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Understanding Juvenile Diabetes

Posted Date: 10/28/2014
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Ask the Doctor

Staten Island Parent – November 2014

Philip Otterbeck, M.D.

Understanding Juvenile Diabetes

Juvenile diabetes classically refers to the onset of diabetes in childhood. This disease, also known as type 1 diabetes, is usually diagnosed in children and young adults. In fact, according to the American Diabetes Association, type 1 diabetes is one of the most common chronic diseases in children.

Diabetes is a serious disorder in which the body has trouble regulating its glucose or sugar levels. A person with diabetes can’t turn the food they eat into energy.  Food changes to a sugar called glucose, which is the body’s main fuel source. Normally, the pancreas, an organ behind the stomach, releases insulin to help your body store and use the sugar and fat from the food you eat. Diabetes occurs when either the pancreas does not produce any insulin, referred to as juvenile diabetes or type 1, or produces very little insulin, known as type 2 diabetes.

Most patients we treat have type 2 diabetes, which is generally a disease of middle to older age.  It can be brought upon by obesity and excessive consumption of carbohydrates and a sedentary lifestyle.  It can be treated with medication and sometimes insulin.  Unfortunately, as our lifestyles have become more sedentary and obesity rates have increased, children and teenagers are being diagnosed more and more with type 2 diabetes.

Juvenile or type 1 diabetes is NOT caused by being overweight.  No one knows exactly why patients develop juvenile diabetes.  There is strong evidence that there is a genetic component to developing the condition.

 Some researchers think juvenile diabetes could be set off by a viral syndrome.  Often, there is a pattern of autoimmune conditions (such as lupus, rheumatoid arthritis, or hypothyroidism) in the patients themselves or their family members.  Unfortunately, there is no way to prevent juvenile diabetes.

Juvenile diabetes should be suspected in a patient who appears lethargic and complains of excessive thirst, urination, and weight loss.  Other signs are a change in a patient’s mental status and evidence of dehydration.  Typically a diagnosis of juvenile diabetes necessitates a short-term hospitalization.  It is important to recognize the symptoms of juvenile diabetes. If left undiagnosed and untreated, patients can develop diabetic ketoacidosis, a condition which can be fatal.

The goal of a child's management for type 1 diabetes is to always keep his or her blood sugar levels within a target range. A target range reduces the chance of diabetes complications. Daily diabetes care and regular medical checkups will accomplish this goal.

 

The only available treatment for juvenile diabetes is insulin therapy, which must be injected before every meal AND either in the morning or at bedtime.  An insulin pump can be a good tool, which avoids having to inject children multiple times per day with a needle.

We recommend for patients to work with a nutritionist to learn effective carbohydrate counting.  Once patients are able to count the number of carbohydrates in their meal, they can administer the proper dose of insulin to meet those needs.  For instance, the insulin a patient would take for a bowl of lettuce would be far different from what he or she should take when eating a piece of cake.

Help keep diabetes under control by checking your child’s blood glucose levels daily, as well as ensuring they take their diabetes medicines. Making healthy food choices and being active every day also helps keep a child’s blood sugar levels in a healthy target range.

Diabetes is a disease that affects the whole family, especially when a child is diagnosed. Whether you're a parent, sibling or other family member, your support and understanding can make all the difference. It is important that parents have open and frank conversations regarding the risks of diabetes and the goals for treatment.  Children should work closely with a pediatrician, certified diabetes educator, pediatric endocrinologist, and, depending on the practice, a physician’s assistant or nurse practitioner.

Currently, there is no cure for type 1 diabetes, but it can be treated successfully by administering insulin, both by an injection or pump, and following a healthy, balanced diet and getting regular physical activity. Looking after diabetes requires planning and attention, but there’s no reason for it to stop your child living the healthy, happy and successful life you had hoped for them.

Contact Richmond University Medical Center, 718-818-1234, for more information and resources to help your child and family adjust to life with diabetes.

 

Philip E. Otterbeck, M.D. is Board Certified in Internal Medicine and Endocrinology, Diabetes, and Metabolism.  He is the Chief of the Division of Endocrinology at Richmond University Medical Center and maintains a private practice on Victory Boulevard in Staten Island.