By Dr. Phoebe Votolato
Diabetes Mellitus (DM) is a disease in which the body cannot make the hormone insulin. Insulin moves glucose (sugar) into cells where it is used as an energy source.
Type I or Juvenile diabetes, aka Insulin-Dependent diabetes mellitus (IDDM) is less common than the late onset version of the disease. It affects 1 in 200 people in the UK.1 Type I typically starts in childhood between 10-13 years.
Late onset DM (Type II) usually affects adults with an unhealthy lifestyle. But Type I is caused when the body's defence system attacks the cells that produce insulin in the pancreas. Exactly why this happens is not clear though, DM Type I does run in families. That means there is a link to your genes, but exactly which ones hasn't been fully worked out yet.
Without insulin, sugar can't get into the cells of your organs and other tissues. This means they have no energy to work. Without insulin, your child may feel lethargic, generally unwell, may faint, won't gain weight normally and may even lose weight. These symptoms can start very quickly as the pancreas starts being attacked by the immune system.
After a meal, sugar floods the bloodstream. Normally, this would be moved into your body's cells by insulin. If there's no insulin around, then sugar gets stuck in your blood. Your body attempts to flush the excess sugar out by making you pee more. Larger volumes are passed and you feel very thirsty. In the short term, dehydration and drowsiness occur.
If these early clues are missed, a serious complication called Ketoacidosis may arise. In this situation, there's too much sugar in the blood, as well as Ketones. These are made when fat is used as an emergency energy source if you can't use sugar. Ketones are toxic in high levels causing serious illness and possibly death. As they build up, they make your blood more acidic than it should be. This is why it's called Ketoacidosis, and it can end up causing serious damage to your body, even leading to a coma.
Long-term, untreated diabetes leads to problems throughout the body as blood vessels are damaged by sugar. Poor vision, kidney problems, stroke and heart attack are potential consequences. Therefore, lifelong treatment is needed.
Treatment involves replacing insulin with a manmade copy via injections several times daily to keep blood sugar levels healthy.
You can monitor sugar levels with a finger prick kit to guide you in balancing insulin dosing with food intake and exercise.
Your GP, Paediatrician and Dietitian will be at hand to ensure you have the knowledge you need to neatly control blood sugar levels and keep your child well.
Advice for Families
Early warning signs of diabetes in children:
- Excessive thirst
- Peeing more frequent
- Weight loss
- Catching infections more often
Keep an eye out for these early clues and get a doctor's appointment quickly if you see them.
If you think your child may have diabetes, your doctor will test his/her blood and urine for sugar.
- Early warning signs include excessive thirst, frequent peeing & weight loss
- Contact your GP if you suspect your child is unwell
- If your child is diagnosed with diabetes, make sure you keep any appointments with your doctors so they can keep an eye on how your child is doing
- Monitor blood sugar at home regularly & adjust food intake & insulin dosing accordingly
- Change insulin injection sites often. Rotating between stomach, thighs & buttocks helps prevent hard lumps from forming in overused spots
- Sweatiness & confusion may indicate very low blood sugar which could lead to a coma. Treat urgently with a sugary drink or snack, or you can use an injection of another hormone called glucagon, which lets your body release glucose from its own stores
Dr. Phoebe Votolato is a medical writer for Medikidz, a charity providing children and teenagers with informative, accessible and fun comic books to help them understand their diagnosis.