Understanding diabetes in children

What is diabetes?

Diabetes — formally known as diabetes mellitus — is a chronic medical condition that affects the body's blood sugar levels (or glucose levels). A "chronic" condition does not go away and typically lasts the rest of a person's life. 

When someone has diabetes mellitus, their body doesn't process sugars the right way. Sugars (glucose) enter the bloodstream when foods or drinks are broken down in the body. A hormone called insulin then helps move these blood sugars into the cells to be used for energy. 

In people with diabetes mellitus, their bodies either do not make insulin, don't make enough insulin, or cannot use insulin the way they should. This causes sugar to build up in the bloodstream, leading to high blood sugar and, eventually, diabetes.

Types of diabetes in children

Two types of diabetes can affect children:

• Type 1 diabetes mellitus: Type 1 diabetes is an autoimmune condition that causes the body to attack the cells in the pancreas that produce insulin. By restricting their ability to make insulin, the body cannot regulate its blood sugar levels. Type 1 diabetes is the most common form of diabetes diagnosed in children.
• Type 2 diabetes mellitus: Type 2 diabetes used to be less common in children but is now diagnosed more often. Type 2 diabetes is often associated with lifestyle and obesity but can also be related to genetics or family history. Type 2 diabetes develops over time as the body stops responding to insulin the way it should (also known as insulin resistance) or doesn’t produce enough insulin.

What are the signs and symptoms of diabetes in children?

Many diabetes symptoms overlap with those of other common childhood conditions. Still, being aware of common signs and symptoms could lead to earlier diagnosis and better care if your child does have diabetes. Early diabetes diagnosis is critical for starting treatment, keeping blood sugar levels within a safe range, and preventing complications.

Signs and symptoms of diabetes include:

• Frequent urination: Your child may suddenly start having accidents or use the bathroom more often than usual.
• Excessive thirst: You may notice your child drinking more fluids than usual and always thirsty.
• Unexplained weight loss: Even if they eat normally, some children may lose weight unexpectedly.
• Fatigue: An unexplained drop in energy levels, irritability, or appearing unusually tired can be related to diabetes.

How is diabetes diagnosed in children?

If you or your pediatrician suspects your child may have diabetes, there are several tests to confirm the diagnosis:

• Blood sugar tests to measure your child's blood sugar levels at a specific point in time
• Hemoglobin A1C tests to determine their average blood sugar levels over a range of time
• Urine tests to check for the presence of glucose or ketones, which can indicate the body is not processing sugar correctly

A doctor may also test for pancreatic antibodies to determine whether your child has type 1 or type 2 diabetes. 

Understanding type 1 diabetes (juvenile diabetes)

Type 1 diabetes used to be called juvenile diabetes and is the most common type of diabetes mellitus in children. Because the body's immune system mistakenly attacks and destroys insulin-producing cells in the pancreas, children with Type 1 diabetes always need insulin therapy to help regulate their blood sugar levels. The exact cause of Type 1 diabetes is unknown, but genetic and environmental factors likely play a role. 

Managing type 1 diabetes in children

As a caregiver, you'll need to monitor your child’s blood sugar levels throughout the day using a glucometer or continuous glucose monitor (CGM) to avoid blood sugar highs (hyperglycemia) or lows (hypoglycemia). Insulin therapy is a key component of care, so you may need to help your child use an insulin pump to help regulate their blood sugar around the clock. Managing your child's food intake helps them keep their blood sugar levels in a safe range while meeting their nutritional needs for growth and development.

Understanding type 2 diabetes 

Type 2 diabetes is becoming more and more common in children and teens. It is largely influenced by lifestyle factors, obesity, and family history. 

Managing type 2 diabetes in children

For type 2 diabetes, the goal is to manage high blood sugar levels. Depending on their age, helping your child make healthy lifestyle choices, such as getting exercise and moving their bodies, and eating healthy foods is key. Even though these lifestyle choices make a positive impact, children diagnosed with type 2 diabetes will likely need medications to manage their blood sugar levels.

Metformin is a common diabetes medication and is often the first choice for children who need diabetes medications. Depending on the level of your child's diabetes, metformin and/or insulin may be recommended upon diagnosis.

How will childhood diabetes affect my family?

Managing a child’s diabetes involves the entire family. Daily routines may need to be adjusted, as you’ll need to measure blood sugar levels and administer or monitor insulin throughout the day. But it’s important to remember that you’re not alone and your child's condition is manageable. With the right support, children with diabetes can lead healthy, active lives.