Managing Type 1 Diabetes In Children
Type 1 Diabetes In Children
Type 1 diabetes is a chronic autoimmune condition that affects around 24,000 children in the UK. In type 1 diabetes, the levels of sugar or glucose in your child’s blood are too high, which can impact their current and future health.
Type 1 diabetes can strike suddenly in children, and frustratingly we don’t know any way to prevent or cure the condition. That’s why it’s essential to recognise the symptoms and signs of diabetes in children so that you can get them the medical help they need to live a full and active life with diabetes.
What is type 1 diabetes in children?
Type 1 diabetes is a long-term condition in which your child’s body destroys cells in the pancreas that produce the hormone insulin.
Type 1 diabetes affects the way your child’s body uses energy from the food they eat. Their body breaks down carbohydrates in their diet into glucose. Glucose is absorbed into their bloodstream and distributed around their body to provide cells in organs and tissue with the energy they need to work and live.
Insulin is an essential hormone that controls the glucose levels in your child’s blood. It acts as a biological key, unlocking cells so that they can use glucose for energy. It also lets their body store excess glucose for future use. Without insulin, your child’s cells are starved of energy, and glucose builds up in their bloodstream.
When your child has type 1 diabetes, they will need replacement insulin to control their blood glucose levels and provide the energy their body’s cells need to function and stay alive.
Causes of type 1 diabetes in children
We don’t fully understand the causes of type 1 diabetes in children; however, we know that it isn’t related to their diet or lifestyle. The average age of diagnosis with type 1 diabetes is 13, but it can come on at any age.
Type 1 diabetes is an autoimmune condition, which means that the body’s immune defenses start to attack its own cells. In type 1 diabetes, the immune system attacks and kills the insulin-producing cells in the pancreas.
Experts believe that genetic factors may make children vulnerable to type 1 diabetes. An infection or something in the environment appears to trigger the condition in genetically vulnerable children, but many children with type 1 diabetes don’t have diabetes in their families, so it’s not the full story. Research into the underlying causes is ongoing but be reassured that nothing you have done has made your child develop type 1 diabetes.
Symptoms of type 1 diabetes in children
The most classic and common symptoms of type 1 diabetes in children are the 4 Ts: Tired, Thirsty, Thinner, and Toilet. However, children can have more subtle signs like a tummy ache or behavioural problems. Contact your doctor urgently if you’re concerned that your child may have diabetes. The symptoms of type 1 diabetes in children include:
- Passing urine more frequently – they may be back and for to the loo, or you may notice that younger children have more wet nappies
- Feeling very thirsty and drinking more
- Feeling tired and lethargic
- Losing weight without trying
- Feeling hungry, even after meals
- Recurrent infections such as thrush
- Cuts, scrapes, and abrasions may take longer to heal
- They may complain that their vision is blurry
- Repeated episodes of tummy pain
- Behavioural problems
- Fruity-smelling breath
If their diabetes isn’t identified and treated promptly, they may develop diabetic ketoacidosis or DKA. DKA is a serious complication of diabetes that can be life-threatening. Around a third of people with type 1 diabetes initially go to the hospital with diabetic ketoacidosis, a medical emergency. Get urgent medical care if you notice these symptoms:
- The fruity smell of ketones on their breath. Ketones smell like nail varnish remover or pear drops
- Dehydration and dry mouth and tongue
- Nausea and vomiting
- Abdominal pain
- Listless floppy and lethargic
- Sleepy and difficult to wake
- Deep and laboured pattern of breathing
Complications of type 1 diabetes
Type 1 diabetes can affect your child’s body from top to toe. If their blood glucose levels are persistently high, they can progressively damage their small blood vessels. Over time, diabetes can affect the blood supply to different organs and body systems, but the cells in the back of their eyes, kidneys, heart, and feet are more at risk.
The good news is that excellent diabetes control reduces the risk of them developing the long-term complications of diabetes. They can also have regular screening to identify problems at an early stage so that they can have treatment to safeguard their future health.
Type 1 diabetes can cause:
Cardiovascular disease: Diabetes can affect the heart and the blood vessels, increasing the risk of stroke, angina, heart attacks, and circulation problems in the limbs. However, heart disease is not inevitable; careful diabetes control can reduce the danger
Retinopathy: Retinopathy is an eye disease that develops in diabetes, particularly if it is poorly controlled. The small blood vessels supplying the back of the eye become damaged and can bleed. Laser therapy can prevent the progress of the disease, but if it is not treated promptly, it can cause visual disturbance and blindness
Nephropathy: The kidneys produce urine, get rid of waste products and carefully balance the body’s salts and acidity. If their function is affected, it can be critical for your health. The small vessels in the kidneys can be damaged by diabetes, so it is vital to have regular checks to ensure they’re working properly
Foot damage: High sugar levels for a prolonged time can affect the circulation in their feet and damage the nerves, making them feel numb. Cuts, blisters, and infections take longer to heal-and without pain; they can be easy to ignore. People with diabetes are 15 times more likely to have a limb amputated. So, it’s crucial to take foot care and diabetes monitoring and management seriously
Treating type 1 diabetes in children
Children with type 1 diabetes should have an individualised care plan to treat their diabetes, prevent complications and educate them about their condition. They will need treatment to replace insulin by an injection or a pump, but effective diabetes care is about more than insulin; there should be a holistic approach supporting their health, wellbeing and lifestyle:
Blood sugar monitoring: Careful checking of blood glucose levels is key to controlling diabetes. Regular finger-prick testing is one option, but for children, continuous glucose monitors can reduce painful pricking, improve sugar monitoring, and raise the alarm if the glucose is too low or high.
Insulin injections: Your child will need a basal level of slow-acting insulin throughout the day; they will also need an extra ‘bolus’ dose of fast-acting insulin around meals. Insulin pumps are often prescribed to provide better control and more flexibility around meals. Pumps also reduce the risk of hypos and provide more stable blood glucose levels.
Weight management: Children need food to grow and live an active life. Modern insulin regimes and insulin pumps can help children eat normally without rigid routines, meals, and snacks. A healthy balanced diet is vital for all children and can help children with diabetes control their blood sugar levels. Focus on plenty of fresh fruits and vegetables, lean meat and protein, dairy produce for calcium and complex carbohydrates in whole grains. Try to avoid too much sugar and processed carbohydrates, but there’s no need to totally ban sweet treats. A dietician and your child’s diabetes team can teach you and your child to count carbohydrates and balance the insulin dose, as well as providing help, support and guidance.
Exercise: Activity is vital for children’s health and wellbeing. It’s an integral part of a healthy lifestyle – and it’s fun. All children, with or without diabetes, should enjoy at least an hour of exercise each day, that could be a sport like football or netball, dancing, games, swimming, or energetic play.
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Carol Willis - Diabetes Clinic Facilitator
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