Diabetes mellitus is a condition that develops when one is not able to efficiently use the glucose, also known as sugar, in the body for energy. There are a lot of misconceptions about diabetes mellitus in children; many people think that diabetes is something that can only develop in adults.
It’s important for parents to be aware about the various types of diabetes that children can develop and the symptoms of high blood glucose so that new onset diabetes can be detected early.
There are many types of diabetes that children can develop, including:
- Type 1 diabetes
- Prediabetes, which occurs before type 2 diabetes
- Type 2 diabetes
- Neonatal diabetes
- Mature Onset of Diabetes in the Young (MODY)
- Cystic fibrosis related diabetes
- Diabetes associated with syndromes like Wolfram or Alstroms
- Medication induced diabetes
Signs of Childhood Diabetes
Regardless of the cause of diabetes, the symptoms of high blood glucose (also known as hyperglycemia) are the same.
The most common diabetes symptoms in children to watch out for include:
- Increased thirst and urination: As excess glucose (sugar) builds up in your child’s bloodstream, fluid is pulled from tissues, increasing thirst and urination, ultimately leading to dehydration.
- Unexplained weight loss and increased hunger: Despite eating more than usual to relieve hunger, your child might lose weight, often rapidly. This occurs because without enough insulin to metabolize glucose, the body uses alternative energy stores in muscles and fat.
- Fatigue: If your child seems unusually tired and lethargic, it could be because their body is unable to use glucose for energy effectively.
- Other symptoms: Watch for additional signs of diabetes like blurry vision, slow-healing sores or frequent infections. Girls might show signs of a yeast infection, and children of all genders can experience skin and gum issues, including infections.
The signs of diabetes in children can sometimes be subtle, making them easy to overlook or mistake for other common childhood conditions. For example, symptoms like increased thirst or frequent urination may not always raise immediate concerns, as these can be attributed to normal childhood activities and dietary habits like not drinking enough water.
However, when these symptoms are persistent and coupled with other indicators, such as unexplained weight loss or constant fatigue, they warrant a closer examination by your doctor for diabetes.
If a child is developing ketones, a form of acid in the body, from lack of insulin in body, they may have nausea, abdominal pain and vomiting.
Types of Childhood Diabetes and How They’re Treated
Type 1 Diabetes
Type 1 diabetes is the most common type among children, causing about two-thirds of all cases. It occurs when the pancreas produces little or no insulin, the hormone that allows glucose to enter cells to provide the body with energy. Without insulin, your child’s body is unable to convert glucose into energy, causing it to accumulate in the bloodstream. This results in high blood levels and if left untreated could result in a life-threatening condition called diabetic ketoacidosis.
Unlike type 2 diabetes—which is often linked to lifestyle and diet—type 1 diabetes is considered an autoimmune condition and can develop in children at any age. The only way to treat type 1 diabetes is by giving insulin. Many times, the child is the first person in the family to develop type 1 diabetes.
How Common is Type 1 Diabetes?
In the United States, the rate of type 1 diabetes has increased 200 percent to 300 percent over the past few decades. Currently, over 1.25 million Americans live with type 1 diabetes, including about 500,000 children.
What Causes Type 1 Diabetes?
The exact cause of type 1 diabetes is still unknown; however, it’s believed to involve a combination of factors including:
- Genetic susceptibility/inheritance
- Environmental factors that somehow trigger the immune system to attack insulin-producing cells in the pancreas
- Potentially viral infections, which have been noted as potential triggers in some cases
How is Type 1 Diabetes Treated in Children?
Managing your child’s diabetes will involve a combination of:
- Regular blood sugar monitoring, including the use of continuous blood sugar monitors
- Insulin therapy either using injections or pump therapy
- A healthy, balanced diet to support blood glucose
- Physical activity to help maintain overall metabolic health
- Screenings for related conditions, such as those affecting the eyes, kidneys, thyroid
Treatment plans for childhood diabetes should always be individualized and based on a child’s changing needs. A pediatric endocrinologist can help you create a management plan that helps your child maintain normal blood sugar levels and helps prevent complications.
Type 2 Diabetes
Type 2 diabetes, which used to be rare in children, is now more common among adolescents and is increasingly seen in younger children who are overweight or obese.
How Common is Type 2 Diabetes?
Historically, over 95 percent of children with diabetes had type 1, but now about one-third of new diabetes cases in children are type 2, largely due to rising obesity rates. This form of diabetes usually emerges after puberty, particularly between ages 10 to 19, peaking in late adolescence. Children with type 2 diabetes often have a close family member with the same condition, contrasting with those who have type 1 diabetes.
What Causes Type 2 Diabetes?
In this form of diabetes, the pancreas is making a lot of insulin but the body is not able to use it efficiently. Someone who is developing insulin resistance, a pre-cursor to type 2 diabetes, may have darkening of the skin around the back of the neck, in the underarms, and around abdomen and groin.
How is Type 2 Diabetes Treated in Children?
Some children with type 2 diabetes are able to be managed with diet and lifestyle changes alone, some may need to take pills to lower their insulin resistance, while others may need to be treated with insulin or other types of injections.
The best way to prevent this form of diabetes from developing is making sure that your child eats a healthy well balanced diet, engages in regular physical activity, and maintains a healthy body mass index.
Other Forms of Diabetes in Children
The other forms of diabetes make up less than 2 percent of pediatric cases. They include:
- Neonatal Diabetes: A form of diabetes that typically develops in the first six moths of life; it is not due to autoimmunity but rather to a genetic mutation in the pancreas
- Mature Onset of Diabetes in the Young (MODY): Another form of genetic diabetes and tends to run in families
- Cystic Fibrosis Related Diabetes: Occurs in some indivduals with cystic fibrosis as mucous builds up in the pancreas, making it less able to produce insulin
- Diabetes associated with syndromes like Wolfram or Alstroms
- Medication Induced Diabetes: Most commonly occurs with prolonged high doses of steroids or various forms of chemotherapy
Awareness and timely action are key for managing diabetes at any age. If you notice any of the signs of diabetes in your child, consult with a healthcare provider for a proper diagnosis and treatment plan. For more support and information, please reach out to the Stony Brook Medicine’s Pediatric Endocrinology department. Our dedicated team is here to provide care and assistance every step of the way.
