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What You Need to Know About Diabetes in Kids

In the United States, more than 176,000 people 20 years old and younger have diabetes. As the numbers rise, it’s becoming an increasingly urgent health issue for thousands of parents. It can sometimes be difficult to determine if your child is at risk — but with diabetes in children reaching alarmingly high proportions, it is of the utmost importance. Knowing the risk factors and having a plan of attack in the event of a diagnosis are key. Yes, diabetes is life-changing, but it doesn’t have to be life-threatening. Arm yourself with the knowledge you need to tackle diabetes head on.

Diabetes Explained

Diabetes occurs when the body becomes resistant to or cannot produce sufficient amounts of insulin, the main hormone that allows sugar (glucose) to be processed by cells. Glucose levels in the blood stream rise, making people with diabetes extra thirsty and causing them to urinate more. If the disease is not treated properly, the microcirculation of blood eventually becomes affected, leading to kidney disease, loss of vision, ulcers of the feet and heart disease. There are different types of diabetes including type 1, type 2 and pre-diabetes.

Type 1 diabetes, also called juvenile diabetes, is a disorder in which the body’s immune system destroys the insulin-producing cells in the pancreas. The onset of this form of diabetes often follows a viral infection, but the time frame can vary, and symptoms may not appear for several weeks to several months afterward. With type 1 diabetes, there usually is no family history of the disease.

Type 2 diabetes, also called adult-onset diabetes, is a disorder where the body does produce insulin, but there is resistance to its effects and/or there is an insufficient supply of insulin. Many children and teens with type 2 diabetes have a family history of the disease.

Some physicians recognize a third type of diabetes, sometimes called pre-diabetes. Pre-diabetic children have elevated levels of insulin in the bloodstream but glucose levels that are close to normal. What this means is that children and teens with pre-diabetes do not yet show the signs and symptoms of the disease. Many of these children will progress to type 2 diabetes later in life, but the condition may be reversible with diet and lifestyle changes.

The good news is that for many kids with pre-diabetes and type 2 diabetes, changing the way they eat and making sure they are physically active might be all they need to do to manage their disease.

Why My Child?

You may be worried that there was something you could have done to prevent diabetes in your child. Chances are, there wasn’t. Don’t fall prey to the commonly held misconception that over indulging in sweets can lead to diabetes — doctors no longer believe this is true. Researchers haven’t yet been able to determine exactly what causes diabetes in certain people. Environmental and genetics play a role; children who have close relatives (parents or siblings) with the disease do have a higher chance of becoming diabetic. For type 2 diabetes and pre-diabetes, there are multiple risk factors, including being overweight and/or physically inactive. Latinos, African-Americans, Native Americans and Asian Americans all have a higher risk of type 2 diabetes, as do people with type 2 diabetes in their families.

Signs and Symptoms

Diabetes is a disease that may be diagnosed with a few simple blood tests, but parents and physicians need to really suspect that the disease is present. Often, diabetes is diagnosed well after the disease has started, because many of the symptoms may seem nonthreatening and may appear gradually. However, it is not unusual for the symptoms to progress rapidly during an infectious illness that may stress the body. In fact, symptoms may come and go for several weeks or months until they become more regular and more severe.

Type 1 diabetes is associated with:
• Increased thirst (children seem to be constantly drinking)
• Increased need to urinate (be alert if a toilet-trained child starts to wet the bed every night)
• Rapid weight loss (often 10 percent or more)
• Irritability
• Fatigue
• Complaints of blurred vision
• Nausea and vomiting (often confused with an intestinal virus)

Type 2 diabetes has several of the same symptoms as type 1 diabetes, but they almost always appear slowly. There are often other physical signs and symptoms as well, including:
• Almost every child with type 2 diabetes is severely overweight
• Dark patches of skin around the neck and underarms
• Cuts and scratches that take a long time to heal
• Unexplained itchiness of the skin

Treatment Options

Treating diabetes involves monitoring blood glucose levels and making sure they are kept in the right range. While there still isn’t a cure, it is possible to manage the disease with a combination of diet and lifestyle changes along with insulin when necessary.

Type 1 diabetes is treated by taking insulin throughout the day. Fortunately, most children no longer require twice a day self-administered injections. The availability and improvements of insulin pumps and monitors has made management of type 1 diabetes much easier and less painful. Pumps, each about the size of a cell phone, constantly feed insulin directly into the blood stream through a tiny tube, automatically adjusting the amount of insulin needed according to the blood glucose level. More progress is on the horizon — the FDA is expected to approve insulin nasal sprays soon. The ability to noninvasively maintain normal glucose levels in the blood stream, the ability to allow children to have less strict meal planning and freedom from multiple daily injections all mean that parents and children can enjoy a more normal and pleasant life with type 1 diabetes.

Many adults with type 2 diabetes are prescribed oral medicines or insulin shots. However, for children and teens with pre-diabetes and type 2 diabetes, treatment may be as simple as a more active lifestyle, losing weight and, most importantly, keeping track of food intake. Kids with these problems need a diet that eliminates fast and fatty foods, includes more water and low fat milk instead of soda, juice and sports drinks, and concentrates on smaller portions and lower-calorie foods. It’s also important for these kids to get daily rigorous physical activity — for a minimum of 30 to 40 minutes. Jogging, jumping rope, even a game of tag or basketball can all achieve this goal.

Living a Healthy Life with Diabetes

While there isn’t yet a cure for diabetes, new treatment options and earlier diagnosis offer great hope for patients and families. It is a disease that takes a dedicated medical team to create the best and most workable treatment plan for patients and families alike. By working closely with your child’s medical team and following the right combination of diet, lifestyle changes and medications, you can help manage your child’s diabetes effectively.

Approved for accuracy by Larry Scherzer, M.D., a pediatrician with the University of Connecticut Health Center – a Solucient 2006 Top 100 Hospital.

Health and Nutrition

Diabetes-Friendly Recipes

It’s always important to make sure your child eats healthy meals —
but when your child is diabetic, it’s crucial. Of course, knowing what your child SHOULD eat and making sure that’s what he DOES eat can be tough for any parent. That’s where these tasty, healthy, kid-friendly recipes will come in handy. They’re proof that healthy, diabetes-friendly meals can still be absolutely delicious — and appealing for the entire family.

Chicken Kabobs with Nectarine Salsa | Pancakes with Berries

Carbohydrates: The key to managing diabetes

There are many beliefs when it comes to eating when you have diabetes. From having to stop eating sugar to a list of “good” carbs and “bad” carbs, common misconceptions may have to be unlearned once one is diagnosed with diabetes.

A healthy diet for an individual with diabetes is no different from a healthy diet for an individual without diabetes. The key difference is level of awareness. After being diagnosed with diabetes, it is essential to learn what does and does not affect your blood glucose (sugar) level.

The food we eat helps make glucose for our cells to use as energy. Carbohydrates, or carbs, are the body’s preferred source of glucose as they directly affect blood glucose levels. The higher the amount of carbohydrates eaten, the higher your blood glucose level rises. Since it is imperative to maintain a constant level of blood glucose, eating a consistent amount of carbohydrates over the course of a day is a must. By dividing carbohydrates throughout the day, spikes (high blood sugar) and dips (low blood sugar) can be minimized.

Although all foods can fit in your diet when you have diabetes, it is best to acquire carbohydrates through high fiber whole grains, fruits, vegetables and low fat milk products. The higher the fiber, the slower food breaks down and releases glucose into the blood. To meet nutrient needs, let vegetables, fruits, low fat milk and yogurt and whole grain cereals, breads, rice and pastas provide your daily carbohydrates more often than high-sugar treats, drinks and desserts. To enjoy desserts and treats as often as individuals without diabetes, keep serving sizes at a minimum and allot enough carbohydrates in your meal plan for them.

Keep in mind that protein and fat slow down digestion as well, causing glucose to enter the blood slowly after eating. Since diabetes is closely tied with heart disease, high blood pressure and being overweight, it is important to follow a low fat diet. Make monounsaturated fat, from nuts, avocados, canola and olive oil and omega-3 fatty acids from fish, your primary source of fat. Choose lean meat, low fat cheese, fish and high fiber legumes (dried beans, peas, and lentils) for protein.

Remember, in moderation and with sensible serving sizes, all foods can fit in your diet when you have diabetes. Read food labels to keep meals and snacks within recommended carbohydrate goals. Meet with a dietitian to learn what meal plan meets your specific nutrient needs. For example, a dietitian can develop a meal plan for an individual following a 2,000 calorie diet designed with 60 grams of carbohydrates for breakfast, lunch and dinner, and leftover carbohydrates used for snacks. A dietitian will also help you learn how carbohydrates, fat, protein and fiber affect your blood glucose.

For more information, contact the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or the American Dietetic Association at 1-800-877-1600 extension 5000.