Pediatric type 1 diabetes

What is pediatric type 1 diabetes?

Type 1 diabetes occurs at any age but is most commonly diagnosed in children, teens, and young adults and accounts for 5 – 10% of all cases of diabetes. Without insulin, your body cannot convert sugar, starch, and other food into energy.

Type 1 was previously known as insulin dependent diabetes mellitus (IDDM), juvenile onset diabetes or brittle diabetes. Unlike type 2 diabetes, this type cannot be prevented.

Most people who develop type 1 diabetes are of normal weight and are healthy before it starts. Despite active research, type 1 diabetes has no cure, but it can be managed.

Target glucose levels:

• Before a meal: 90 – 130

• 2 hours after a meal: less than 160

Complications of pediatric type 1 diabetes

It is important to know the long term complications of untreated diabetes. If you experience any of these complications, please discuss this with your endocrinologist and primary care provider.  

• Cardiovascular disease

• Eye disease

• Kidney disease

• Nerve disease

What are the signs and symptoms of pediatric type 1 diabetes?

• Being tired

• Blurry eyesight

• Fatigue (feeling tired)

• Frequent urination

• Increased/decreased appetite

• Thirst

• Weight loss

How is pediatric type 1 diabetes diagnosed?

There are several ways diabetes can be diagnosed:

• Fasting (nothing to eat eight for hours or more) plasma glucose ≥ 126 mg/dL

• Random blood glucose ≥ 200 mg/dL with symptoms of high blood glucose

• Hemoglobin A1C test ≥ 6.5%

• Oral glucose tolerance test (OGTT) with 2-hour blood glucose test ≥ 200 mg/dL

What are the causes of pediatric type 1 diabetes?

The exact cause of type 1 diabetes is unknown but doctors believe it is an autoimmune disorder. This means that the body sees the pancreas as an invader and attacks it. Sometimes an infection causes the body to attach the beta cells that make insulin by mistake.

There are three contributing factors.

1. Genetics – Inherited gene cell types

2. Autoimmunity – The immune system mistakes insulin cells for invaders and attacks them

3. Environment – A genetic makeup may allow a virus or chemical to attack islet cells

Type 1 diabetes is not caused by eating to much sugar, staying up too late or poor parenting.

How is pediatric type 1 diabetes treated?

Insulin

Type 1 must be treated with insulin. Insulin can be thought of as the key that unlocks the doors on the cells of the body. Insulin allows food to enter the cells of the body. Glucose (sugar) is formed when foods are digested. The cells of the body use glucose for energy. Without insulin, cells will starve. The main treatment for type 1 is to replace the insulin that the body needs. 

This is usually done using one of three methods:

1. Insulin syringes

2. Insulin pens

3. Insulin pumps

Diet and exercise

• Diet is another important part of the care for type 1 diabetes, as different foods will have different impacts on blood sugar. The American Diabetes Association has information on planning healthy meals.     

• Regular exercise works to control sugar and helps burn extra calories and fat to help your child get to maintain a healthy weight. Since exercise can change blood sugar, talk to your child’s doctor before starting a program. Some changes may have to be made in the treatment plan before, during and after physical activity.     

Living with type 1 diabetes is a lifelong project. Exercise and diet are not helpful in reversing type 1 diabetes; however, both are important in treating it.