Diabetes Mellitus Type 1 In Children

What is diabetes mellitus type 1?

Diabetes mellitus is a disease that affects how your child's body makes insulin and how it uses glucose (sugar). Insulin is a hormone that helps the body use sugar by allowing the sugar to enter cells. With type 1 diabetes, your child's body does not make enough insulin, causing high blood sugar levels. Type 1 diabetes is also called insulin-dependent diabetes mellitus (IDDM), or juvenile-onset diabetes.

What causes diabetes mellitus type 1?

Type 1 diabetes is an autoimmune disease. This means your child's defense system attacks some of his own cells. Normally, when your child's blood glucose level increases, the pancreas (an organ that lies behind the stomach) makes insulin. In type 1 diabetes, the cells in the pancreas that make insulin have been destroyed.

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

Your child may have any of the following:

• More thirst than usual
  
  
• Frequent urination
  
  
• Hunger most of the time
  
  
• Weight loss without trying
  
  
• Blurred vision

How is diabetes mellitus type 1 diagnosed?

If your child has signs or symptoms of type 1 diabetes, blood tests are done to diagnose the disease. Your child may need any of the following blood tests:

• Blood glucose: A sample of your child's blood is collected, and the amount of sugar in the blood is checked.
  
  
• Fasting plasma glucose: After your child has fasted (no food or liquid) for 8 hours, his blood sugar level is checked.
  
  
• Hemoglobin A1C (HbA1C) test: This blood test shows the average amount of sugar in your child's blood over the past 2 to 3 months.

How is diabetes mellitus type 1 treated?

Type 1 diabetes can be treated and controlled most of the time. The goal is to keep your child's blood sugar at normal levels. Insulin medicine and diet help control blood sugar levels. It is very important that insulin be taken correctly. This can be done with injections (shots) or with continuous subcutaneous insulin infusion (CSII) through an insulin pump. Ask your child's caregiver what method of taking insulin is best for your child. Carefully planning meals, snacks, and activities are also very important in diabetes management.

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

You will learn how to check your child's blood sugar levels at home. You may have to check his blood sugar level at least 3 times each day. Caregivers will teach you how to use a glucose monitor. This is a small device that tells how much sugar is in the blood. The monitor uses a small drop of blood from a prick of your child's finger. Ask caregivers what your child's blood sugar levels should be before and after he eats a meal. Ask them when and how often you must make sure that your child's blood sugar is tested. Write the blood sugar results in a diary each time they are checked. Bring the diary when you take your child to see his caregiver. Ask your child's caregiver how to use the results of blood tests to change your child's diet, exercise plan, and medicine, if changes are needed.

What other health problems can diabetes mellitus type 1 cause?

Uncontrolled diabetes for a long time can damage your child's nerves, veins, arteries, and organs. This can cause damage to his feet and legs, eyes, kidneys, and heart. Your child may need tests to check for the following:

• Kidney damage: Your child may need yearly tests to check for kidney damage. Ask your child's caregiver when these tests need to be done.
  
  
• High cholesterol: Children found to have type 1 diabetes at or after puberty need to have their cholesterol and other blood fat levels checked. If your child is not yet at puberty but there is a history of high cholesterol in your family, your child will need to have his blood fat levels checked. Talk to your child's caregiver about any family history of high cholesterol.
  
  
• Eye disorders: Your child may need tests to check for retinopathy. Retinopathy is an eye disorder that can occur with diabetes. Ask your child's caregiver how often these tests need to be done.
  
  
• Celiac disease: Your child may need a blood test to check for a disorder called celiac disease that affects the digestion of food. Children with type 1 diabetes are more likely to have this disorder. Celiac disease reduces the body's ability to absorb nutrients from food and can lead to weight loss and malnutrition.
  
  
• Thyroid disease: Your child may need a blood test to check for thyroid disorders that can occur with diabetes. Autoimmune problems with the thyroid gland can cause it to make too much or too little thyroid hormone.

What should I know about making changes to my child's diet?

A dietitian will help you create a meal plan that will help your child keep his blood sugar levels under control. This caregiver may suggest the following:

• Choose foods low in fat, saturated fat, cholesterol, and sodium. Examples of low-fat foods are lean cuts of meat, fish, skinless poultry (chicken and turkey), and low-fat milk. Use less table salt and limit foods that are high in sodium. Some foods that are high in sodium are soy sauce, processed meats (bologna, hot dogs), crackers, potato chips, and soups.
  
  
• Choose foods that are good sources of fiber and complex carbohydrates, such as vegetables, whole grain breads and cereals, and legumes. Legumes include garbanzo, pinto, and kidney beans, and lentils.
  
  
• The dietitian may suggest you limit how much carbohydrate your child eats at one time to prevent his blood sugar level from getting too high. Carbohydrates are also found in fruit and dairy foods such as milk and yogurt. Limit or avoid sweets, such as candy, desserts, or regular soda that contain simple carbohydrates from sugar. When your child eats simple carbohydrates, sugar moves into his blood too fast.
  
  
• Your child should not skip meals to control his blood sugar level, because it can fall too low.

How can diabetes mellitus type 1 be controlled?

• Medicines: Make sure your child takes his insulin and other medicines as ordered. Ask for more information about the medicines that your child needs to take.
  
  
• Exercise: Regular exercise helps blood sugar levels stay in the best range, and decreases your child's risk for heart disease. It can also help your child lose weight, and improve how he feels overall. Have your child do at least 30 minutes of moderate exercise, 5 days a week. Playing can be a very good exercise. Work with your child's caregiver to plan the best exercise program for your child.
  
  
• Weight loss: Ask caregivers if your child needs to lose weight. 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?

• Vaccinations: A vaccination is a shot of medicine to help prevent your child from getting sick. Ask your child's caregiver about the vaccinations that your child may need.
  
  
  • Influenza vaccine: This vaccine helps prevent influenza (flu). Everyone older than age 6 months should get a yearly influenza vaccine. Get the vaccine as soon as it is available, usually in October or November each year.
    
    
  • Pneumococcal vaccine: Your child should also get an extra pneumococcal vaccine when he is 2 years old or older.
  
  
• Medical alert identification: Make sure your child always wears a medical alert bracelet or necklace, or carries a card that says he has diabetes. You may get one from your local drugstore or ask your caregiver where to get these items.
  
  
• Talk to officials at your child's school: Make sure your child's teachers know he has diabetes. Provide instructions about what to do if your child has symptoms of high or low blood sugar levels at school.
  
  
• Smoking:
  
  
  • Do not let anyone smoke around your child. Breathing in cigarette smoke can harm your child's body in many ways. Your child is more likely to get certain types of infections if he breathes in cigarette smoke. Being around cigarette smoke can also affect your child’s lungs and cause breathing problems. Do not let anyone smoke inside your home. If you smoke, you should quit. Quitting smoking will improve your health and the health of those around you. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
    
    
  • Do not let your child smoke: Smoking worsens the problems that can occur with diabetes, such as poor blood flow to the feet. Your child is more likely to get heart disease, lung disease, cancer, and other health problems if he smokes. Ask your child's caregiver for help and more information about how to stop smoking if your child smokes.
  
  
• Sexually active girls: If you have an older daughter who has diabetes, talk to her about how diabetes affects pregnancy. Explain the risk of problems when diabetes is poorly managed. Ask her caregiver for more information about diabetes, birth control, and pregnancy.

Where can I find support and more information?

School aged children want to be like their friends. Your child may feel different because he has to take insulin, test his blood, and follow a meal plan. If your child is a teenager, doing these things make the normal troubles of adolescence even more difficult. Talk to your child's caregiver about how to help your child. You and your child or family may want to see a mental health worker (talk therapist). This caregiver can help your child take an active role in managing diabetes. Contact the following for more information:

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria , VA 22311
  Phone: 1- 800 - 342-2383
  Web Address: http://www.diabetes.org
  

When should I contact my child's caregiver?

Contact your child's caregiver if:

• Your child is vomiting or has an upset stomach.
  
  
• Your child feels dizzy or has headaches.
  
  
• Your child feels very weak or very tired.
  
  
• 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 disease, medicine, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• 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.

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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.

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