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How do I know if my child has diabetes?
Insulin-dependent diabetes mellitus (IDDM) or otherwise known as juvenile-onset diabetes is due to failure of the beta cells of the pancreas to produce insulin. The beta cells of the pancreas are a type of cell that makes insulin. Let me explain further.
The pancreas is an organ located in the abdomen (stomach area) and it plays an important role in converting the foods we eat into fuel or nutrition to the body’s cells.
The pancreas has two main functions:
1. Exocrine function which helps in digestion (it secretes a substance out through a duct) and,
2. Endocrine function (it secretes a hormone named insulin) to regulate blood sugar.
So, you might be asking yourself “how do I know if my child has diabetes?” and my goal is to walk you through the signs and symptoms to watch out for, how it’s diagnosed and how it is treated. I want to mention that this is by no means a medical advice type of article nor is it to be taken as medical advice. It is meant to be an aid or guide to help you make the correct decision to take your child to the doctor for medical advice and management.
Approximately 97% of newly diagnosed juvenile diabetics have insulin-dependent diabetes mellitus (IDDM) or type 1 diabetes. The age of onset is typically 11 years in girls and 13 years in boys. The age ranges of peak incidence are 5 to 7 years and puberty. Interestingly to note, that among preschool aged children, the disease is more commonly noted in boys. Among children diagnosed 5 to 10 years of age, the disease is more commonly diagnosed in girls. Here is another interesting note. This disease is diagnosed more often in the winter than in summer.
Signs and symptoms
The following signs and symptoms are classic signs of diabetes.
1. Excessive and large amounts of urinating.
2. Excessive thirst.
3. Excessive hunger.
4. Recent weight loss (during a period of less than 3 weeks).
7. Yeast infections in girls.
8. Fruity breath odor.
9. Dehydration (usually 10% dehydrated).
10. Diabetic ketoacidosis (I will explain this later in this article as this deserves its own attention and is a medical emergency. This is not always a typical sign, but could occur unexpectantly).
11. Abdominal pain or belly pain.
12. Change in level of consciousness as result of the above symptoms not being addressed and progression of the disease.
Diagnosis is confirmed by the presence of symptoms combined with an elevated blood glucose (sugar) level [higher than 200mg/dl] and glucose or sugar in the urine.
Long term effects
The long term effects of hyperglycemia (a blood sugar level higher than 200) if left untreated, are very serious. I have made a list of these effects here:
1. Failure to grow at a normal rate and delayed maturing.
2. A nerve problem that causes pain, numbness, tingling, swelling, or muscle weakness in different parts of the body.
3. Recurrent infection.
4. Retinal disease of the eye (damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina).
5. Renal (pertaining to the kidney) micro vascular disease (complications that affect the small blood vessels of the kidneys).
6. Cardiovascular disease (damage to the blood vessels and nerves that control the heart and blood vessels).
7. Arterial obstruction (hardening or obstruction of the arteries throughout the body because of too much sugar, or glucose, building in the blood due to a lack of insulin.
There are several complications that result if a person is not medically treated for diabetes. It is imperative that you understand the seriousness of this disease no matter the age of the person. If treated adequately, diabetes can be controlled. It is within this section I will elaborate on the complication I mentioned above – diabetic ketoacidosis. Also, I will show you some of the other problems or complications that can arise.
If a child or adult does not receive treatment for their diabetes, any of the following complications can arise.
1. Coma (a deep state of prolonged unconsciousness).
2. Hypokalemia (blood potassium level is too low).
3. Hyperkalemia (blood potassium level is too high).
Note: Your blood potassium level is normally 3.6 to 5.2 millimoles per liter (mmol/L).
4. Osteopenia (loss of bone mass and weaker bones).
5. Limited joint mobility.
6. Thromboemboli [a blood clot that breaks loose and is carried by the blood stream to obstruct another blood vessel. The clot may obstruct a vessel in the lungs (pulmonary embolism), brain (stroke), gastrointestinal tract, kidneys, or leg].
7. Overwhelming infections.
Diabetic ketoacidosis. This is a serious condition in which the body produces high levels of blood acids called ketones. This is caused by the body not producing enough insulin. The symptoms of this complication include the ones listed above for diabetes along with what we call Kussmaul respirations which are deep sighing respirations or breaths. The blood sugar level is higher than 300 mg/dl and there are moderate to large amounts of ketones in the urine. The pH of the blood becomes acidic, electrolytes become unbalanced and as a result can cause a life-threatening irregular heart beat. Coma can occur as a result of the electrolyte imbalance and the acidic level of the blood. Death can occur but is infrequent.
Diagnosis and treatment
If your child has any of the signs and symptoms for diabetes as listed in the first part of this article, make an appointment with your child’s doctor to have him or her evaluated. Do not delay or put it off. Having your child seen, diagnosed and treated right away will prevent the more serious complications of diabetes. The doctor will evaluate your child by doing thorough blood work and urinalysis. They will teach you how to check your child’s blood sugar levels with a device called a glucose monitor. Depending on the doctor’s orders, you will be checking the blood sugar anywhere from 2 to 4 times a day. Very rarely will you have to check it more than 4 times a day, but sometimes it can’t be avoided. It just depends on your child’s condition. The blood sugar level will determine the amount of insulin you’ll need to give. This is given by an injection on either the arm, stomach or thigh and you will rotate sites for each injection.
Diet and nutrition
The purpose of a dietary plan provides the necessary intake of calories for energy requirements and appropriate distribution of nutrients (carbs, fats and proteins). The American Diabetic Association (ADA) diet is designed specifically for diabetics and your doctor will involve a dietician or nutritionist to go over this diet plan with you. These types of diets are tailored to fit your individual nutritional needs.
Taking care of a child with type 1 diabetes
To manage diabetes in your child you will be taught by a nurse how to check your child’s blood sugar, give an insulin injection and you will be given an ADA diet for your child. It is usually recommended that your child should eat 4 to 6 small meals per day. You may be checking your child’s urine for glucose levels and may be checking for ketone levels, but this is if your doctor orders it. Sometimes it is not necessary. It depends on your child’s condition. Always check your child’s skin and feet. Encourage regular play and activities. It is important for your child’s self-esteem and emotional health. It is important to get involved with a support group for yourself and your child as it will help alleviate your concerns and you can find great strength as you meet other parents and children who are living with diabetes.
Ketone testing strips can be found here for purchase!
Here below I have attached two of the best performing and well-known blood glucose monitors. The Accu Chek glucose monitor was the one I used when I was working at the hospital. I found it to be very reliable and fast for my patients. I think you will really like it too. You don’t want to skimp on a purchase like this, it is too important. The One Touch Ultra Mini is small enough to fit in your pocket or purse. It has some really cool features such as it automatically tests each blood sample twice for accuracy. This blood glucose monitor might be small, but it is mighty!
I have attached a link for both the glucose monitor and test strips for the Accu Chek and One Touch Ultra Mini monitors.
Take a look at these blood sugar monitors and get yours here!
Wrapping it all up
If you find out that your child has type 1 diabetes, just know that it can be treated and controlled. You will learn a new way of life as well as your child and that is why I highly recommend becoming part of a good support group. Talk to your doctor about it and he or she can direct you to one. Adjusting to new dietary measures, watching blood sugar levels, insulin injections and skin care will become second nature to you and your child. Remember, there are a lot of people who have diabetes and you are not alone.
If you have any questions or concerns, please leave them for me in the comment section below. I will respond in a timely manner.