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Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.
Type 1 diabetes is caused by autoimmune destruction of the insulin-producing cells in the pancreas, resulting in insulin deficiency. Type 2 diabetes is different because the pancreas still makes insulin, but cannot produce enough insulin to overcome the body’s insulin resistance.
Diabetes can develop at any age. Type 1 diabetes is commonly referred to as childhood diabetes or juvenile diabetes because it often presents in childhood and adolescence. Children with a strong family history of autoimmune disease are at a higher risk for developing Type 1 diabetes.
Type 2 diabetes in children generally presents during adolescence, due to the increased insulin resistance associated with puberty. Children who are obese and have a strong family history of Type 2 diabetes are at a higher risk for developing Type 2 diabetes.
At Children's Hospital Colorado on Anschutz Medical Campus in Aurora, a Family Health Library is available with information in broad areas such as parenting, child development, and medical diagnosis in children. Please feel free to stop by and use this great resource as you would like.
Type 1 diabetes generally presents with excessive urination, excessive thirst, fatigue and weight loss. If children are not diagnosed early, this can quickly progress to nausea, vomiting, dehydration and severe illness, requiring admission to a pediatric intensive care unit in the hospital.
Type 2 diabetes generally presents over a longer period of time, and is often discovered by laboratory testing. Type 2 diabetes is associated with obesity, weight gain and darkening of the skin around the neck and in the armpits.
Blood and urine tests can be used to diagnose diabetes. A small hand-held device called a glucometer can be used to test for elevated blood sugar from a drop of blood from the finger. Urine tests can also be used to evaluate for the presence of sugar in the urine. For Type 1 diabetes, it is also important to evaluate the acid levels in the blood and urine. For Type 2 diabetes, it may be necessary to perform an oral glucose tolerance test (OGTT), which is similar to what is done to evaluate for diabetes during pregnancy. Another blood test called hemoglobin A1c can be used to look for chronic elevations in blood sugar in kids with Type 1 or Type 2 diabetes.
Children who are admitted to the emergency department and exhibit signs and symptoms of diabetes will be evaluated in the ER. The doctors in the emergency department will perform blood tests to evaluate the levels of sugar and acid in the blood. If these levels are only mildly elevated, the child may receive fluids through an IV, followed by one to two injections of insulin. The family is then expected to come to the Barbara Davis Center for Childhood Diabetes the following day for new onset diabetes education.
However, if the sugar and acid levels are very high, then the child will receive fluids through an IV, along with insulin through the IV, and will likely be admitted to the hospital for one or two days. Once the child is ready for discharge from the hospital, the family is then expected to come to the Barbara Davis Center the following day for new onset diabetes education.
Most children with newly diagnosed type 2 diabetes are not acutely ill. Families generally come to the Barbara Davis Center within a few weeks of diagnosis for education specifically designed for children with type 2 diabetes.
Children with Type 1 diabetes require frequent blood sugar testing and insulin replacement. Children will need to test their blood sugar 4-8 times per day using a small hand-held device called a glucometer. Unfortunately, insulin can only be given intravenously or subcutaneously, so it generally requires multiple daily subcutaneous injections. At the Barbara Davis Center, families are taught how to draw up insulin from a vial and how to safely inject it just under their child’s skin. Children with Type 1 diabetes generally need at least 4 injections of insulin every day.
The best treatment for Type 2 diabetes is weight loss and increased physical activity. However, most children with Type 2 diabetes will also need the addition of a medication called metformin, which is generally given twice a day as the dosage is increased over several weeks. Some children will also need the addition of subcutaneous insulin injections to help control their blood sugar. Currently, there are a number of other medications used to treat Type 2 diabetes in adults, but none of these are approved for use in children.
Children and teens with diabetes receive care at The Barbara Davis Center for Childhood Diabetes. There, pediatric diabetes experts provide holistic, family-centered care for children with diabetes.
The care team at the Barbara Davis Center for Childhood Diabetes includes board-certified pediatric endocrinologists, physician assistants, nurse practitioners and certified diabetes educators in nutrition, nursing and family counseling. This multidisciplinary team can devise plans to manage your child’s diabetes, which may include dietary changes, exercise, medicine and weight loss.
Certified Family Nurse Practitioner, Endocrinology - Pediatric