Type 1 Diabetes may not be the global epidemic that is Type 2 but it still needs our attention. Let's talk about Type 1 Diabetes in children.
Children are bundles of joy, a delight to watch, and forever stuffing their mouths with candies right? But there are some diseases that may affect children, and seemingly out of nowhere. One such disease is Type 1 Diabetes. Let us understand all about Type 1 Diabetes in children.
What is Type 1 Diabetes?
Type 1 Diabetes is an autoimmune condition in which the immune system attacks and destroys the insulin-producing beta cells of the pancreas by mistake. The body no longer produces the insulin hormone, which regulates the blood glucose (sugar) levels in the body.
In absence of insulin, the body is unable to utilise the glucose (sugar) released by the breakdown of food. Thus, blood glucose levels become extremely high and can cause life-threatening complications if left untreated.
Type 1 Diabetes mainly affects children, adolescents and young adults. However, there is no fixed age for Type 1 Diabetes and it can also be diagnosed in older adults.
Type 1 Diabetes in Childhood
Type 1 Diabetes in children used to be known as juvenile diabetes or childhood-onset diabetes. Though it can affect children at any age, there are two distinct peaks that are noticed in the diagnosis of Type 1 Diabetes in children. The first peak is in children between 4 and 7 years old and the second in children between 10 and 14.
Causes of Type 1 Diabetes in Children
Type 1 Diabetes is an autoimmune disorder with the exact cause still unknown. However, children with Type 1 Diabetes may have been born with a genetic susceptibility toward autoimmune conditions.
In this condition, your body’s immune system, which normally fights harmful bacteria and viruses, mistakenly destroys the insulin-producing beta cells in the pancreas. In rare cases, Type 1 Diabetes causes can include an injury to your pancreas.
Some risk factors that can raise the risk for Type 1 Diabetes in childhood include:
- Family History: Children with a family history of Type 1 Diabetes (having a parent or sibling with the condition) are more likely to develop it.
- Genetics: Having certain genes can also play a role in the development of Type 1 Diabetes.
- Age: Children in the age groups of 4 to 6 and 10 to 14 are more likely to be diagnosed with Type 1 Diabetes.
Symptoms of Type 1 Diabetes in Children
The symptoms of juvenile diabetes or Type 1 Diabetes in childhood are generally caused by high blood glucose levels. The symptoms often appear suddenly and can differ in each child. The symptoms of Diabetes in teens and kids are generally the same as those in adults.
Some of the most commonly observed childhood Type 1 Diabetes symptoms are as follows:
- Increased thirst (polydipsia)
- Excessive urination (polyuria) that presents as frequent diaper changes or bed wetting
- Increased hunger frequent eating (polyphagia)
- Unintended weight loss
- Irritability and behaviour changes
- Fatigue and extreme tiredness
- Nausea and vomiting
- Abdominal pain
- Blurred vision
- Slow-healing wounds and sores
- Fruity-smelling breath
- Diaper rash
- Yeast infection in girls
Diagnosis of Type 1 Diabetes in Children
Type 1 Diabetes in children is diagnosed on the basis of blood tests to check their blood glucose levels.
Type 1 Diabetes is diagnosed if:
- Random blood glucose is greater than 200 mg/dL, along with symptoms of diabetes. This is a primary screening test for diabetes and is taken at a random time in the day.
- Fasting blood glucose is greater than 126 mg/dL on two separate tests. This test is taken when your child has not eaten for more than 8 hours, usually in the morning before having breakfast.
- Glycated Haemoglobin A1c is greater than 6.5 on two separate tests indicating diabetes. This test indicates your child’s average blood glucose level for the past 3 months.
The diagnosis of Type 1 Diabetes is confirmed and differentiated from Type 2 by performing the following tests:
- Islet Autoantibodies Test: Islet autoantibodies are found in Type 1 Diabetes but not in Type 2 Diabetes.
- C-Peptide Test: C-peptide is a substance made in the pancreas along with insulin. In Type 1 Diabetes, the pancreas makes little to no C-peptide.
- Ketone Test: The presence of ketones in urine also confirms the diagnosis of Type 1 Diabetes.
Treatment of Type 1 Diabetes in Children
Unfortunately, there is no cure for Type 1 Diabetes, in children or in adults. This condition requires lifelong care and treatment. You will have to work with your child’s healthcare providers to ensure efficient management of the condition.
Insulin therapy, a balanced diet, regular exercise, and healthy lifestyle habits can help you manage the condition effectively.
- Insulin: Presently, insulin is the only medication available to treat Type 1 Diabetes in children and adults. It has to be taken every day for effective blood glucose control.
- Balanced Diet: Including vegetables, fruits, whole grains, legumes, dairy, lean meat, etc. in your child’s diet in the right amounts and choosing low to moderate Glycemic Index (GI) foods can help your child receive all the essential nutrients while exercising control over blood sugar levels.
- Exercise: When your child exercises, the muscles in the body use up the glucose present in the bloodstream. This helps lower blood sugar levels and manage Type 1 Diabetes symptoms. Make sure they perform at least 60 minutes of exercise such as walking, running, climbing, jumping, etc. every day. Remember that physical activity can affect blood sugar levels and your child’s meals and insulin doses have to be adjusted accordingly.
- Regular Blood Sugar Monitoring: Frequent blood sugar monitoring is the only way to make sure that your child’s sugar levels remain within the target range. Your child’s blood sugar levels need to be checked at least four times a day, before every meal and at bedtime. It may need to be checked occasionally during the middle of the night as well. Blood sugar monitoring can be done using a glucometer, flash glucose monitoring (FGM) system and continuous glucose monitoring (CGM) system.
Complications of Type 1 Diabetes
If Type 1 Diabetes is left untreated, your child may develop any of these short-term complications:
- Hypoglycaemia: It is a condition that occurs when your child’s blood glucose levels drop below 70 mg/dL (milligrams per deciliter). You may observe symptoms such as headache, confusion, slurred speech, rapid heartbeat, sweating, paleness of skin, and numbness in limbs.
- Hyperglycaemia: This condition occurs when your fasting blood glucose levels are above 125 mg/dL. The symptoms of hyperglycemia include excess thirst, increased hunger, frequent urination, fatigue, and blurred vision.
- Diabetic Ketoacidosis: If your child’s blood glucose level is above 250 mg/dL, they may develop diabetic ketoacidosis. When the body cannot use the glucose in the blood to generate energy, it starts breaking down fat to use as fuel. Your liver processes these fats and turns them into ketones. The presence of too many ketones in your child’s blood can turn it acidic and cause symptoms like fruity-scented breath, vomiting, flushing, headache, muscle stiffness, fatigue, weight loss, abdominal pain, confusion, cold skin, etc.
Long-term complications of Type 1 Diabetes develop gradually due to persistently high blood glucose levels and include:
- Diabetic Retinopathy: High blood glucose levels can damage the tiny blood vessels in your child’s eyes, resulting in blurred vision and dark spots, and even partial or complete loss of eyesight. Type 1 diabetics may also develop cataracts.
- Diabetic Neuropathy: This condition includes damage to peripheral, autonomic, proximal, and focal nerves. The most common damage is to the peripheral nerves in limbs and hands. Nerve damage can cause tingling, numbness, or pain in limbs, with the symptoms gradually progressing to partial or complete loss of sensation.
- Diabetic Nephropathy: Damage to the blood vessels in and around the kidneys can cause kidney malfunctioning and infections, and may lead to kidney failure.
- Heart and Blood Vessel Disease: High blood glucose levels can damage the arteries that supply blood to the heart and other major organs. When cholesterol accumulates in the damaged artery walls, it can lead to the clogging, narrowing and stiffening of blood vessels, which can reduce or cut off the blood and oxygen supply to the heart. This can damage heart tissue and cause various cardiac problems.
- Gum Disease: Children with Type 1 Diabetes may also experience gum disease, also called gingivitis. The excess sugar in the blood can increase sugar concentration in the saliva, causing the accumulation of bacteria on and around the tooth and gums. If the gum infection is left untreated, it may spread to the jawbone and lead to tooth loss.
Prevention of Type 1 Diabetes
At the moment, there are no ways to prevent Type 1 Diabetes in children, as the cause of the condition is still unknown. However, research is ongoing on ways to identify those at risk of developing the condition and prevent it before the beta cells in the pancreas are destroyed.
What is the Role of Childhood Trauma in Type 1 Diabetes?
Children who develop Type 1 Diabetes are born with a genetic predisposition to the condition. However, these genetic triggers may not be activated unless they come in contact with certain environmental factors or experience extreme stress or trauma.
Though not caused directly by childhood trauma, Type 1 Diabetes in children may be triggered by the psychological stress that results from trauma.
Childhood trauma could be defined as psychological stress caused by any “serious life event” in children. A few examples of serious life events include divorce, illness or death in the family, accidents, abuse, etc.
As per experts, high-stress situations may lead to a boost in the hormone cortisol in children, pushing the insulin-producing beta cells of the pancreas to work harder. The immune system may view this added influx of insulin as abnormal and undesirable, and start attacking and destroying the beta cells. This may lead to the development of Type 1 Diabetes in children.
Don’t Have Time To Read?
- Type 1 Diabetes is an autoimmune disorder, where the immune system mistakenly attacks and destroys the insulin-producing β-cells in the pancreas. This condition mainly affects children and adolescents, though it can also be diagnosed in older adults.
- Though the exact cause of Type 1 Diabetes in children is still unknown. The risk factors for Type 1 Diabetes in children include genetics, age, and family history. In a few cases, psychological stress due to childhood trauma can also lead to Type 1 Diabetes in children.
- Symptoms of Type 1 Diabetes in children include increased thirst (polydipsia), frequent urination (polyuria), increased hunger (polyphagia), unintended weight loss, fatigue, irritability and other mood changes, etc.
- Type 1 Diabetes in children is diagnosed by blood tests to check for high blood glucose levels. The diagnosis is confirmed by performing the C-peptide test, islet autoantibodies test, and ketone test.
- Type 1 Diabetes in children cannot be prevented. It is a condition that requires lifelong care and treatment. The only medication that presently exists for Type 1 Diabetes is insulin. A healthy diet, regular exercise, and healthy lifestyle habits can help you manage the condition effectively.
- Over time, high blood glucose levels in children can lead to complications. The complications include short-term effects such as hypoglycaemia, hyperglycemia, and diabetic ketoacidosis and long-term effects such as cardiovascular disease, ischemic stroke, diabetic nephropathy, neuropathy, and retinopathy.
- Use the Phable Care App to consult India’s leading diabetologists, order medicines, book lab tests, integrate blood sugar monitoring and other devices to get real-time remote care from the comfort of your home. Also, check out our Diabetes Management program which provides 360º care. Let’s treat diabetes together.
Friendly Asked Questions
The three main most common signs of a child with undiagnosed Diabetes, also known as the 3 P’s of Diabetes, are excess hunger (polyphagia), increased thirst (polydipsia) and frequent urination (polyuria). Children with a high risk of developing Diabetes should consult a doctor immediately upon observing these symptoms.
No, Type 1 Diabetes cannot be reversed, even if it develops in childhood. The symptoms can only be managed with proper medication, diet, and regular exercise.
Yes, a child with Type 1 Diabetes can live a normal life by leading a disciplined life including insulin therapy, a balanced diet, regular exercise, and everyday monitoring of their blood sugar levels.
Your child may show symptoms like excess hunger, thirst, urination, fatigue, unintentional weight loss, irritability, vision changes, fruity-smelling breath etc. You should consult a doctor immediately upon observing these symptoms. During the consultation, your doctor may perform a blood sugar test to diagnose diabetes in your child. A high blood sugar level can indicate Diabetes and Type 1 Diabetes can be confirmed through further tests.
Type 1 Diabetes can appear at any age, but its diagnosis peaks in two age groups. The first age group is between 4 and 7 years old. The second is in children between 10 and 14 years old.
Type 1 Diabetes is a serious life-long condition that needs constant monitoring and management. There is no cure for Type 1 Diabetes and it needs to be managed with insulin therapy, a balanced diet, regular exercise, and blood glucose monitoring. If left untreated, it can lead to serious short-term and long-term complications in a child.