Type 1 diabetes
Diabetes has reached epidemic levels throughout the world. Worldwide, there are approximately 463 million adults living with diabetes, and that number is expected to rise to 700 million by the year 2045. Diabetes reportedly causes 70 billion dollars in health expenditures annually (as of 2019).
Type 1 diabetes is an autoimmune response against the beta cells of the pancreas. These beta cells, which produce insulin, are mistaken for foreign cells and destroyed. Once known as juvenile diabetes, Type 1 diabetes is often diagnosed in children and young adults. with symptoms appearing typically over a matter of weeks. It is estimated that 5-10% of all cases of diabetes are Type 1 in nature. Currently there is no cure for Type 1 diabetes. Ongoing treatment will include daily injectable insulin therapy.
Signs and Symptoms indicating possible diabetes (both Type 1 and Type 2) may include the following:
Polyuria (Increased frequency of urination)
Polyphagia (increased appetite)
Polydipsia (increased thirst)
Slow healing cuts
Unexplained weight loss
Headaches, nausea and vomiting
Since Type 1 diabetes often occurs in toddlers and young children that may not be able to verbalize many of the symptoms associated with diabetes, the following list can assist in identifying possible diabetes indicators.
Signs and symptoms of type 1 diabetes in babies and toddlers may include the following:
· Weight loss or inability to gain weight combined with stunted growth (failure to thrive)
· Colic or fussiness that just won’t let up
· Poor-quality sleep
· Bedwetting, especially after successful potty-training
A preferred screening test for Type 1 diabetes is a random blood glucose test. Results over 200mg/dl are suggestive for diabetes. A second confirmatory blood test, such as a fasting glucose level or oral glucose tolerance test, should be completed on a separate day.
The American Diabetes Association recently lowered the A1C target for children to less than 7.0%, hoping to improve their long-term health outcomes without increasing the risk of hypoglycemic events. The child’s A1C goal be personalized, taking into account many factors, including coexisting health conditions, their baseline A1C, and previous episodes of hypoglycemia.
A multidisciplinary team approach is best in terms of education for a child with Type 1 diabetes, focused on diabetes self-management education and medical nutrition therapy. Ongoing psychosocial support is needed to address the developmental needs of a growing child and their family. Physical activity recommendations will be based on the growth and developmental needs of the child. There should be an ongoing relationship between the family and the child’s school, to ensure that the baseline essentials for diabetes management are in place.