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What is juvenile diabetes?
Type 1 diabetes is when the body does not produce insulin, which is a hormone that converts sugar, starches and other food into energy needed for everyday life.
Type 1 diabetes in children is a condition in which your child’s pancreas no longer produces the insulin your child needs to survive, and you’ll need to replace the missing insulin.
Causes
- The cause is unknown.
- Scientists do know that in most people with type I diabetes, their body’s own immune system, which normally fights harmful bacteria and viruses, mistakenly destroys the insulin-producing (islet) cells in the pancreas.
- Genetics may play a role in this process, and exposure to certain viruses may trigger the disease
- Once islet cells are destroyed, the body produces little or no insulin.
- Normally, the hormone insulin helps insulin help glucose enter your cells to provide energy to your muscles and tissues. Insulin comes from the pancreas. When everything is working properly, once you eat, the pancreas secretes insulin into the bloodstream. As insulin circulates, it acts like a key by unlocking microscopic doors that allow sugar to enter the body’s cells. Insulin lowers the amount of sugar in the bloodstream, and as the blood sugar level drops, so does the secretion of insulin from the pancreas.
Statistics
- 5% of people with diabetes have Type 1 diabetes.
- Total: 8.3% of the total population (25.8 million) are diagnosed with diabetes (Type I and II)
- Under age 20: 215,000 or 0.26% of all people in this age group have diabetes
- 1 in every 400 children and adolescents has type 1 diabetes
Treatment
- Frequent blood sugar monitoring
- Finger sticks or other sites
- Up to three times a day or more
- Doctor will inform your child’s blood sugar target range
Types of insulin
- Oral insulin: not recommended due to the fact stomach enzymes interfere with the insulin taken by mouth
- Rapid-acting insulin: (Humalog or NovoLog) starts working in five to 15 minutes and peaks 30 to 90 minutes later
- Short-acting insulin: (Humulin R, Novolin R, others) starts working 30 to 60 minutes after injection and generally peaks in two to four hours
- Long-acting insulin: (Lantus or Levemir) has almost no peak and may provide coverage for as long as 20 to 26 hours
- Intermediate-acting insulin: (Humulin N or Novolin N) starts working one to three hours after it is taken and peaks in eight hours. Insulin is similar in effectiveness to long-acting types of insulin, but may be more likely to cause low blood sugar. Using this type of insulin allows for less flexibility with meal times as well as in the amount of carbohydrates your child can eat
Depending on the child, the doctor may prescribe certain types of insulin or a mixture of multiple insulins
Insulin Delivery Options
- Most commonly injected by using a fine needle and syringe, or insulin pen
- Insulin pumps: device (about the size of a cell phone) worn on the outside of the body. In most cases, a tube connects the reservoir of insulin to a catheter that is inserted under the skin of the abdomen. Pump is programmed to sense the different level of insulin in the body and dispenses specific amounts of insulin automatically
Healthy Eating and Exercise
- There is no diabetes diet.
- Plenty of fruits, vegetables, whole grains, and foods that are high in nutrition and low in fat and calories.
- It is recommended that the child consumes fewer animal products, sweets, and carbohydrates.
- In order for the child to be successful, the whole family is recommended to participate in healthy eating. Support for the child is led by example and it is very helpful that everyone in the family eats the same foods as the diagnosed family member.
- Every diet is different depending on the child and his/her insulin levels
- Regular physical activity
- Sport teams, dance lessons, or other organized physical activites
- Exercise as a family (whole family support)
- **exercise usually lowers blood sugar levels. Check blood sugar more often than usual until you know how the child’s body reacts to exercise.
Side effects of Type 1 Diabetes
Hypoglycemia: low blood sugar levels that drop below the child’s target range
Symptoms
- Sweating
- Shakiness
- Hunger
- Dizziness
- Pale skin
- Rapid or irregular heart rate
- Fatigue
- Difficulty concentrating
- Headaches
- Irritability
Treatment
- If your child has a low blood sugar reading, give him or her fruit juice, glucose tablets, hard candy, regular (not diet) soda or another source of sugar.
- Retest blood sugar 15 minutes after
- Repeat if sugar is still to low
- It is helpful for the child to eat another snack, one containing a mixed food source, such as peanut butter and crackers. This help stabilize the blood sugar
Hyperglycemia: high blood sugar levels that are above the target level
Causes
- eating too much, eating the wrong types of food, not taking enough insulin or illness
Symptoms
- Frequent urination
- Increased thirst
- Blurred vision
- Fatigue
- Nausea
- Irritability
- Difficulty breathing
- Difficulty concentrating
Treatment
- If you suspect hyperglycemia, check blood sugar levels. The child’s meal plan or medications might need to be adjusted.
- If the blood sugar level is above the target levels, insulin may be used to correct the sugar levels
- If the high blood sugar is consistent, the child may need to check for unhealthy levels of ketones in the body by using a urine test stick. A build-up of ketones in the body is toxic. Have the child drink extra fluids to flush out the ketones.
- Call the child’s physician or emergency care if the high blood sugar is persistently above 300mg/dL
What To Do At School
- In the state of California, nurses are the only authorized person who can administer treatment
Back to School checklist
Current Diabetes Medical Management Plan (DMMP)
- What are the child’s typical symptoms of hypoglycemia?
- What snacks does he/she use to treat it?
- Can he/she giver her own injections?
Write up a 504 plan or Individualized Education Program (IMP)
- Document which explains the information from the DMMP and translates it into the school’s specific responsibilities
Prepare “Low Box” preparedness kits
May include:
- Glucose tablets
- Fast-acting sugar (juice, regular soda, hard candies, or cake icing)
- One with the child, one in the classroom, and one in the nurse’s office
- Want two or more kits available at home as well
At-home teachings
- Teach the child independence and responsibility
- Encouragement/motivation
- Want to make the child feel comfortable in handling their own diagnosis.
- Check with the child’s school for any additional requirements they may need.
Helpful websites
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