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Diabetes Mellitus Type 1 In Children

What is diabetes mellitus type 1?

Diabetes mellitus type 1 is a disease that affects how your child's body makes insulin and uses glucose (sugar). Insulin helps move sugar out of the blood so it can be used for energy.

What causes diabetes mellitus type 1?

Normally, when the blood sugar level increases, the pancreas makes more insulin. Type 1 diabetes develops because the immune system destroys pancreas cells that make insulin. The pancreas cannot make enough insulin, so the blood sugar level continues to rise. A family history of type 1 diabetes may increase your child's risk for diabetes.

What are the signs and symptoms of diabetes mellitus type 1?

  • More thirst than usual

  • Frequent urination

  • Hunger most of the time

  • Weight loss without trying

  • Blurred vision

How is diabetes mellitus type 1 diagnosed?

  • Blood glucose test: A sample of your child's blood is tested for the amount of sugar it contains.

  • Fasting plasma glucose: After your child has fasted for 8 hours, his blood sugar level is checked.

  • A1c test: This blood test shows the average amount of sugar in your child's blood over the past 2 to 3 months. Your child's healthcare provider will tell you the A1c level that is right for your child. He will tell you how often to have it checked. He can also help you and your child make changes if a check shows the A1c is too high.

  • Antibody testing: This blood test may be done to check for signs that your child's immune system is attacking his pancreas.

How is diabetes mellitus type 1 treated?

Type 1 diabetes cannot be cured, but it can be controlled. The goal is to keep your child's blood sugar at a normal level.

  • Your child will need at least 1 dose of insulin each day. Insulin can be injected or given through an insulin pump. Ask your child's healthcare provider which method is best for your child. You and your child will be taught how to give insulin injections if this is the best method for him. Give your child insulin as directed. Too much insulin may cause his blood sugar level to go too low.

  • You will be taught how to adjust each insulin dose he takes with meals. Always check his blood sugar level before the meal. The dose will be based on his blood sugar level, carbohydrates in the meal, and activity after the meal.

How do I check my child's blood sugar level?

You will be taught how to check a small drop of blood with a glucose monitor. You will need to check your child's blood sugar level at least 3 times each day. Ask your child's healthcare provider when and how often to check during the day. Ask what your child's blood sugar levels should be before and after he eats. You may need to check for ketones in your child's urine or blood if his level is higher than directed. Write down the results and show them to your child's healthcare provider. He may use the results to make changes to your child's medicine, food, or exercise schedules.

What should I do if my child's blood sugar level is too low?

Ask your healthcare provider for a plan to use if your child's blood sugar level is below 70 mg/dL. Ask how much fast-acting carbohydrate or how many glucose tablets to give your child. Check his blood sugar level again 15 minutes later. If it is above 70 mg/dL, give him a small snack. If it is still below 70 mg/dL, give him fast-acting carbohydrates or glucose tablets as directed. Ask your child's healthcare provider for more information on diabetic hypoglycemia (low blood sugar level).

What do I need to know about nutrition for my child?

A dietitian will help you create a meal plan to keep your child's blood sugar level steady. Do not let your child skip meals. His blood sugar level may drop too low if he takes insulin and does not eat.

  • Keep track of carbohydrates (sugar and starchy foods): Your child's blood sugar level can get too high if he eats too many carbohydrates. His dietitian will help you plan meals and snacks that have the right amount of carbohydrates.

  • Offer low-fat and low-sodium foods: Examples of low-fat foods are lean meat, fish, skinless poultry (chicken and turkey), and low-fat milk. Limit foods that are high in sodium, such as soy sauce, potato chips, and soup. Do not add salt to food you cook. Limit your child's use of table salt.

  • Offer high-fiber foods: Foods that are a good source of fiber include vegetables, whole grain bread, and beans.

What else can I do to manage my child's diabetes?

  • Keep all follow-up appointments: Your child's healthcare provider may want him to have additional tests to check his blood pressure, cholesterol, and A1c.

  • Exercise: Exercise can help keep your child's blood sugar level steady and help him lose weight. Have your child exercise for at least 60 minutes on most days of the week. Work with your child's healthcare provider to create an exercise plan. Check your child's blood sugar level before and after he exercises. He may need a carbohydrate snack before, during, or after exercise. If your child's blood sugar level is high, check his blood or urine for ketones before he exercises. Do not let him exercise if his blood sugar level is high and he has ketones in his urine or blood. If your child's blood sugar level is lower than 100 mg/dL, give him a carbohydrate snack before he exercises. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice.

  • Weight loss: Ask healthcare providers if your child needs to lose weight, and how much to lose. Ask them to help you and your child create a weight loss program.

What other care will my child need for diabetes mellitus type 1?

  • Medical alert identification: Make sure your child always wears medical alert jewelry or carries a card that says he has diabetes. Ask his healthcare provider where to get these items.
    Medical alert ID bracelet

  • Give instructions to your child's school: Make sure your child's teachers know he has diabetes. Provide written instructions about what to do if your child has symptoms of high or low blood sugar levels at school.

  • No smoking: Cigarette smoke can worsen the problems that occur with diabetes. Do not smoke around your child, and do not let others smoke around him. Do not let your child smoke. Ask your child's healthcare provider for information about how to stop smoking if you need help quitting.

  • Pregnancy education: If you have an older daughter who has diabetes, explain the risk of problems when diabetes is poorly managed. Ask her healthcare provider for more information about diabetes, birth control, and pregnancy.

  • Ask about vaccines: Diabetes can put your child at risk of serious illness if he gets the flu or pneumonia. Ask your child's healthcare provider if your child should get a flu or pneumonia vaccine, and when to get the vaccine.

What are the risks of diabetes mellitus type 1 in children?

  • Uncontrolled diabetes can damage your child's nerves, veins, and arteries. Long-term high blood sugar levels may damage other body tissue and organs over time, such as your child's eyes and kidneys. Diabetes is life-threatening if it is not controlled.

  • Even with treatment, your child may be at an increased risk of thyroid or Celiac disease. Certain medicines used to treat diabetes may increase the risk of pancreas or thyroid problems.

When should I contact my child's healthcare provider?

  • Your child is vomiting or has diarrhea.

  • Your child has an upset stomach and cannot eat the foods on his meal plan.

  • Your child feels dizzy or has headaches.

  • Your child feels weak or more tired than usual.

  • Your child has numbness in his arms or legs.

  • Your child has red, dry skin.

  • Your child gets easily irritated.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care or call 911?

  • Your child's blood sugar level is lower than directed and does not improve with treatment.

  • Your child has blurred or double vision.

  • Your child is having trouble staying awake or focusing.

  • Your child is shaking or sweating.

  • Your child's breath has a fruity, sweet smell, or his breathing is deep and labored.

  • Your child's heartbeat is fast and weak.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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