Straight Talk About Kids and Diabetes

Lisa Swartz Topor, MD, MMSc

Diabetes is a common disease, but is often misunderstood. As diabetes can impact anyone at any age, it is important to understand more about the condition.

What is diabetes?

There are two types of diabetes, known as type 1 and type 2.

Type 1 diabetes occurs when the pancreas stops producing insulin, the hormone that enables the body’s cells to get energy from food. This lack of insulin causes a rise in blood sugar.

There is no way to prevent type 1 diabetes. It is an autoimmune illness; relatives of children who have diabetes may have autoimmune disorders, such as a thyroid disease or celiac disease. Type 1 diabetes is not a result of lifestyle or diet.

In type 1 diabetes, symptoms tend to come on quickly, and are often more severe than with type 2 diabetes. It can develop at any age, though 80 percent of cases are diagnosed in childhood or adolescence, before age 20. Type 1 diabetes is treated with insulin.

With type 2 diabetes, the body’s insulin needs are often elevated, and the pancreas cannot produce enough insulin. Blood sugar levels rise, and over time the eyes, kidneys, nerves, or heart may be damaged.

Because type 2 diabetes is often linked to obesity and a sedentary lifestyle, some patients can control it by adopting a healthy diet and being more active. Others may need oral medication or insulin injections. Type 2 diabetes frequently gets worse over time.

Cases of both type 1 and type 2 diabetes are on the rise. In days past, type 2 diabetes was only seen in adults. But today, many more children and teens are being diagnosed as obesity becomes more common.

What are the symptoms?

Some of the signs and symptoms of type 1 and type 2 diabetes are:

  • increased thirst
  • frequent urination (including frequently soaking through diapers, backsliding on toilet training, or new bedwetting)
  • extreme hunger
  • unexplained weight loss
  • breath that smells fruity, or like nail polish remover (this indicates that ketones, a metabolic byproduct that occurs when the body does not have enough insulin, are present)
  • behavioral changes, such as fatigue or irritability
  • blurred vision

A misconception

Study screens family members of children with diabetes

One brother helps another

A study helped doctors identify antibodies predictive of type 1 diabetes in Henry Cross, age seven. His brother, Frank, age five, had already been diagnosed with the disease.

Watch Their Story

One thing that should be stressed is that those challenged by this disease — or any disease — should never be blamed or shamed. Well-meaning friends or relatives might see a child enjoying a food that they think must be off-limits. They might be thinking, “If only you did not eat that cupcake, you would not have diabetes.”

The fact is, dietary choices are not the cause of type 1 diabetes. A child who has it can enjoy a cupcake at a party or pizza with the soccer team, if he or she also is receiving the correct medication. No foods are banned. However, choosing the right combination and portions of foods and following the medication regimen is necessary.

Coping with the school day

When your child has diabetes, challenges can arise at school. Communication is vital. Meet with the school nurse as soon as possible after your child is diagnosed or after moving to a new school. Make sure he or she has enough testing supplies, syringes and insulin, and treatment for low blood sugars such as juice boxes on hand. It is important that the nurse, parents, child, and diabetes medical providers work as a team.

Apply for a 504 plan in your school district, which lays out the medical accommodations your son or daughter needs — for example, access to the restroom at all times.

While children who have diabetes do not have any restrictions on sports they can play, their blood sugar must be monitored carefully before and after the activity. This is because of the extra energy that they are burning.

Ongoing research

Hasbro Children’s Hospital is participating in TrialNet, an international study to screen relatives of children with type 1 diabetes. Family members of children with type 1 diabetes are at higher risk of developing the disease. Early detection ensures that they get treatment as soon as possible. For information on the TrialNet study, call 401-444-8049.

If you notice that your child is showing signs of diabetes, such as excessive thirst or more frequent urination, make an appointment with a pediatrician as soon as possible. Type 1 diabetes can develop suddenly, and beginning treatment quickly is vital.

For more information on pediatric diabetes treatment at Hasbro Children’s Hospital, visit our website.

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