Type 1 Diabetes In Children

Type 1 diabetes in children is a condition in which the pancreas no longer produces insulin, which is required for the transportation of sugar into the body's cells. It was once know as juvenile or insulin-dependent diabetes.

Types 1 diabetes in children, as that of adolescents or adults requires consistent care to prevent the development of complications.

Signs and symptoms of type 1 diabetes in children develop quickily, usually over a few weeks. They may include:

• Increased thirst
• Frequent urination and bedwetting in children who previously don't wet the bed during the night.
• Extreme hunger
• Unintended weight loss
• Irritability or unusual behaviour
• Fatigue and weakness
• Blurred vision
• Vaginal yeast infections in females
• Diaper rash caused by yeast

The exact cause of type 1 diabetes in children still remains unknown.

Doctors believe it may be caused by the body's immune system attacking and destroying the insulin-producing cells of the pancreas. This can also be caused by toxins produced by certain viruses and bacteria may also destroy the islets of the pancreas. Genetics play a role in this process.

The following tests can be used for the diagnosis of type 1 diabetes in children:

• Glycated hemoglobin (A1C) test - which can indicate the amount of sugar in the blood for the past two to three months.
  This tests works by measuring the amount of glucose attached to hemoglobin, the oxygen carrying protein of red blood cells. An A1C level of 6.5 percent or higher indicates diabetes.
• Random blood sugar test - which can be taken at any time. Regardless of when the patient last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) indicates diabetes.

Several treatment for type 1 diabetes in children are available. They include:

• Insulin therapy is required for lifelong treatment of type 1 diabetes in children. Types of insulins which are available include, rapid-acting, long-acting and intermediate acting insulin. Examples are regular insulin (Humulin 70/30, Novolin 70/30), insulin isophane (Humulin N, Novolin N) insulin glulisine (Apidra), insulin lispro (Humalog) and insulin aspart (Novolog). Long-acting insulins include glargine (Lantus) and determir (Levemir). Because insulin is degraded by enzymes of the stomach, it should not be taken orally. It can be given through injections or an insulin pump. A fine needle or an insulin pen , which looks similar to ink pens can be used to inject insulin under the skin. Multiple daily injections usually consist of different types of insulin (Long-acting and regular insulin). An insulin pump is a small device about the size of a cellphone that can be worn outside the body. A tube connects the reservoir to a catheter that is inserted under the skin of the abdomen. It can be worn as a waistband, in a pocket or as a specially designed pump belt. Pumps are programmed to dispense specific amounts of rapid-acting insulin automatically. This steady dose of insulin is known as the basal rate, and it replaces any long-acting insulin that a person was using.
• Medications, such as high blood pressure medications, drugs like pramlintide which reduce the rate of movement of food through the stomach to reduce the sharp rise in blood sugar that occurs after meals, aspirin to protect the heart and cholesterol-lowering drugs.
• Artificial pancreas is an emerging treatment approach in which patients are given a closed-loop insulin delivery. The device automatically delivers the correct amount of insulin when a monitor indicates the need for it. There are a number of different versions of the artificial pancreas, and clinical trials have had encouraging results.
• Healthy eating and monitoring carbohydrates.
• Regular exercising, at least 30 minutes of aerobic exercise on most days of the week. There is ongoing research for new treatments for type 1 diabetes, such as pancreas, islet cell and stem cell transplant.

Lifestyle modifications are necessary in order to cope with type 1 diabetes in children.

Living with type 1 diabetes can be stressful, especially for children. If it is not managed properly, it can result in changes in behavior such as irritability.

People with diabetes are at an increased risk of having depression and diabetes-related distress. Diabetes can also make a child is different from other children and this can make the child feel alone. Joining a support group can be very helpful for patients with type 1 diabetes.

Children should be encouraged to follow the treatment plan in order to prevent the development of complications associated with type 1 diabetes. They are encouraged to:

• Take medications as recommended.
• Wearing a tag that shows a person has diabetes.
• Having yearly physical and regular eye exams.
• Being up to date with immunizations since diabetes can weaken the immune system.
• Learn how to test their own blood sugar levels and to inject insulin.
• Keeping blood pressure and blood cholesterol under control.
• Staying physically active
• Stay positive

There are several risks and complications associated with type 1 diabetes in children.

Risk factors include:

• A family history
• Presence of genes which may indicate an increased risk of diabetes.
• Exposure to certain viral infections, such as Epstein-Bar, Coxsackie, mumps and cytomegalovirus.
• Early exposure to cow's milk
• Low levels of vitamin D
• Having a mother mother with preeclampsia during preganancy.
• Being born with jaundice

Complications can arise due to lack or improper treatment of diabetes. The changes develop over a long period of time. They include:

• Eye damage which can include diabetic retinopathy, in which there is destruction of the vessels supplying the retina of the eye, cataracts and even blindness.
• Foot damage
• Osteoporosis
• Skin conditions
• Kidney damage (nephropathy)
• Nerve damage (neuropathy)
• Heart and vessel damage