Type 1 Diabetes In Children and Adolescents

Also known as juvenile diabetes, diabetes type 1 is more often diagnosed in children and young adults. 

What are the causes, symptoms, treatments, and outlook of type 1 diabetes? This article answers all these questions. 

Diabetes type 1 causes 

The exact cause of type 1 diabetes is not known. Diabetes type 1 is considered an autoimmune disease as the insulin-producing cells are mistakenly attacked by the immune system.  Genetics and environmental factors like viruses may play a role. 

Some genetic variations increase susceptibility to diabetes type 1 ((HLA DRB1*03, HLA DRB1*04, and HLA DQB1*0302), while others offer protection (HLA DQB1*0602) from disease.

Regarding viral infections, a number of viruses may contribute to an increased risk of developing type 1 diabetes, including enteroviruses, such as coxsackievirus B, rotavirus, mumps virus, rubella virus, and cytomegalovirus. 

The geographical location appears to be a risk factor, as this condition is more prevalent as a person lives away from the equator. Living further away from the equator also increases the risk of vitamin D deficiency, which has been linked with diabetes type 1 and other autoimmune conditions. 

Although diabetes type 1 can occur at any age, it is diagnosed more often at a young age, and there are two peaks: in children between age 4 and 7 (first peak), and between 10-14 years of age (second peak). 

Diabetes type 1 symptoms 

The signs and symptoms of diabetes in infants and young children. Diabetes is not always easy to pinpoint at a very young age, as babies can’t tell their parents when they feel sick. 

In addition to the typical signs of increased thirst, urination, and hunger associated with unexplained weight loss, young children may look more lethargic and tired, because the body is not able to properly convert sugar into energy. Changes in vision may also occur, particularly blurry vision.
Yeast infections can be also a sign of diabetes, manifesting in babies as a diaper rash. Irritability, moodiness, and unusual behavior could be related to diabetes as well 

Fruity-smelling breath is suggestive of diabetic ketoacidosis, and lab tests may reveal glucose in the urine.  

The signs and symptoms of diabetes in teenagers. Teenagers and young adults can be seen going more often to the washroom and feeling their glass of water more often. That’s because they also have the characteristic signs of diabetes:  increased urination, thirst, and hunger. They also lose weight despite eating more. Sudden changes in vision and complaining of fatigue and drowsiness can also develop. In the case of diabetic ketoacidosis, they may have labored breathing, look confused, and become unconscious. Other symptoms include stomach pain, nausea, and vomiting 

Diabetic ketoacidosis, which is a medical emergency, occurs when the blood sugar is dangerously high and ketones are found in the urine, and both tests are available at home. Urinary ketones occur because the body doesn’t have enough insulin and burns fat for energy. Parents should test the child’s urine for ketones when blood glucose levels are 250 or greater or the child is not feeling well. 

When to see a doctor 

It is important to check blood sugar levels more often in case the child or teenager had a recent illness, injury, or problem with insulin therapy- either a missed dose or malfunctioning insulin pump. Alcohol or drug abuse in teens or certain medications- like steroids can also increase the risk of diabetic ketoacidosis. A consultation with a doctor is needed if the child or teen is unable to eat food or consume liquids due to vomiting if the blood sugar levels are too high or the urine ketone bodies are moderate or high in the urine. 

Seek emergency treatment if the blood sugar levels are very high (ie 300 (mg/dL), ketones are detected in the urine, and the family doctor can’t be reached or if there are signs and symptoms of diabetic ketoacidosis.

Diabetes type 1 treatment

Diabetes type 1 treatment includes a healthy, balanced diet, regular exercise, stress management, and lifelong insulin injections or insulin pump. The blood sugar levels have to be checked regularly. 

Diabetic ketoacidosis is treated in the hospital with insulin, along with fluids. Although the treatment is lifesaving, complications like dangerously low blood sugar, low potassium levels (hypokalemia), or swelling of the brain can occur. 

The newest treatments for type 1 diabetes include whole pancreas or islets transplantation. These treatments offer a lot of hope to everyone with this condition, as they replace the need for daily insulin. 

Diabetes type 1 outlook 

Diabetes type 1 is associated with long-term complications like heart diseases and stroke, vision problems (including vision loss), kidney damage, nerve damage which can lead to amputations and loss of teeth. Maintaining blood sugar well under control significantly reduces the risk of complications. 

While there is no known cure for diabetes, advances in modern medicine dramatically changed the outlook of diabetes type 1. Before insulin therapy, this was a fatal disease. Nowadays, with regular monitoring of sugar levels, daily insulin, and a healthy lifestyle including proper nutrition and regular exercise, a child or teenager can have a happy, successful,  normal life without limitations

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