What is diabetes?

Diabetes is a condition that happens when the amount of blood sugar (also called glucose) in the blood becomes too high. Glucose is the main source of energy for the body and comes mostly from the food you eat. Normally, insulin, a hormone made by the pancreas, helps glucose from your food get into your cells to be used for energy. But if your body can’t produce enough insulin or produces none at all, too much sugar remains in the blood. High blood sugar levels can cause many health concerns.

Types of diabetes

There are two main types of diabetes:

Type 1 diabetes: type 1 is primarily genetic and is the most common form of diabetes diagnosed in children and adolescents. It occurs when the body is unable to produce any insulin. 

Type 2 diabetes: type 2 usually develops gradually and is much less common in children and young people. It mostly affects adults over the age of 40, but it can develop at any age. It is often linked to lifestyle factors such as weight gain, lack of exercise and diet, as well as a family history of type 2 diabetes. It occurs when the body produces some, but not enough, insulin; or is resistant to insulin. 

Type 1 diabetes

The most common type of diabetes in children is type 1 or juvenile diabetes. Type 1 is a lifelong (chronic) autoimmune disease that prevents the pancreas from making insulin. Anyone at any age can develop type 1 diabetes, though the most common age at diagnosis is between the ages of 4 to 6, and in adolescence (10 to 14 years). A child is more at risk of type 1 diabetes if they have a family member with the condition.

Symptoms of diabetes in children

Symptoms of type 1 diabetes typically start out mild and get progressively worse or more intense over time. Symptoms can be different for each child, and include:

• Going to the toilet a lot: the body tries to get rid of the extra glucose in the blood by passing it out in the urine. This means that sometimes children can start to bed wet.  

• Feeling really thirsty: passing lots of urine makes you very thirsty.

• Extreme fatigue: tiredness is a common symptom as the body cannot work properly without enough energy.

• Hunger, at times excessive, associated with weight loss: when the body cells cannot use the glucose from food, they break down fat and muscle for energy and you lose weight.

• Behavioural changes: irritability, mood changes, and feeling low due to the fluctuations in blood sugar level which is caused by diabetes.

• Blurred vision: not a common symptom, but this can occur if the sugar is very high.

How is type 1 diabetes diagnosed?

To confirm a diagnosis of type 1 diabetes, your child’s doctor may order some or all of the following tests:

• Blood test: A test that measures the amount of sugar in the blood. High blood sugars show that a child has diabetes.

• Haemoglobin A1C test: diabetes can also be diagnosed by a test that shows what the average blood sugar has been in your child’s blood over the previous three months. A result that is found to be higher than 6.5 per cent on two separate tests is an indication of diabetes.

• Urine test: this can either be done through your child’s doctor, or you can buy your own testing strips online if you are concerned and want to monitor your child’s ketone levels. High levels of ketones in the blood or urine can lead to diabetic ketoacidosis, which is life-threatening and requires immediate medical care.

• Additional blood tests: to help distinguish between type 1 and type 2 diabetes, your child’s doctor may also check for antibodies in the blood that are common in type 1 diabetes.

How is type 1 diabetes treated in children?

Type 1 diabetes is a lifelong condition and there is no known cure. However, there are very effective treatments that can help children to lead an active and healthy life. Treatment involves your child’s diabetics team putting together a care plan, which tells you and your child the things to do every day to help keep blood sugar levels in a healthy range.

Each child’s diabetes care plan is unique to them, but all plans have the same 4 basic parts:

1. Daily insulin injections

Children with type 1 diabetes need to have daily injections of insulin to keep their blood glucose level within normal ranges. Insulin is given either by injection or an insulin pump. Your child will need a basal level of slow-acting insulin throughout the day; they will also need an extra dose of fast-acting insulin around meals. Insulin pumps are often prescribed to provide better control, as they work automatically, and allow more flexibility around mealtimes.

2. Eating a healthy, balanced diet that includes counting carbohydrates 

A healthy balanced diet and eating the right foods can help children with diabetes control their blood sugar levels. Ensure they are getting plenty of fresh fruits and vegetables, lean meat and protein, dairy produce and complex carbohydrates in whole grains. Avoid too much sugar and processed carbohydrates, but you don’t have to totally ban sweet treats. A dietician and your child’s diabetes team can teach you and your child to count carbohydrates and balance the insulin dose.

3. Getting regular physical activity

Getting consistent exercise helps to lower blood sugars. Children with diabetes should have at least an hour of exercise each day; that could be a sport like football or basketball, dancing, games, swimming, or energetic play.

4. Regular blood sugar monitoring

Checking blood glucose levels is key to managing diabetes. A fingerpick check will tell you what your child’s blood glucose level is. The blood is then quickly analyzed on a small machine called a glucometer, to give a result. A better and more pain-free option for children is a continuous glucose monitor, which can improve sugar monitoring, and raise the alarm if the glucose level is too low or high.

Complications with type 1 diabetes

Good control of blood sugar in children with type 1 diabetes reduces long-term risks and complications which can include:

• Eye problems

• Kidney disease

• Nerve problems

• Foot problems

• Heart attack and stroke 

• Diabetic ketoacidosis

Diabetic ketoacidosis (dka) is a serious health problem that can occur if your child has diabetes. This is life-threatening and requires immediate medical care. It occurs when there’s not enough insulin in the body, so it starts to break down fat instead. Symptoms of DKA can include nausea, vomiting, stomach pain, rapid breathing, drowsiness, and, in severe cases, unconsciousness.

9 tips to help children cope with diabetes

It can be very challenging for parents to manage a diagnosis of type 1 diabetes in a child. Here are some tips that may help. 

1. Learn about insulin

Learn how insulin works, how to give shots, and how to use an insulin pump instead.

2. Check blood sugar

Regular blood sugar monitoring is key to keeping your child’s glucose level as close to the healthy range as possible. Learn how to check your child’s blood sugar and how to interpret the results.

3. Help your child make healthy food choices

Support your child to eat healthily and watch their diet. Help your child to understand the relationship between food and blood sugar and that eating equals a need for insulin. 

4. Help your child understand the idea of balance

It is important to match your child’s meal insulin dose to the amount of carbohydrate food in their meal to prevent high or low blood glucose levels.  So, if your child wants to eat a food not on their meal plan, then you need to adjust the insulin dose to reflect this change. 

5. Get the whole family involved in counting carbs

Being aware of the amount and type of carbs in both food and drinks is very important for children with type 1 diabetes. It helps if the entire family makes healthy food choices, and learns about counting carbohydrates. The more carbs your child eats, the more short or rapid acting insulin they will need to inject.

6. Help your child be active

Exercise helps with diabetes treatment, so encourage your child to find an activity they enjoy doing.

7. Support your child’s mental and emotional health

Reach out for professional help if you need it. Local support groups and online resources can provide emotional support as well as information to help you cope with your child’s diabetes.

8. Work with your child’s school

School can pose a particular challenge for children with type 1 diabetes because of the need to take insulin throughout the day and eat on a regular schedule. Work with your diabetes team to make a care plan for school, and then meet with your child’s teacher and the school staff to discuss the plan, and how they can help.

9. Help your child become independent over time

As children with type 1 diabetes grow older, start encouraging them to take more control over their treatment.

Although type 1 diabetes is a serious and challenging disease, long-term management options continue to evolve, allowing children to enjoy full and active lives.

If you have any questions about diabetes or need guidance on how to help your child, remember to use our Telehealth service, which is included into your cover. Our Telehealth service connects you to a medical professional within minutes, wherever you are.

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