Children's Hospital Colorado

Diabetes

What is diabetes?

Diabetes refers to metabolic disorders in which the body doesn’t produce or properly use insulin. Insulin is a hormone that our bodies need to convert sugar, starches and other food into the energy we need for daily life.

Diabetes occurs when someone's blood glucose levels, also called blood sugar, are too high. Over time, having too much glucose in the blood can cause health problems.

Diabetes has no cure, but there are actions you can take to manage diabetes and stay healthy.

What causes diabetes?

The causes of diabetes in children differ according to the type of diabetes and vary from person to person.

Some of the causes of both type 1 and type 2 diabetes are:

  • Health
  • Behaviors
  • Risk factors
  • Genetic makeup
  • Family history
  • Ethnicity

What is type 1 diabetes?

There are two different types of diabetes that pediatric patients can have: type 1 and type 2 diabetes.

Type 1 diabetes – also referred to as childhood diabetes, juvenile diabetes or insulin-dependent diabetes – is a chronic condition that commonly begins in childhood and adolescence. Even though the condition and symptoms of juvenile diabetes tend to manifest early in life, adults can also develop type 1 diabetes.

When an individual has type 1 diabetes, their pancreas produces little or no insulin. The body needs insulin to allow energy producing sugars (glucose) into its cells. Without it, sugar builds up in the bloodstream, potentially causing various complications.

What causes type 1 diabetes?

Type 1 diabetes is caused by someone’s immune system (which normally fights harmful bacteria and viruses) wrongly destroying the insulin-producing cells in their pancreas, resulting in insulin deficiency. In type 1 diabetes, the body is actually attacking itself.

While there isn’t a specific cause of type 1 diabetes, an underlying genetic disposition or a family history of type 1 diabetes may be a cause.

What is type 2 diabetes?

Type 2 diabetes is another type of chronic endocrine condition that also affects the way the body metabolizes glucose.
When you have type 2 diabetes, your body either resists the effects of insulin or doesn't produce enough to maintain a normal glucose level.
People can develop type 2 diabetes at any age, even during childhood.

What causes type 2 diabetes?

Similarly to type 1, the most significant cause of type 2 diabetes in children is a family history of the disease.

And while not everyone with type 2 diabetes is overweight, two of the most common causes of type 2 diabetes are obesity and lack of physical activity.

There are also specific risk factors that put a child at a higher risk for developing this condition, including:

  • Being overweight
  • A poor diet with high fat and carbohydrate intake
  • High blood pressure
  • High levels of fat in the blood

Who gets diabetes?

Anyone can get diabetes, and it can develop at any age.

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 occurs 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.

What is the difference between type 1 and type 2 diabetes in children?

Both types of diabetes are chronic conditions that affect the way the body regulates blood sugar (glucose). Think of insulin as the key that allows glucose – what fuels the body – to enter its cells.

With type 1 diabetes, kids don’t produce insulin, so their bodies are missing the key they need.

When it comes to type 2 diabetes in children, this key is broken; their bodies can’t use insulin properly (a condition known as insulin resistance) or they can’t produce enough insulin.

Type 2 diabetes is different from type 1 diabetes because when someone has this condition, their pancreas still makes insulin, but it can’t produce enough insulin to overcome the body’s insulin resistance.

Another major difference between type 1 and type 2 diabetes is that type 1 diabetes is not preventable, while type 2 diabetes can be prevented or delayed by adhering to a healthy lifestyle.

Helpful resources for diabetes

The following resources are available to help parents learn more about their children’s diabetes diagnosis:

What are the signs and symptoms of diabetes?

When not controlled, both types of diabetes share certain symptoms. The common symptoms of both type 1 and type 2 diabetes are:

  • Frequent urination
  • Excessive thirst
  • Feeling very fatigued
  • Weakness
  • Extreme hunger
  • Blurry or decreased vision

Signs of type 1 diabetes

In addition to the signs listed above, children with type 1 diabetes may also have specific symptoms, including:

  • Unintentional weight loss
  • Mood changes
  • Irritability
  • Bed-wetting during the night (when they previously didn't)

The symptoms of juvenile diabetes typically develop fast. If children are not diagnosed early, type 1 diabetes symptoms can quickly progress to nausea, vomiting, dehydration and severe illness. If a child has these symptoms, it’s important they come to the hospital immediately, as they often will need to be admitted to a pediatric intensive care unit.

Signs of type 2 diabetes

Type 2 diabetes tends to come on gradually, so people often won’t show signs of the disease or have any symptoms for years. In fact, type 2 diabetes in children is often discovered by laboratory testing.

In addition to the signs listed above, the symptoms specific to type 2 diabetes are:

  • Obesity
  • Recent weight gain or unexplained weight loss
  • Numbness and tingling in the hands or feet
  • Darkening of the skin around the neck and in the armpits
  • Dry mouth
  • Headaches
  • Wounds that don’t heal

What tests are used to diagnose diabetes in children?

If your child has symptoms of diabetes, or if you think they may be at-risk for developing diabetes, they should be tested for the disease. Your doctor can diagnose diabetes using:

  • A glucometer: A hand-held device that tests your blood sugar levels using a small drop of blood from the tip of the finger
  • A urine sample: A simple urine collection that your doctor will use to test for the presence of sugar in the urine
    • For type 1 diabetes, it’s important to evaluate the acid levels in blood and urine.
  • An oral glucose tolerance test (OGTT): A test that’s similar to what doctors do to test for diabetes during pregnancy that tests for type 2 diabetes
  • Hemoglobin A1c: This blood test looks for chronic elevations in blood sugar in kids with type 1 or type 2 diabetes.

How do doctors at Children’s Colorado diagnose and treat diabetes?

Children who are admitted to the emergency department and exhibit signs and symptoms of diabetes will be evaluated for the condition. Our doctors will perform blood tests to evaluate the levels of sugar and acid in the blood.

If these levels are only mildly elevated, your child may receive fluids through an IV, followed by one to two injections of insulin. The next day, we recommend families come to the Barbara Davis Center for Childhood Diabetes for education and training on how to manage new diabetes.

However, if your child’s blood sugar and acid levels are very high, our doctors will provide fluids and insulin through an IV and admit them to our hospital for one or two days. The day after discharge, we recommend your family come to the Center for new diabetes education.

Most children with newly diagnosed type 2 diabetes are not acutely ill. Families generally come to the Center within a few weeks of diagnosis for education specifically designed for children with type 2 diabetes.

If your primary care provider thinks your child may have type 2 diabetes, you may be referred to the Lifestyle Medicine Program at Children's Colorado. Our multidisciplinary team of pediatric experts will conduct a comprehensive medical assessment to provide the specialized treatment your child needs.

 

How is type 1 diabetes treated after it has been diagnosed?

Children with type 1 diabetes require frequent blood sugar testing and insulin replacement via injections (shots). Children will need to test their blood sugar four to eight times each day using a glucometer. To compensate for the insulin their bodies don’t produce, children with type 1 diabetes generally need multiple (at least four) insulin injections each day.

At the Barbara Davis Center, clinicians teach families how to safely give their children the insulin injections they need to control the condition.

How is type 2 diabetes treated after it has been diagnosed?

The best treatment approach for children with type 2 diabetes is to implement healthy lifestyle choices. Lifestyle changes can help manage type 2 diabetes, prevent its complications and can even slow or halt the progression of the disease from prediabetes to diabetes.

If your child is diagnosed with type 2 diabetes, the way to treat it is to make positive lifestyle changes, including:

  • Eating healthy foods
  • Losing extra weight
  • Increasing the daily level of physical activity

Children who are diagnosed with type 2 diabetes may be referred to the Weight Management Specialty Clinic at Children’s Colorado. This specialized clinic provides evaluation and treatment of children and adolescents whose weight is associated with conditions like type 2 diabetes.

Even with healthy lifestyle choices, most children diagnosed with type 2 diabetes will also need to take a medication called metformin, which is generally given twice a day as the dosage is increased over several weeks. Some children will also need daily 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.

Why choose Children’s Colorado for your child’s diabetes treatment?

At Children’s Colorado, your child has access to the experts they need, all in one place.

Children and teens with type 1 diabetes receive care at the Barbara Davis Center for Childhood Diabetes located on the Anschutz Medical Campus. There, pediatric diabetes experts provide holistic, family-centered care for children with diabetes.

The care team at the Center 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.

Type 2 diabetes treatment at Children’s Colorado

For kids with type 2 diabetes, we have every specialist, program, clinic and referral they may need to manage their diabetes right here at our hospital. By taking a multidisciplinary approach to diabetes care, we’re able to give kids the support, tools, care and resources they need to build a healthier future.

Your child’s care team at Children’s Colorado is able provide comprehensive care for every aspect of their condition because it’s comprised of pediatric experts from various specialties and disciplines. The team members treating your child may include clinicians like an endocrinologist, psychologist, gastroenterologist, cardiologist, nutritionist, dietitian, exercise physiologist, recreational therapist and whoever else your child needs.

Our multidisciplinary team of experts will walk you through the process – from testing and diagnosis to goal setting and treatment – taking an individualized, family-centered approach every step of the way.


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