When Shamron Cook's 7-year-old daughter was diagnosed with type 1 juvenile diabetes, she wasn't all that surprised. Her daughter had been showing symptoms of it, and Cook picked up on the signs.
"In December, I noticed she was incredibly thirsty and urinating frequently," Cook says. "I have a family history of diabetes, so I knew this was a big symptom of it. I took her in to a naturopath [ND] and told the ND that I wanted my daughter checked for it. Sure enough, she had it."
After getting the call back from her ND confirming her suspicions, Cook took her daughter to the emergency room for more testing. Her daughter ended up being admitted into the hospital for several days, and they started her on insulin immediately.
"It's been hard, but she's been incredibly brave through it all," Cook says. "Sometimes, though, she gets kind of down and says, 'I don't want this anymore.'"
Diabetes occurs when the pancreas cannot produce enough insulin or the body is not able to use the insulin it is receiving. Insulin is a hormone that allows sugar to be processed effectively. This causes blood sugar levels to rise above what is healthy. There are two different types of diabetes that affect children – type 1 diabetes and pediatric type 2 diabetes.
Type 2 Diabetes
Dr. Ramin Alemzadeh is the Director of the Children's Hospital of Wisconsin Diabetes Program. He says almost all the patients who get type 2 diabetes are overweight, unlike type 1 diabetes, which has a different cause.
"Type 2 diabetes represents a state of insulin insufficiency and insulin resistance," Dr. Alemzadeh says. "In pediatric type 2 diabetes, almost all patients are obese. In contrast, individuals with type 1 diabetes have insulin deficiency with little or no insulin resistance based on age and pubertal status and BMI [body mass index]."
Unfortunately, as Americans get fatter, the incidence of type 2 diabetes in children has increased, too.
"The emerging epidemic of type 2 diabetes parallels increased prevalence of obesity in youth," Dr. Alemzadeh says. "It is commonly believed that in the presence of obesity and genetic predisposition [family history of type 2 diabetes], there is progressive loss beta-cell [insulin-secreting cells] function due to engorgement of these cells with lipid [fat]. This leads to impairment of pancreatic insulin secretion."
Type 2 diabetes is believed to be accelerated in children at the time of puberty. Experts are now calling type 2 diabetes among children an epidemic.
"This epidemic is very alarming since poorly controlled diabetic children are at risk of developing diabetes complications as early as in the second decade of life," Dr. Alemzadeh says.
Type 1 Diabetes
Type 1 diabetes is both similar and different than type 2 diabetes. Gary Feit is the manager of public information for Juvenile Diabetes Research Foundation International. He says type 1 diabetes can occur at any age but is most commonly diagnosed from infancy to the late 30s.
"In this type of diabetes, a person's pancreas produces little or no insulin," Feit says. "Although the causes are not entirely known, scientists believe the body's own defense system [the immune system] attacks and destroys the insulin-producing cells in the pancreas. People with type 1 diabetes must inject insulin several times every day."
While type 2 diabetes goes hand in hand with obesity, type 1 diabetes has a strong family connection. According to Feit, researchers are still trying to get a clear picture about how genes and environmental factors interact to determine a person's risk of developing type 1 diabetes. Forty percent of everyone in the United States carries one or more of the HLA genes that lead to increased risk of type 1 diabetes. To be at increased risk, however, an individual needs two copies of these genes, one from each parent.
"One in 300 people in the general population develops type 1 diabetes, but one in 20 of these people are at risk if a parent, sibling or child has the disease," Feit says. "Research has shown, however, that genes don't tell the whole story and suggests that environmental factors – which are not yet fully known – play a role as well."
Symptoms of Juvenile Diabetes
The symptoms of type 1 and type 2 diabetes are very similar, though the causes and treatments may differ. Symptoms may occur suddenly and include one or more of the following:
- Extreme thirst
- Frequent urination
- Drowsiness, lethargy
- Sugar in urine
- Sudden vision changes
- Increased appetite
- Sudden weight loss
- Fruity, sweet or wine-like odor on breath
- Heavy, labored breathing
- Stupor, unconsciousness
"If you think your child has diabetes, call a doctor immediately, and [have the child] drink fluids without sugar, if able to swallow, to prevent dehydration," Feit says.
Diagnosing and Treating Juvenile Diabetes
Diagnosing juvenile diabetes takes a simple blood test. It is the treatment that varies in type 1 and type 2 diabetes and from child to child.
"To stay alive, people with type 1 diabetes must take multiple insulin injections daily, or continually infuse insulin through a pump, and test their blood sugar by pricking their fingers six or more times per day," Feit says. "While trying to balance insulin doses with their food intake and daily activities, people with this form of diabetes must always be prepared for serious hypoglycemic [low blood sugar] and hyperglycemic [high blood sugar] reactions, both of which can be life-limiting and life-threatening."
Treatment for type 2 diabetes focuses mainly on diet and exercise, though medications may be needed as well.
Control of the diabetes is crucial. The goal is to prevent or delay complications or damage to the kidneys, eyes, heart and blood vessels. In most cases, though not all, diabetes can be controlled, and there are more and more breakthroughs being made that will make diabetes easier to manage for your child.
"Although the ultimate goal of research is to find cures for diabetes and its complications, some of this research has contributed to improve the lives of people with diabetes in a more immediate fashion," Feit says. "Self-monitoring of blood glucose is one of the most important advances in diabetes management since the discovery of insulin. And the latest technology in monitoring devices offers a feature that promises significant new benefits for patients: the ability to read glucose continuously (or near continuously) and provide information on blood glucose trends."
Along with a new insulin inhaler, which would decrease or do away with daily shots, these breakthroughs will make it easier for you to help your child take control of and learn to live with diabetes.