013-02-09
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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