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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). Normally, when the blood sugar level increases, the pancreas makes more insulin. Insulin helps move sugar out of the blood so it can be used for energy. Type 1 diabetes develops because the immune system destroys cells in the pancreas 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 or unexplained bedwetting
  • Feeling hungry most of the time
  • Weight loss without trying

How is diabetes mellitus type 1 diagnosed?

  • An A1c test shows the average amount of sugar in your child's blood over the past 2 to 3 months.
  • A fasting plasma glucose test is when your child's blood sugar level is tested after he has fasted for 8 hours. Fasted means he has not eaten anything or had anything to drink except water.
  • An oral glucose tolerance test starts with a fasting blood sugar level check. He is then given a glucose drink. His blood sugar level is checked again after 2 hours. Healthcare providers look at how much your child's blood sugar level increases from the first check.
  • An antibody test may show 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 may need 3 to 4 doses 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 trained in 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 also 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. Before meals , your child's blood sugar should be between 90 and 130 mg/dL. At bedtime , it should be between 90 and 150 mg/dL. 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?

Your child's blood sugar level is too low if it goes below 70 mg/dL. Ask your child's healthcare provider how much carbohydrate to give your child. You may need to give him 15 grams of carbohydrate. This amount of carbohydrates can be found in 4 ounces of juice or 3 to 4 glucose tablets. 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.
  • Give him low-fat and low-sodium foods. Examples of low-fat foods are lean meat, fish, skinless chicken or turkey, and low-fat milk. Limit high-sodium foods, such as potato chips and soup. Do not add salt to food you cook. Limit your child's use of table salt.
  • Give him 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?

  • Go to all follow-up appointments. Your child may need to return to have his A1c checked at least twice a year. He may also need tests to check his blood pressure, cholesterol, eyes, and feet.
  • Encourage your child to exercise for at least 60 minutes on most days of the week. Exercise can help keep your child's blood sugar level steady. 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.
  • Help your child maintain a healthy weight. Ask your child's healthcare provider how much your child should weigh. A healthy weight can help control your child's diabetes. Ask your child's healthcare provider to help you create a weight loss plan for your child if he is overweight.
  • Check your child's feet each day for sores. Have your child's feet checked at least once each year for problems that may develop if his diabetes is not controlled. Make sure his shoes and socks fit correctly. Ask your child's healthcare provider for more details about foot care.

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

  • Make sure your child always wears medical alert jewelry or carries a card that says he has diabetes. Ask your child's 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.
  • Do not smoke. 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 healthcare provider for information if you currently smoke and need help quitting.
  • Ask about vaccines. Your child has a higher risk for 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 and arteries. Long-term high blood sugar levels can damage his eyes and kidneys. Your child may develop thyroid or celiac disease. Celiac disease is a condition where your child's intestines do not absorb nutrients properly. Diabetes is life-threatening if it is not controlled.

When should I seek immediate care?

  • 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.

When should I contact my child's healthcare provider?

  • Your child has a fever.
  • Your child has abdominal pain, diarrhea, or is vomiting.
  • 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 warm, red patches of skin.
  • Your child gets easily irritated.
  • You have questions or concerns about your child's condition or care.

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.

© 2015 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.