Diabetes is a growing problem in the United States among children and adults. According to the National Diabetes Education Program, about 215,000 people younger than age 20 have diabetes.

Most of them have Type 1 diabetes, which is more commonly diagnosed in childhood. However, Type 2 diabetes, a disease that used to be seen mostly in adults, is becoming more common in young people, primarily due to increasing rates of obesity in children and adolescents. 

With Type 1 diabetes, the immune system attacks and destroys the insulin-producing cells of the pancreas. As a result, the body can no longer produce insulin, which is the hormone that allows glucose to enter cells to provide fuel. Since the glucose is locked out of the cells, it builds up in the blood stream and can cause damage throughout the body. To prevent this, children with Type 1 diabetes need to take daily insulin injections and monitor their blood sugars regularly.

Signs and Symptoms

So how do you recognize diabetes? It’s not always obvious.

“With Type 1 diabetes, symptoms are often very subtle in the beginning because of the slow destruction of beta cells in the pancreas,” explains Beth Alseth, MS, RN, certified diabetes educator at St. Louis Children’s Hospital.

Some symptoms to watch for include:

  • Increased and frequent urination. This can show up as sudden bed-wetting or when a child has to get up several times a night to urinate.
  • Increased thirst. Increased thirst and urination help the kidneys as they try to get rid of the extra sugar in the body.
  • Increased appetite. Your child wants to eat a lot more because the cells aren’t able to get fuel from carbohydrates, and there’s not enough insulin to transport sugar to the cells for energy.
  • Fatigue. Children with undiagnosed Type 1 diabetes tire out easily.
  • Blurred vision
  • Nausea and vomiting
  • Abdominal pain
  • Irritability and mood changes

If your child has these symptoms, especially the first three listed, contact your pediatrician for a urine and blood sugar test.

“It’s better to diagnose diabetes early,” Alseth says. “As diabetes progresses, the body produces less and less insulin. This may lead to diabetic ketoacidosis, which is very serious.”

Type 2 diabetes has similar symptoms to Type 1 diabetes. With Type 2 diabetes, the body still produces insulin, but not enough. In addition, the insulin may not work properly. This is called insulin resistance.

“Kids with Type 2 diabetes are typically overweight with a high body mass index of 30 or more,” Alseth says. “But it can often be managed with weight loss, exercise and meal plans. If blood sugar remains high after those efforts, they may need insulin. The best strategy is to prevent Type 2 diabetes by exercising and eating well-balanced meals that include fruits, vegetables, and lean meats while avoiding candy, juices, and high-fat foods.

Education Is Key

The Diabetes Program at St. Louis Children’s Hospital provides patients and their families a comprehensive approach to diabetes treatment. St. Louis Children’s Hospital is the only pediatric hospital in St. Louis and one of two pediatric facilities in the state of Missouri recognized by the American Diabetes Association for excellence in diabetes education.

Children first diagnosed with Type 1 diabetes usually stay 48 hours at St. Louis Children’s Hospital to learn about the disease and how to manage it.

“Education is ongoing, but first we give them survival skills,” Alseth says. “The child and family learn day-to-day management skills, such as counting carbs, how to test blood sugar and when to give insulin. There is no vacation from managing diabetes and many families go through a grief process. To lend support to the parents, we encourage as many family members to learn about managing diabetes as possible.”

Patients have frequent outpatient follow-up visits as the team educates patients on a variety of topics including dental care, foot care and more. St. Louis Children’s Hospital also offers a diabetes support group.

“The most challenging age is adolescence because more of diabetes management is shifted to the teen during a time when some risk-taking behaviors take place,” Alseth says. “Hormones affect insulin needs and blood sugar levels, too.”

She says diabetes treatments have improved in the past few years. Analog insulins allow more flexibility with timing of meals. Insulin pumps are also helpful for some children and adolescents.

“There’s a lot of research being done in Type 1 diabetes and hopefully new tools for easier management of diabetes will be developed in the next few years,” Alseth says. “The outlook is excellent for kids with diabetes if they keep their blood sugar under control. They can learn to work diabetes into their lives, play sports and be happy and healthy.”


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