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Diabetes in Children

By Gregory Penny, M.D.

Young girl checking her blood sugar using a digital monitor.

Diabetes is a chronic metabolic disorder that affects how the body uses glucose, a substance that provides energy for the cells that make up the muscles and tissues. There are a few types of diabetes, but the result is the same: too much glucose in the bloodstream.

The three types of diabetes are type 1, type 2 and gestational (pregnancy-induced). There is also a condition known as impaired glucose tolerance or “prediabetes.” The most common type among children is type 1 diabetes.

Type 1 Diabetes

The exact cause of type 1 diabetes is unknown, however there is a genetic component. Studies have shown that if a parent or sibling has type 1 diabetes, a child’s risk for developing the condition increases.

When a person has type 1 diabetes, the body’s immune system attacks the insulin-producing cells in the pancreas. Insulin is the hormone that allows our cells to use glucose, and without it, the glucose begins to build up to unhealthy levels.

Type 2 Diabetes

Type 2 diabetes is caused by increased resistance to insulin. It is often, but not always, associated with overweight status or obesity.

When a person has type 2 diabetes, the pancreas produces insulin, but the body’s cells do not respond to it as well and, as a result, glucose levels in the bloodstream rise.

Symptoms of Diabetes in Children

  • Increased thirst
  • Frequent urination
  • Bedwetting in children who did not previously wet the bed
  • Extreme hunger
  • Unintended weight loss
  • Irritability
  • Mood changes
  • Fatigue and weakness
  • Blurred vision
  • In females, vaginal yeast infections
  • Fruity or sweet-smelling breath

Testing for Diabetes in Children

Your child should be tested for diabetes if you notice some of the symptoms above.

The doctor will likely measure the glucose level in the blood and test for glucose in the urine first. Another test that may be done is a glycated hemoglobin (A1c). This measures the average blood sugar level for the past two to three months. Other tests that may be helpful include:

  • A fasting blood sugar: a blood sample is taken after an overnight fast
  • A glucose tolerance test: the patient is given a glucose-containing beverage to drink; then blood glucose is tested to see how the body handles the glucose load.

If a child’s glucose levels indicate diabetes, the doctor will then conduct a test to see if the child has autoantibodies, to help determine if he or she has type 1 or type 2 diabetes.

Treating Diabetes in Children

Type 1 diabetes requires insulin therapy. The goal of insulin therapy is to replace the insulin that the body is no longer making and maintain a normal level of glucose in the bloodstream.

Insulin can be delivered in two different ways:

  • Injection using either a syringe or insulin pen
  • Continuously using an insulin pump that delivers insulin from a reservoir in the pump through a tiny tube inserted under the skin

In addition, people with type 1 diabetes may need to adjust their lifestyles. Good nutrition and exercise habits and regular visits to the doctor are essential. Monitoring blood sugar and administering insulin will become a daily routine. With good control, children with diabetes can participate fully in activities and live normal, healthy lives.