Children's Hospital Colorado

Type 1 Diabetes

What is type 1 diabetes?

Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone that our bodies need to convert sugar, starches and other food into the energy we need for daily life. The body needs insulin to allow energy-producing sugars called glucose into its cells. Without it, glucose builds up in the bloodstream. Over time, high blood glucose levels can cause health problems.

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

What causes type 1 diabetes?

Type 1 diabetes occurs when the immune system (which normally fights harmful bacteria and viruses) destroys the insulin-producing cells in the pancreas. This causes the body to stop making insulin over time. With type 1 diabetes, the body is actually attacking itself.

A family history (genetics) of type 1 diabetes may be a cause of type 1 diabetes. There are also causes from the environment, but we do not have a good understanding of what those causes are.

Who gets type 1 diabetes?

Type 1 diabetes commonly begins in childhood and adolescence. Even though the condition and symptoms of type 1 diabetes tend to manifest early in life, adults can also develop type 1 diabetes. Children with a strong family history of autoimmune disease are at a higher risk for developing type 1 diabetes. Children who have a history of thyroid problems or celiac disease may also be at higher risk for developing diabetes.

What's the difference between type 1 and type 2 diabetes?

Both types of diabetes are chronic conditions that affect the way the body regulates blood sugar (glucose). Insulin is the key that allows glucose (the body's fuel) to enter its cells. For type 1 diabetes, kids don't produce insulin, so their bodies are missing the key they need.

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

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.

What are the signs and symptoms of type 1 diabetes?

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

  • Frequent urination
  • Excessive thirst
  • Feeling very tired
  • Weakness
  • Extreme hunger
  • Blurred or decreased vision
  • Unintentional weight loss
  • Mood changes
  • Irritability
  • Bedwetting during the night (when they previously didn't)

The symptoms of type 1 diabetes typically develop quickly. 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.

What tests are used to diagnose diabetes in children?

Your child should be tested for diabetes if they have symptoms of diabetes, or if you think they may be at risk for developing diabetes. Your doctor can diagnose diabetes using the following tests:

  • 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.

If your child does not yet have signs or symptoms, but you have concerns for increased risk for type 1 diabetes due to a family history or the presence of other autoimmune conditions like celiac or Addison disease, diabetes antibody testing and genetic risk testing can be done.

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

Our doctors will evaluate your child for type 1 diabetes if they are admitted to the emergency department and show signs and symptoms of diabetes. They will perform blood tests to evaluate the levels of sugar and acid in your child's blood.

If your child's blood sugar 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.

How is type 1 diabetes treated?

Children with type 1 diabetes need frequent blood sugar testing and insulin replacement using insulin injections (shots). Children with type 1 diabetes generally need multiple (at least four) insulin injections each day. Many children use a pump that delivers insulin to their body without giving injections. Children will need to test their blood sugar four to eight times each day using a glucometer. Some children use a device that is attached to their skin with a small sensor under the skin that measures their blood sugar frequently throughout the day.

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

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 and medicine.

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

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