Type 1 Diabetes In Children

It’s natural to worry when you find out your children have type 1 diabetes. However, they can live a healthy life when appropriate measures are taken. Knowing the signs of type 1 diabetes in kids and its potential complications can help you detect any issues long before they worsen.  

What is type 1 diabetes?

Type 1 diabetes mellitus is a blood sugar disorder typically diagnosed during childhood or adolescence. Children with this condition cannot regulate the amount of sugar in their blood, and parents need to monitor this closely. 

The good news is that treatment is available. Some lifestyle changes can also offer improvements. 

Subcategories of type 1 diabetes

According to the American Diabetes Association,¹ there are two subcategories of type 1 diabetes: type 1A and type 1B. Type 1A is immune-mediated diabetes, and type 1B is idiopathic diabetes. 

Both subtypes result in a high concentration of sugar in the blood. However, you might have heard health professionals mention hyperglycemia or high blood glucose instead. All these terms mean that there is too much sugar in the blood. 

Too much sugar can accumulate in the blood when the body lacks a hormone called insulin. Insulin is produced by a digestive organ known as the pancreas, and it is required so that cells can absorb sugar from the blood for energy. 

The main difference between immune-mediated diabetes and idiopathic diabetes¹ is that the first arises from an immune disorder, and the other does not. 

For example, immune-mediated diabetes is an autoimmune condition that arises from dysfunctional immune cells attacking insulin-secreting cells in the pancreas. To determine if immune-mediated diabetes is present, doctors can order a blood test that looks for autoimmune markers. 

On the other hand, autoimmune markers are not present with idiopathic diabetes because this subtype does not arise from an immune disorder. Only a small percentage of diabetics have this subtype, and immune-mediated diabetes is more common. 

People with idiopathic diabetes are more susceptible to developing ketoacidosis,² a secondary condition that arises from having diabetes. 

Causes of type 1 diabetes in children

With immune-mediated diabetes, insulin deficiency is caused by genetic and environmental factors combined. 

With genetic factors, several malfunctioning genes contribute to the development of type 1 diabetes. These genes can be inherited, and some diabetics have parents or siblings who also have type 1 diabetes. 

However, regardless of family history, type 1 diabetes can still occur. For example, one study found that 85%³ of patients with type 1 diabetes did not have a family member who also tested positive for diabetes.

Experts state that the genetic component is relevant to diabetes development. Some genes can cause immune cells to become dysfunctional. 

Regarding environmental factors, exposure to certain viruses, a person’s microbiome, or diet may contribute in some way. Although these factors are believed to increase the susceptibility to developing type 1 diabetes, genetic factors are still largely at play. 

With idiopathic type 1 diabetes,⁴ scientists say that the exact cause of this subtype remains unknown. But, while it remains a mystery, treatment options are still available, just like they are for immune-mediated diabetes.

Signs and symptoms of type 1 diabetes in children

Signs of type 1 diabetes in kids can occur suddenly or take some time to develop. Common symptoms include:

• Going to the toilet often to urinate

• Starting to wet the bed at night 

• Increased thirst

• Increased hunger

• Tiredness 

• Weight loss 

• Dry or itchy skin

• Slow-healing sores or wounds

• Loss of feeling in the feet or tingly feet

• Blurred vision

What children are at risk for type 1 diabetes?

Any child is at risk of developing type 1 diabetes. While some children could be more at risk than others, it’s still essential to determine whether type 1 diabetes is present regardless. 

Here are some factors⁵ that increase a child’s risk of developing type 1 diabetes:

• European origin (although some areas, such as African regions, are underrepresented in studies), especially those from Finland, Italy, and Sweden

• Living in seasonal areas (more diagnoses occur during winter)

• Age (peaks in adolescence)

Gender is not a factor; both girls and boys are equally at risk.  

Experts have also suggested that some factors regarding birth and pregnancy⁵ may also contribute, including the following:

• Increased birth weight

• Neonatal respiratory disease (undeveloped lungs after birth)

• Certain viral infections during pregnancy, such as rubella or polio 

• Blood group incompatibility between mother and child

• Older maternal age

• Maternal preeclampsia 

• Early introduction of cow milk proteins to baby’s diet 

How does type 1 diabetes affect a child?

Several complications of diabetes can occur. These are secondary conditions that result from type 1 diabetes, the primary disease. 

It’s unlikely that your child will encounter every complication possible. However, being aware of these conditions can help you manage your diabetes more effectively. 

Ketoacidosis 

Ketoacidosis can become a life-threatening problem when left untreated. This condition occurs when the body breaks down fat due to a lack of energy from blood sugar. 

While it’s common for the body to utilize fat for energy, the problem with ketoacidosis is that this process occurs rapidly.

When stored fat is metabolized, the liver converts those fats into ketone compounds. Unfortunately, too many ketones can make the blood acidic, which is harmful. 

Symptoms of ketoacidosis include:

• Fruity-smelling breath 

• Flushed face

• Frequent urination 

• Increased thirst

• Dehydration

• Dry mouth and skin

• Headache

• Muscle stiffness and pain

• Nausea, vomiting, and stomach pain 

Hypoglycemia

Hyperglycemia is when blood sugar levels are high. When blood sugar levels drop too low, this is called hypoglycemia. An easy way to distinguish the two is by remembering that “hypo means low.” 

Since type 1 diabetes is associated with elevated blood sugar levels, it can be easy to forget that it can sometimes go the other way with insulin treatment. Hence, it’s vital to monitor your child’s blood sugar even when they are on treatment for diabetes.

In type 1 diabetics, hypoglycemia occurs when diabetics take insulin for treatment and don’t match the dose with their food or physical activity. Therefore, it’s vital to ensure that your child gets the correct amount of insulin. 

However, this doesn’t always happen, and signs to watch out for include:

• Hunger

• Tiredness

• Dizziness and lightheadedness

• Confusion and irritation 

• Headache

• Shaky or jittery

• Not speaking properly

• In severe cases, seizures or loss of consciousness can occur 

Eye problems

Blurry eyesight is a common eye problem associated with diabetes. Most of the time, this is linked to high blood sugar levels, and maintaining blood sugar in the future can help prevent eye problems. 

However, other eye problems linked to diabetes are:

• Diabetic retinopathy 

• Diabetic macular edema 

• Cataracts 

• Glaucoma 

• Blindness 

Staying on top of the disease and enforcing good habits while your child is young can help prevent these conditions later in life. 

Kidney disease

Diabetic kidney disease is linked to high blood sugar levels. When blood sugar concentrations rise, it can damage the blood vessels in the kidneys. As a result, the kidney’s blood vessels no longer work properly, and kidney function becomes compromised. 

Kidneys filter unwanted substances from the blood to excrete in the urine. They also regulate blood pressure. Thus, when the kidney is compromised, diabetics develop high blood pressure or become more prone to developing kidney disease. 

Nerve damage

Another complication of high blood sugar levels is nerve damage, which can be painful and which come in several types. Diabetic nerve damage is also referred to as diabetic neuropathy. 

There are four types of diabetic nerve damage:

• Peripheral neuropathy—damage in the feet, legs, and hands 

• Autonomic neuropathy—damage to the internal organs such as the heart or digestive tract

• Proximal neuropathy—nerve damage related to the hips, thighs, or buttocks

• Focal neuropathy—damage to single nerves in the hand, head, torso, or legs

Tooth and gum problems

Unfortunately, children who have diabetes are more likely to develop dental problems and gum disease. For example, they could be more prone to cavities in the teeth or gingivitis (gum inflammation).  

Both the disease itself and the medications used to treat it can contribute to gum disease. Keeping up with regular dental check-ups can ease this problem. 

Skin and foot problems

The nerve damage caused by diabetes usually happens in the feet. A diabetic may experience pain or tingly sensations in their feet. There could also be a complete loss of feeling in one foot or both feet.  

Foot problems occur because the nerves in the feet become damaged from the prolonged elevation of blood sugar. The blood flow to the feet also tends to decrease, which can lead to further complications. 

With this decreased blood flow, your child could be more prone to skin problems on the feet; sores and infections on their feet, for example, could take longer to heal.

Diagnosis and tests of type 1 diabetes in children

A fasting plasma glucose test can measure your child’s blood sugar level after eight hours of fasting. This means your child cannot eat anything for eight hours before this test to get the best results. However, the occasional sip of water is fine. 

This test aims to determine whether blood sugar levels stay elevated despite having no food. If they remain high, this could be due to an insulin deficiency from diabetes. 

However, since the fasting test is difficult for children, especially toddlers, the random plasma glucose test can be used instead. This is another blood test that can be used to help diagnose diabetes. 

Treatment of type 1 diabetes in children

To ensure that your child gets the treatment they need, it’s worth committing to regular blood testing to check blood-glucose levels and urine testing to check ketone levels.

You can also implement a range of lifestyle changes, such as finding the right foods to manage glucose levels or ensuring they exercise daily. 

However, insulin injections are the best treatment for anyone with an insulin deficiency. Insulin injections are vital for restoring blood glucose levels to an optimal range. 

Management of type 1 diabetes in children

Children with type 1 diabetes will need additional support because they are often too young to understand what is happening. They might also find it difficult to adjust to daily insulin injections and the significant changes to their everyday life. 

Thankfully, many doctors understand how challenging it can be for families to stay on top of this condition. They can offer many solutions and guide you through the process until your family has it under control. 

Anyone who looks after your child, including extended family members, a nanny, babysitter, or teacher, will also need to know that your child has type 1 diabetes.

How to prevent type 1 diabetes in children

You cannot prevent type 1 diabetes in children. However, early diagnosis could prevent the disease from worsening.

How can parents help their children with type 1 diabetes?

If you have a child with diabetes, the best thing you can do is be there to support them, especially during the early stages of this disease. From the moment your child is diagnosed, managing diabetes will become part of your and your child’s routine.

First of all, you will need to learn everything your child needs to do to stay on top of their condition. This includes counting carbohydrates, calculating insulin doses, monitoring blood sugar levels, and giving injections.

As your child grows up, you must start passing some of these responsibilities to them so they become more independent in managing their condition.

When to visit a doctor

If you suspect your child has diabetes or any health problem, it’s always best to see a doctor sooner than later. Many complications are associated with diabetes, and they can worsen when the underlying cause is left untreated.

The lowdown

Knowing the signs of type 1 diabetes in your child can reduce the impact of this disease. However, some complications may still arise, and regular appointments with your child’s doctor are recommended.