Type 1 diabetes is the most
common form of diabetes in children: 90-95 per cent of under 16s with diabetes
have this type.
It is caused by the inability of
the pancreas to produce insulin.
Type 1 diabetes is classified as
an autoimmune disease, meaning a condition in which the body's immune system
'attacks' one of the body's own tissues or organs.
In Type 1 diabetes it's the
insulin-producing cells in the pancreas that are destroyed.
How common is it?
Childhood diabetes isn't common,
but there are marked variations around the world:
in England and Wales 17 children
per 100,000 develop diabetes each year
in Scotland the figure is 25 per
100,000
in Finland it's 43 per 100,000
in Japan it's 3 per 100,000.
The last 30 years has seen a
threefold increase in the number of cases of childhood diabetes.
In Europe and America, Type 2
diabetes has been seen for the first time in young people. This is probably in
part caused by the increasing trend towards obesity in our society.
But obesity doesn't explain the
increase in the numbers of Type 1 diabetes in children - who make up the
majority of new cases.
What causes childhood
diabetes?
As with adults, the cause of
childhood diabetes is not understood. It probably involves a combination of
genes and environmental triggers.
The majority of children who
develop Type 1 don't have a family history of diabetes.
What are the symptoms?
The main symptoms are the same as
in adults. They tend to come on over a few weeks:
thirst
weight loss
tiredness
frequent urination.
Symptoms that are more typical
for children include:
tummy pains
headaches
behaviour problems.
Sometimes diabetic acidosis
occurs before diabetes is diagnosed, although this happens less often in the UK
due to better awareness of the symptoms to look out for.
Doctors should consider the
possibility of diabetes in any child who has an otherwise unexplained history
of illness or tummy pains for a few weeks.
If diabetes is diagnosed, your child
should be referred to the regional specialist in childhood diabetes.
How is diabetes treated
in children?
The specialised nature of
managing childhood diabetes means that most children are cared for by the
hospital rather than by their GP.
Most children with diabetes need
insulin treatment. If this is the case, your child will need an individual
insulin routine, which will be planned with the diabetes team.
Most now use frequent daily
dosage regimes of fast-acting insulin during the day and slow-acting insulin at
night.
Very small children normally
don't need an injection at night, but will need one as they grow older.
Increasing numbers of older
children use continuous insulin pumps.
Often in the first year after
diagnosis, your child may need only a small dose of insulin. This is referred
to as 'the honeymoon period'.
As well as insulin treatment,
good glucose control and avoidance of ‘hypos’ (low blood glucose attacks) is
important. This is because many of the complications of diabetes increase with the
length of time diabetes has been present.
What can parents do?
Children bring their own problems
in relation to:
diet restrictions
activity levels
compliance with instructions.
Your family and your child's medical
team can help you through difficult times.
Living with diabetes can put
families under considerable strain, so access to backup support is crucial.
This may be from your GP, the hospital team or social services.
Understanding all the different
aspects of diabetes and its treatment requires patience, but will benefit your
child and family life.
The diabetes team at the hospital
can help you with the list below.
Learn how to administer insulin
injections. Insulin is usually injected into the skin over the abdomen or the
thighs.
Know the symptoms of low blood
glucose and diabetic acidosis and what to do about them.
Make sure glucose is always
available.
Measure blood glucose levels and
teach your child how to do this as soon as they are old enough.
Teach your child how to
self-administer insulin injections as soon as they are old enough - around the
age of nine is typical.
See the doctor on a regular
basis, and particularly if your child becomes ill for any reason - treatment is
likely to need adjusting.
Inform the school and friends
about the symptoms of low blood glucose and what to do about them.
Contact your local diabetes
association for help and support.
Diet
Diet guidelines
Current recommendations for
children with diabetes:
three main meals
two to three snacks
the whole family eats the same
meals.
A trained dietician is usually
one of the members of the hospital diabetes team.
It's important to give your child
a healthy balanced diet that is high in fibre and carbohydrates.
A healthy diet is the same for
everyone, whether or not they have diabetes.
How much your child should eat
depends on age and weight. The dietician and parents should determine this
together.
Sweets are no longer off limits
because the 'diabetic diet' is now a relic of the past.
Once your child gets to know how
her body responds to eating and taking insulin, sweets in moderation are
possible - accompanied by the appropriate dose of insulin.
Physical activity
Physical activity is important
for children with diabetes, who should try to exercise every day.
Physical activity lowers the
blood sugar level, so if your child takes insulin, she may need to reduce the
dose.
This is because a combination of
too much insulin and exercise can lower the blood sugar level and lead to
hypos. To counter this, your child should always carry sugar.
Physical activity also affects
how much your child can eat. Before your child exercises or plays sport, give
extra bread, juice or other carbohydrates.
In the long term
A child who develops diabetes
will live with the condition longer than someone who develops diabetes in
adulthood.
The longer diabetes is present,
the higher the risk of long-term complications such as those affecting the eyes
and kidneys.
These can start after puberty,
but are usually a concern only in later life.
Regular check-ups for late-stage
complications begin around the age of nine. From then on, this check-up is done
every year.
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