A healthy diet including fruits and vegetables, regular exercise, and a reasonable weight can often prevent or manage Type 2 diabetes. Type 1 diabetes is different. How can these two types be dealt with?

by Karen Doyle

Parents are justifiably concerned about the increase in childhood obesity and the rising prevalence of diabetes in children. Here’s a summary of recent knowledge about diabetes, and what to do if your child develops it.

Type 1 diabetes:  the body can’t make insulin

“In a person with Type 1 diabetes, the cells in the pancreas that make insulin are destroyed by the body’s immune system and cannot make insulin,” said Mary Wood, diabetes clinical nurse specialist at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. “Type 1 diabetes is always insulin dependent, meaning that the person with diabetes has to inject insulin every day.”

According to Wood, Type 1 diabetes cannot be yet prevented or cured. It can only be managed. Research into a cure is ongoing, and many clinical and prevention trials are planned and in process.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) maintains a registry of Type 1 diabetics and their family members so that they can be quickly notified if there is a research study seeking volunteers or a  breakthrough in the search for a cure. Their website also has information on prevention trials.

“The key risk factor for Type 1 diabetes is family history, but it can come out of the blue,” said Wood. “Parents should be aware of the symptoms for Type 1 diabetes, which are excessive thirst, frequent urination, and weight loss. These symptoms can come on quite suddenly—a child may be completely normal today, and have significant symptoms a month from now.”

Type 1 treatments and potential cures

A cure for Type 1 diabetes will likely come in the form of a pancreas transplant or an islet cell transplant, according to Wood. Researchers are experimentally injecting islet cells (the cells that make insulin) into adults, and pancreas transplants have been performed on adults.

Another possible cure is an artificial pancreas. This would be an internal device that would sense blood sugar levels and deliver the right amount of insulin at the right time.

Currently, there are external insulin pumps available, which are quite successful, particularly in children. There are also continuous glucose sensors, a half-inch probe implanted under the skin that senses glucose levels every five minutes. An alarm sounds if the glucose level drops too low. These sensors are FDA-approved for children age 7 and older.

Type 2 diabetes:  the body resists insulin

“Type 2 diabetes is primarily resistance to insulin,” said Wood. “The pancreas still makes insulin, and may even over-produce it. The cells throughout the body, particularly the muscles and the liver, cannot take in the insulin. Glucose builds up in the bloodstream because it cannot get into the cells.”

Type 2 diabetes can be prevented or delayed with healthy diet, regular exercise, and maintaining a reasonable weight. Make sure your child is eating five servings of fruits and vegetables every day, and getting an hour of physical activity every day. Work with your pediatrician to ensure that your child is getting the right foods and enough exercise.

According to Wood, risk factors for Type 2 diabetes are a family history of Type 2 diabetes, obesity, and/or gestational diabetes in the mother during pregnancy. African Americans, Hispanics, Native Americans and Pacific Islanders have a higher risk for Type 2 diabetes.

If a child is overweight and has two or more of these risk factors, he should be screened every three years beginning at age 10. Type 2 diabetes often has no symptoms.

“Because Type 2 diabetes is better prevented, most of the current research is dedicated to finding a cure for Type 1 diabetes,” said Wood. “The risk of Type 2 diabetes can be drastically reduced with a healthy diet, regular exercise, and maintenance of a healthy body weight.”

Type 2 treatments

If your pediatrician diagnoses type 2 diabetes in your child, she should have specific recommendations as to how to treat it. The most common recommendation is usually to change your child’s lifestyle. Parenting children with Type 2 diabetes calls for maintaining a healthy weight, eating a healthy diet, and getting plenty of regular exercise. These steps are often enough to control Type 2 diabetes.

Eating at approximately the same time each day, and eating protein, carbohydrates, and fats in the correct proportion and combination, can go a long way toward controlling blood sugar. If these steps do not control your child’s blood sugar levels, medication may be recommended.

“You will probably be instructed to test your child’s blood sugar, or glucose, regularly,” said Wood. “Your pediatrician can suggest a blood glucose meter and show you how to use it. You will have to prick your child’s finger, put a drop of blood on a test strip that is inserted in the meter to get a reading of your child’s sugar level.”

By keeping track of your child’s blood sugar levels, you can determine which foods should be encouraged and which should be avoided. Your child will be seen by his pediatrician about every three months to adjust the treatment plan.

For more information:

• National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health – Includes information on diabetes, clinical trials and the Type 1 diabetes registry.

• American Diabetes Association – Comprehensive information on prevention, management and research.

• Juvenile Diabetes Research Foundation International – An excellent source of information on research, management and treatment for diabetes in children.

 

Karen Doyle is a freelance writer who lives with her husband and three children in Scituate, Massachusetts. She writes on parenting topics and personal finance issues, as well as writing what she hopes is humor.

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