Type 1 Diabetes: What Is It?

If you have a child who has been diagnosed with diabetes, you’re not alone. Every year in the United States, 13,000 children are diagnosed with type 1 diabetes, and more than 1 million American kids and adults deal with the disease every day.

Diabetes is a chronic (long-lasting) condition that needs close attention. But with some practical knowledge, you can become your child’s most important ally in learning to live with the disease.

About Diabetes

Diabetes is a disease that affects how the body uses glucose, the main type of sugar in the blood. Glucose comes from the foods we eat and is the major source of energy needed to fuel the body’s functions.

After you eat a meal, your body breaks down the foods you eat into glucose and other nutrients, which are then absorbed into the bloodstream from the gastrointestinal tract. The glucose level in the blood rises after a meal and triggers the pancreas to make the hormone insulin and release it into the bloodstream. But in people with diabetes, the body either can’t make or can’t respond to insulin properly.

Insulin works like a key that opens the doors to cells and allows the glucose in. Without insulin, glucose can’t get into the cells (the doors are “locked” and there is no key), so it stays in the bloodstream. As a result, the level of sugar in the blood remains higher than normal. High blood sugar levels are a problem because they can cause a number of health problems.

What Is Type 1 Diabetes?

There are two major types of diabetes: type 1 and type 2. Both type 1 and type 2 diabetes cause blood sugar levels to become higher than normal. However, they cause it in different ways.

Type 1 diabetes (formerly called insulin-dependent diabetes or juvenile diabetes) results when the pancreas loses its ability to make the hormone insulin. In type 1 diabetes, the person’s own immune system attacks and destroys the cells in the pancreas that produce insulin. Once those cells are destroyed, they won’t ever make insulin again.

Although no one knows for certain why this happens, scientists think it has something to do with genes. But just getting the genes for diabetes isn’t usually enough. A person probably would then have to be exposed to something else — like a virus — to get type 1 diabetes.

Type 1 diabetes can’t be prevented, and there is no practical way to predict who will get it. There is nothing that either a parent or the child did to cause the disease. Once a person has type 1 diabetes, it does not go away and requires lifelong treatment. Kids and teens with type 1 diabetes depend on daily insulin injections or an insulin pump to control their blood glucose levels.

Type 2 diabetes (formerly called non-insulin-dependent diabetes or adult-onset diabetes) is different from type 1 diabetes. Type 2 diabetes results from the body’s inability to respond to insulin normally. Unlike people with type 1 diabetes, most people with type 2 diabetes can still produce insulin, but not enough to meet their body’s needs.

Signs and Symptoms of Type 1 Diabetes

A person can have diabetes without knowing it because the symptoms aren’t always obvious and they can take a long time to develop. Type 1 diabetes may come on gradually or suddenly.

Parents of a child with typical symptoms of type 1 diabetes may notice that their child:

• urinates frequently. The kidneys respond to high levels of glucose in the bloodstream by flushing out the extra glucose in urine (pee). A child with diabetes needs to urinate more frequently and in larger volumes.
• is abnormally thirsty. Because the child is losing so much fluid from peeing so much, he or she becomes very thirsty to help avoid becoming dehydrated. A child who has developed diabetes drinks a lot in an attempt to keep the level of body water normal.
• loses weight (or fails to gain weight as he or she grows) in spite of a good appetite. Kids and teens who develop type 1 diabetes may have an increased appetite, but often lose weight. This is because the body breaks down muscle and stored fat in an attempt to provide fuel to the hungry cells.
• often feels tired because the body can’t use glucose for energy properly.

But in some cases, other symptoms may be the signal that something is wrong. Sometimes the first sign of diabetes is bedwetting in a child who has been dry at night. The possibility of diabetes should also be suspected if a vaginal yeast infection (also called a Candida infection) happens in a girl who hasn’t started puberty yet.

If these early symptoms of diabetes aren’t recognized and treatment isn’t started, chemicals called ketones can build up in the child’s blood and cause stomach pain, nausea, vomiting, fruity-smelling breath, breathing problems, and even loss of consciousness. Sometimes these symptoms are mistaken for the flu or appendicitis. Doctors call this serious condition diabetic ketoacidosis, or DKA.

In addition to short-term problems like those listed above, diabetes also can cause long-term complications in some people, including heart disease, stroke, vision impairment, and kidney damage. Diabetes also can cause other problems throughout the body in the blood vessels, nerves, and gums. These problems don’t usually affect kids or teens with type 1 diabetes who have had the disease for only a few years. But they can appear in adulthood in some people with diabetes, particularly those who haven’t managed or controlled their diabetes well.

There’s good news, though — proper treatment can stop or control these diabetes symptoms and reduce the risk of long-term problems. Doctors can say for sure if a person has diabetes by testing blood samples for glucose. If you think your child has symptoms of diabetes, talk to your doctor.

If diabetes is suspected or confirmed, the doctor may refer your child to a pediatric endocrinologist, a doctor who specializes in the diagnosis and treatment of kids with diseases of the endocrine system, such as diabetes and growth disorders.

Living With Type 1 Diabetes

Kids and teens with diabetes need to monitor and control their glucose levels. They need to:

• check blood sugar levels a few times a day by testing a small blood sample
• give themselves insulin injections, have an adult give them injections, or use an insulin pump
• eat a balanced, healthy diet and pay special attention to the amounts of sugars and starches in the food they eat and the timing of their meals
• get regular exercise to help control blood sugar levels and help avoid some of the long-term health problems that diabetes can cause, like heart disease
• work closely with their doctor and diabetes health care team to help achieve the best possible control of their diabetes and be watched for signs of diabetes complications and other health problems that happen more frequently in kids with type 1 diabetes

Living with diabetes is a challenge, no matter what a child’s age, but young kids and teens often have special issues to deal with. Young kids may not understand why the blood samples and insulin injections are necessary. They may be scared, angry, and uncooperative.

Teens may feel different from their peers and may want to live a more spontaneous lifestyle than their diabetes allows. Even when they faithfully follow their treatment schedule, teens with diabetes may feel frustrated if the natural body changes of puberty make their diabetes somewhat harder to control.

Having a child with diabetes can seem overwhelming at times, but you’re not alone. Your child’s diabetes care team is not only a great resource for dealing with blood sugar control and medical issues, but also for supporting and helping you and your child cope and live with diabetes.

What’s New in the Treatment of Type 1 Diabetes?

Doctors and researchers are developing new equipment and treatments to help kids cope with the special problems of growing up with diabetes.

Some kids and teens are already using devices that make blood glucose testing and insulin injections easier, less painful, and more effective. One of these is the insulin pump, a mechanical device that can deliver insulin more like the pancreas does. There’s also been progress toward the development of a wearable or implantable “artificial pancreas.” This consists of an insulin pump linked to a device that measures the person’s blood glucose level continuously.

Doctors and scientists are investigating a potential cure for diabetes. This involves transplanting insulin-producing cells into the body of a person with diabetes. Researchers are also testing ways to stop diabetes before it starts. For example, scientists are studying whether diabetes can be prevented in those who may have inherited an increased risk for the disease.

Until scientists have perfected ways to better treat and possibly even prevent or cure diabetes, parents can help their kids lead happier, healthier lives by giving constant encouragement, arming themselves with diabetes information, and making sure their children eat properly, exercise, and stay on top of blood sugar control every day. This will let their kids do all the things that other kids do while helping them grow up to be healthy, well-adjusted, productive adults.