Type 1 Diabetes
by Virginia Cortes Araiza, M.D.
Breaking for the bathroom every 10 minutes or hitting the water fountain every 20 minutes might seem like common classroom-eluding, homework-escaping, or bedtime-evading techniques, but if it’s consistently interfering with your child’s regular routine, stop and consider that these might be symptoms of a serious medical condition.
Type 1 diabetes, sometimes referred to as juvenile diabetes, is most commonly diagnosed at puberty but has been seen in infants as young as eight weeks and in adults as old as 30 years.
It’s a chronic disease, and that means children and adolescents will not outgrow it. It’s an auto-immune disease, and that means you didn’t cause it. It’s an insulin-dependent disease, and that means it is life-threatening.
Not a normal sugar high
Insulin is a hormone produced by the pancreas that controls the level of glucose in our blood. Glucose is a form of sugar that fuels our cells.
Insulin helps cells convert glucose to energy. Without insulin, glucose is in overdrive and the body has to find a way to get rid of it. In this case, it’s through urine. But now we’re on the other side of the spectrum—there’s not enough glucose, so the body begins burning fat and muscle cells for fuel instead.
We don’t know exactly what causes the body to attack its own pancreas, but research suggests genetic or environmental triggers play a role.
We do know for sure that Mom didn’t cause it because she didn’t breastfeed, Dad didn’t cause it because he served Kiddo cookies for breakfast every morning, and Kiddo didn’t cause it because she or he didn’t eat enough broccoli for dinner.
Acute symptoms, chronic condition
Symptoms often come on suddenly, unraveling over the course of a few days or in a matter of weeks.
The most common symptoms are frequent urination and excessive thirst. While the evidence might be there in baby’s diaper—six to eight wet diapers a day becomes a dozen soaked diapers a day—kids are quite obvious in their demands for something to drink.
It’s common sense that the more they drink, the more they have to pee, but with diabetes, the change in behavior is quite dramatic. They may also have increased appetite, but lose weight and have less energy.
As the disease progresses, the body forms ketones. Plain and simple, ketones make people feel really bad. The child’s head and stomach hurt, and he or she usually starts vomiting.
At this stage, parents and even doctors still might not recognize the disease for what it is—an easy oversight, since type 1 diabetes is not nearly as common as gastrointestinal viruses and tummy bugs.
There are, however, some marked differences, such as a lack of other symptoms (diarrhea, for one) typically associated with GI illnesses.
Also, kids with the flu eventually begin to get better; kids with diabetes only get sicker.
Even though they’re dehydrated, they continue to vomit and urinate. Some parents report a sweet-smelling odor on their child’s breath or in their urine. Both of these things are emergencies and need to be reported to a doctor immediately.
A diagnosis of type 1 diabetes can be confirmed with urine and blood tests.
Taking control
A diagnosis now is not nearly as scary as it once was.
According to the National Institutes of Health, in the 1950’s, one in three people with diabetes died within 25 years of diagnosis, one in four went into kidney failure, and approximately 90 percent developed diabetic retinopathy.
Today, studies show that controlling glucose levels prevents eye, nerve, and kidney complications. So how do we control glucose levels? By giving insulin back to the body.
We constantly seek more efficient and less invasive ways to get the insulin where it needs to be. The best method for now is shots, sometimes several times a day.
Kids are not nearly as bothered by this as parents might think, probably because they quickly learn how much better they feel once diagnosed and treated. Little ones obviously need lots of help from Mom or Dad, but parents should encourage their kids to take an active role at some point, since this is something they’ll need to continue doing when they leave the nest.
Type 1 diabetes can be managed. Children, teenagers, and young adults can eat what they like as long as they count their carbohydrates (sugars) and stick to a nutrition plan. They can all expect long, healthy lives as long as they control their blood sugar by monitoring frequently and administering insulin appropriately.
Their healthcare program should include diabetic educators and nutrition consultants, as well as quarterly visits to the doctor for in-depth monitoring of all body systems that could be affected by diabetes.
At the UT Health Pediatric Subspecialty Clinic, located in the new Memorial Hermann Tower at 929 Gessner, we devote Tuesday afternoons and all day Friday to pediatric endocrinology care.
Overall, treatment is a three-pronged approach (education, monitoring, and management) by three main people (doctor, parent, and child).
Type 1 Diabetes—Important Facts
Symptoms:
- extreme thirst
- frequent urination
- increased appetite
- weight loss
- weakness
Fast Facts:
- considered an auto-immune disorder
- cause is unknown
- affects approximately one in every 400-500 children and adolescents
Common Myths:
- is caused by eating too much sugar
- is only diagnosed at puberty
- is cured by insulin
Resources:
- National Diabetes Education Program, www.ndep.nih.gov
- American Diabetes Association, www.diabetes.org
- UT Pediatric Subspecialty Clinic, Suite 2440, Memorial Hermann Tower, 929 Gessner, Houston, TX 77024. Call 832-325-6516 for appointments.
