Dr. Marshall, Auburn Reporter
Diabetes is one of the most common – and increasingly prevalent – chronic diseases in children. For parents, the challenge is recognizing the symptoms in their child.
Since the onset is slow and the changes are subtle, diabetes often isn’t recognized until a child is very ill, usually in conjunction with another illness.
So how do parents know if their child has diabetes? Keep an eye out for these five common signs:
• An increase in thirst or urination.
• Increased appetite with sudden or unexplained weight loss.
• Vision changes.
• A fruity odor to the breath.
A doctor should be consulted for any of those symptoms, because the symptoms may have other causes besides diabetes. If the doctor suspects diabetes, a diagnosis can be made by looking at the results of one fasting blood sugar test or two random blood sugar tests.
After a child has been diagnosed, many parents realize in retrospect that the symptoms of diabetes had been present for quite some time.
What is diabetes?
The two main types of diabetes in children are type 1 (previously known as juvenile diabetes) and type 2 (previously known as adult-onset diabetes).
In the past 10 years, in conjunction with the childhood obesity epidemic, there’s been an increase in the number of children who develop type 2 diabetes.
Diabetes is when the body is unable to convert blood glucose – sugar – into energy. Insulin, produced by the pancreas, is needed to do that.
In type 2 diabetes, the body is producing its own insulin, just not enough. Type 2 diabetes is closely linked to being overweight. Other risk factors for type 2 include being older than 10, having a family member with type 2 diabetes, and being from a high-risk ethnic group, such as African-American, Pacific Islander and Native American.
The most important prevention tools for type 2 diabetes are a healthy diet, exercise and maintaining a healthy weight. Parents should check with a pediatrician to make sure a child’s body-mass index is below the 85th percentile.
With Type 1 diabetes, there’s no way to prevent it and there’s no cure. The body attacks the pancreas so it doesn’t produce insulin. The only treatment is to replace the insulin through an injection, which is a lifelong process.
Diabetes can occur at any age, but it is most commonly diagnosed in toddlers and at puberty. Each year, about 15,000 U.S. children are diagnosed with type 1 diabetes, and about 3,700 are diagnosed with type 2 diabetes, according to the most recent estimates by the Centers for Disease Control and Prevention.
Many children with diabetes are on insulin pumps and some are on continuous glucose monitors. Pumps provide a constant infusion of insulin and allow insulin to be given through a small catheter that is inserted every three days, eliminating multiple injections. Continuous glucose monitors are the size of a quarter and check sugar levels every five minutes.
Families can meet with a diabetes educator specialized in pediatrics to help them through the process. The MultiCare Mary Bridge Pediatric Endocrine and Diabetes Clinic offers testing, treatment, consultation and education for infants, children and adolescents. The pediatric professionals, child-friendly environment and advanced technology provide the ideal setting to evaluate and educate children and their families.
In addition to the services offered in Tacoma, the team makes regular visits to specialty clinics in Puyallup, Olympia and Silverdale, so that children can get care closer to home. Diabetes educators also coordinate services with community resources and direct support groups.
A diabetes education program can offer:
• Individualized education for children and families.
• Comprehensive group classes.
• Brief, age-specific programs.
• Phone consultations available for families, school nurses and other care providers.
Diabetes education and self-management training is generally covered by most insurance companies, including Medicaid. Contact your insurance provider for coverage information specific to your insurance plan; financial assistance may be available.
Untreated diabetes can have serious, lifelong consequences for a child. Short-term risks are hyperglycemia (high blood sugar), hypoglycemia, (low blood sugar), diabetic ketoacidosis (increased ketones in the urine) and coma. Long-term risks are primarily vascular and nerve damage, resulting in blindness, kidney failure, amputations and increased risk of heart attack or stroke.
Since children don’t necessarily understand the long-term consequences, it’s a parent’s responsibility to make sure children get a proper diagnosis and take their medication.
With the technology and treatment options available, children with diabetes can expect to live long and healthy lives.
Dr. Barbara Marshall is a pediatric endocrinologist at MultiCare Mary Bridge Children’s Hospital & Health Center in Tacoma, which also has children’s health centers in Puyallup, Olympia and Silverdale. For more information about diabetes programs, call 253-403-3131 or or 1-800-552-1419.