Juvenile Diabetes Association

What does the  Juvenile Diabetes Association Do?

The Juvenile Diabetes Association (JDA) publishes detailed recommendations and guidelines for the management of type 1 diabetes in the form of position statements, consensus statements, and technical reviews.

This mainly includes special considerations, recommendations, and standards of medical care for children and adolescents. Other position statements include age-specific guidelines for screening for retinopathy and neuropathy in juvenile diabetes.

Special care for children with diabetes

What is Juvenile diabetes associationThe JDA has published recommendations regarding certain aspects of juvenile diabetes that apply specifically to children and adolescents while taking into account care at schools and camps.

The main purpose of the Juvenile Diabetes association is to provide a comprehensive resource on current standards of juvenile diabetes care pertaining to pediatric diabetes.

Although it’s not an exhaustive resource on all aspects of care and management of the condition, current works in progress are indicated and relevant resources are provided as such.

Information provided by the Juvenile Diabetes Association is based on relevant evidence from current and published studies and is supported by expert consensus or opinion. Numerous detailed chapters and guidelines on juvenile diabetes are included. Existing texts include those by the Australian Pediatric Endocrine Group and ISPAD (International Society of Pediatric Adolescent Diabetes).

Children and adolescents have needs and characteristics that dictate special standards of care and management. Management of juvenile diabetes must take the differences between various ages into account.

Read about the Signs of Childhood Diabetes HERE!

Importance of Involving Adults in the Management of Juvenile Diabetes

In caring for adolescents and children with juvenile diabetes, professionals recommend that adults be involved in the kid’s diabetes management. School-aged children, as well as adolescents, may be unable to provide their own juvenile diabetes management care independently.

Therefore, it’s essential to provide education about how to care for children as well as adolescents with diabetes to the entire family unit while emphasizing developmentally and age-appropriate care and integrating this into diabetes management. Therefore, adult supervision is important in most aspects and throughout the transition in and out of age-specific care.

  • Diagnosis

Diagnosis of juvenile diabetes is usually a straightforward process largely because most kids with the condition present a history of polydipsia, weight loss, polyphagia, and polyuria with ketonuria, ketonemia, glycosuria, and hyperglycemia. However, in most cases, the physician must document elevated blood glucose levels to diagnose diabetes.

  • Initial care

The main determinants of where, how, and who provides the initial education and care are the age of the child, clinical severity at presentation, the ability to provide education, and the proximity of the child to tertiary care centers.

Ideally, newly diagnosed patients with type 1 diabetes should be evaluated by a team consisting of a nurse educator, a mental health professional, a dietitian, and a pediatric endocrinologist qualified to provide pediatric-specific support and education.

Unfortunately, such systems are unavailable in most areas and circumstances. However, nowadays the use of telemedicine is beginning to allow the expertise of pediatric centers to improve the care of juvenile diabetes patients in remote regions.

Regardless of the primary and secondary source of care, all providers should understand the stages of juvenile diabetes and how they affect the management of the condition. Moreover, they should understand different management approaches to juvenile diabetes.

  • Diabetes education

Studies in patients with juvenile diabetes show that factors such as family and patient education, close contact with diabetes teams, and delivery of comprehensive diabetes case management are associated with reduced complications, hospitalizations overall costs, and emergency room visits.

The educational program should be personalized to the specific needs of the child, culturally sensitive, and designed to accommodate the needs of the child and family.  The patient’s sibling (s) should also be taken into consideration as they may feel sidelined due to the increased attention paid to the affected child as a result of the new diagnosis.

Proper juvenile diabetes education for the patient and family is complex and intense and requires diabetes educators with skills including compassion, good communication, humor, in-depth knowledge of type 1 diabetes, and sensitivity.

  • Identification

diabetes BraceletsPersons with diabetes should always wear, an ID (identification) that clearly identifies them as having diabetes. Identification is particularly important for school-going children and adolescents who are often away from parents’ and teachers’ supervision and may even be driving or operating machinery.

juvenile diabetes association

Children who are active in sports are a case in point, and it is essential for coaches to be aware of their condition and the signs and proper treatment of hypoglycemia. Bracelets and necklaces are readily available from various organizations and major pharmacies.

Toddlers with diabetes can wear shoe identification tags which may be useful in case of emergencies. Wallet cards are not adequate because they could easily be missed by caregivers or paramedics.

Learn how Vitamin D can help Juvenile Diabetes HERE!

Juvenile diabetes association

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What is Juvenile Diabetes?

Read about the Causes, Signs, and Symptoms of Juvenile Diabetes.

Being diagnosed with any condition or disease can be very scary, especially when it happens to our children. Will the disease affect their ability to lead a normal teenage life? Will they struggle even more when they become adults? In the case of Type 1 Diabetes, which is also referred to as juvenile diabetes, the important and good news is that the condition is totally manageable. Here are some of the things you need to know about the symptoms, causes, risk factors, and treatment of juvenile diabetes.

What is Juvenile Diabetes?

Juvenile diabetes (Type 1 Diabetes) is an autoimmune disorder that is usually diagnosed in adolescence or childhood but can also occur in adults aged between 30 and 40 years. It’s a chronic condition in which the pancreas makes little or no insulin and as a result, sugar starts building up in the bloodstream, which can cause a wide range of life-threatening complications. Therefore, people with Type 1 diabetes must take insulin in order to prevent complications and live healthy lives.

what is juvenile diabetesInsulin is an important hormone that allows glucose (sugar) to enter cells and be converted into energy. Various factors including some viruses and genetics may contribute to juvenile diabetes.

Despite active scientific research, juvenile diabetes has no cure and treatment mainly focuses on diet and lifestyle and managing blood glucose levels using insulin to prevent complications.

According to recent studies, about 193,000 children and adolescents have diabetes; about 77 percent of those cases are Type 1 Diabetes (juvenile diabetes).

How Does Glucose Work?

After eating, the body breaks down food into various substances including glucose, which is then absorbed into the bloodstream. The pancreas is mainly responsible for producing insulin, which helps fat cells and muscles absorb glucose (sugar) and use it for energy.

In people with juvenile diabetes, the immune system attacks the beta cells that make insulin, reducing or stopping production. With little or no insulin to help cells absorb glucose, sugar builds up in the blood, leading to various health issues.

What a the Common Causes of Juvenile Diabetes?

Researchers don’t know exactly what causes juvenile diabetes because it’s not linked to any specific gene that can be tested for. Although some autoimmune disorders tend to run in families, a large number of juvenile diabetes cases happen randomly. According to studies, some of the possible factors that contribute to the development of the condition include:

  • Geography and ethnicity: Juvenile is more common among people who live further away from the equator. Research shows that children and adolescents in Scandinavian countries generally have a higher risk of developing the condition. Caucasians of Northern Europe ancestry also have a higher risk of being diagnosed with the disease than other ethnicities.
  • Infections and toxins: Researchers believe that in a large number of cases a virus or toxin triggers the start of juvenile diabetes by triggering the immune system to mistakenly attack beta cells in the pancreas.
  • Family history: Children from families with a history of autoimmune conditions are at a higher risk of being diagnosed with Type 1 Diabetes. If a parent or sibling has juvenile diabetes, children are 15 times more likely of being diagnosed with the disease than people without a family history of autoimmune diseases.
  • Genetics: While there’s no specific Type 1 Diabetes gene, there are some mutations and genes that have been linked to an increased risk of developing Type 1 Diabetes. For instance, mutations in HLA (Human Leukocyte Antigen) class of genes can increase the risk of various autoimmune conditions, including juvenile diabetes.

What are the Symptoms of Juvenile Diabetes?

Although having these symptoms does not automatically mean your kid has juvenile diabetes, it’s critical to consult their pediatrician if you notice one or more of these symptoms.

  • Extreme thirst: Too much glucose in the bloodstream triggers the body to pull water from surrounding fat cells and tissue to dilute it. This makes some kids extremely thirsty and dehydrated. Kids with diabetes may feel that no matter how much water (and other fluids) they drink, their thirst can’t be quenched.
  • Frequent urination or having pee accidents: In a bid to reduce sugar in the bloodstream, the kidneys filter it and try to dump it into the urine. As a result, more pee is created and the need to urinate increases. Children with juvenile diabetes may start having frequent pee accidents both at night and during the day, despite having been potty-trained. Some kids with juvenile diabetes may feel the urge to urinate frequently. The risk of UTIs (urinary tract infections) is also higher in kids with juvenile diabetes.
  • Dry mouth and bad breath: When the body starts breaking stored fat for fuel, the process creates chemicals known as ketones that may cause children to have bad breath (stale smell). The same thing tends to happen to people who go on low-carb diets.
  • Weight loss: For children who are eating normally and are otherwise healthy, sudden weight loss could be a symptom of juvenile diabetes. This usually happens when the cells are not getting the glucose they need out of the bloodstream. As a result, they start breaking down muscles and storing fat for energy instead.
  • Fatigue and general weakness: Kids with juvenile diabetes may feel weak and tired because their body systems including the brain and muscles are not getting the energy they need to function optimally. Fatigue can also be a result of dehydration from peeing frequently. Sometimes, weakness and listlessness can be a sign of serious complications such as ketoacidosis, which can be deadly and requires immediate attention.
  • Vomiting, belly pain, confusion, and fainting: Ketoacidosis can cause vomiting, and severe stomach aches, and usually causes kids and young adults to lose consciousness or act confused.

What are the signs of an emergency with juvenile diabetes?

  • Belly pain
  • Fruity smell to the child’s breath
  • Confusion and shaking
  • Loss of consciousness (rare)
  • Rapid Breathing

Managing juvenile diabetes can be challenging for both parents and their kids. However, the growing number of support systems and treatments for people with the disease has made it easier than ever to live a happy normal life.

Read more about the signs and symptoms of diabetes in toddlers HERE!

Signs of diabetes in children under 5

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Juvenile Diabetes Cure

A practical cure for Juvenile diabetes focuses on results, not potential research pathways. However, any project that is likely to yield a practical cure for the condition is welcome. Although reversing juvenile diabetes would be an ideal outcome, a practical cure encompasses maintenance therapy and periodic treatment.

Therefore, a practical cure research project for the condition draws on a very wide range of possible research projects and pathways. Currently, there are 4 wide research projects in development that could deliver a practical cure. Even though each approach has the potential to yield a cure by itself, it’s also possible that a practical cure will require a combination of various elements from different research pathways. The 4 broad research projects are

   1.  Transplantation of Pancreas and Islet Cells

Juvenile Diabetes CureSeveral hundred islet cell transplants have already taken place and the success rate of the procedure has been steadily improving and could soon rival kidney transplantation’s success rate!

Such transplants usually depend on suppressing the system to prevent rejection. However, immune suppression has side effects that rival the complications of diabetes.

On the other hand, transplantation of islet cells requires solutions to protect the cells from attack by the immune system. The main approach to protect the islet cells has been encapsulating the cells in implantable devices that act as physical barriers between the immune attack and islet cells. Despite extensive research, various encapsulation methods have been tested with limited success

    2.  Biomechanical Devices that Mimic the Pancreas

Researchers are developing an artificial pancreas that combines an insulin pump, a glucose sensor, and a computer that regulates the pump speed. A device incorporating a glucose sensor and an insulin pump is already being used by many diabetes patients around the globe, and this research field is progressing at a very fast pace.

One of the main problems is that most glucose sensors are not sufficiently sensitive, stable, and accurate. To deliver a practical cure, the device would require a closed-loop system that is reliable, stable, and adaptive to each patient. Also, studies suggest that a glucose sensor alone cannot regulate the pump in the absence of accurate information about calorie intake.

    3.  Glucose-Responsive Insulin

This pathway aims at developing “smart insulin” in the sense that the insulin is only activated in response to rises in glucose levels. The insulin would remain inactive until the chemical compounds around the insulin detect that blood glucose level has risen above a certain point in order for the smart insulin to kick in and bring blood glucose levels down.

The glucose-responsive insulin would become inactive once the blood glucose level reaches a normal point, thus preventing low blood sugar.

   4.  Modifying the Immune System

This pathway aims to stop the immune system from attacking beta cells. The three main approaches to modifying the immune system are:

  • Blocking

This is a direct way to stop juvenile diabetes by stopping the autoimmune attack without compromising the body’s ability to fight infection and disease. In order for this approach to provide a practical cure, the body needs to have sufficient residual beta cells that could multiply, mature, and produce enough insulin after the attack is stopped.

  • Balancing

Some scientists believe that type 1 diabetes develops when the immune system becomes unbalanced. This means either the body is producing very few regulatory T-cells (which keep killer T-cells in check) or too many killer T-cells (which fight disease and kill beta cells in T1D). Balancing involves an approach that aims at restoring the balance between regulatory T-cells and killer T-cells.

  • Retraining

This approach involves retraining the body’s immune system not to attack and kill beta cells. It may be possible to take immune system cells and retrain them not to attack islet cells, either by a mechanized approach that involves taking, treating, and reinserting immune system cells in the blood or by exposure therapy (periodic injections).

While juvenile diabetes can be effectively controlled, decades of extensive research have not yielded a permanent cure. An ideal cure for diabetes would be to get rid of the cause, but a more practical approach is to maintain normal blood sugar levels without the need for insulin injections.

Check here for the Recent advances in Diabetes Research!

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Juvenile Diabetes Diet

Proper management of type 1 diabetes requires maintaining a healthy diet designed to ensure proper nutrition while monitoring the intake of fat, protein, and carbohydrates. However, it is essential to understand that there is no single universal type 1 diabetes diet. Proper management of the condition involves being mindful of what and how you eat and how the body responds to certain foods.

Why Should you Follow a Juvenile Diabetes Diet?

Although there’s no universal diet for juvenile diabetes, people with the condition need to monitor their blood glucose levels closely. Without insulin therapy, proper diet, and exercise, a person with juvenile diabetes could experience serious health complications. Some of the common complications associated with unmanaged type juvenile diabetes include:

  • High blood pressure and increased risk for stroke, poor blood circulation, and heart attack
  • Skin sores can be infected causing pain and tissue death
  • Vision problems
  • Nerve damage
  • Kidney damage

Following the proper type 1 diabetes dietary guidelines can mitigate the complications associated with the condition and improve the overall quality of life.

Read about the Obesity Epidemic associated with Juvenile Diabetes HERE!

How Can you Prepare for a Juvenile Diabetes Diet?

type 1 diabetes meal planAlthough there is no standard diet for juvenile diabetes, a dietitian or nutritionist can help you come up with a diet and create meal plans that work for you even in the long term.

It might seem easy to reach for processed foods and fast foods especially when you’re short on money or time, but it’s essential to keep in mind that these foods are high in salt, sugar, and fat, and they offer minimal nutrients.

Grocery shopping regularly and planning meals ahead can help reduce “emergency eating” which is usually “unhealthy eating”.

Stocking your kitchen well with healthy foodstuffs can also help reduce your intake of unhealthy sugar, sodium, fat, sodium, and carbohydrates that can spike blood glucose.

One of the most important aspects of a healthy juvenile diabetes diet is consistency. You can maintain consistent blood sugar levels by:

  • Eating around the same time every day
  • Avoiding skipping meals
  • Paying keen attention to food labels

Starting a Diabetes Diet

Type 1 Diabetes dietYou should work with your doctor to calculate the right dosage of insulin according to your carbs intake. Your healthcare provider will also guide you on the importance of exercise and your recommended activity level.

Choosing nutritious foods high in minerals and vitamins is optimal. It is generally recommended that you choose nutrient-dense carbohydrates, healthy proteins, and fats.

In case you’re having any problems managing juvenile diabetes, work with your dietitian or doctor to help manage your timing of meals and medications. It is also important to discuss the portions of carbohydrates per meal that are appropriate according to your specific condition and needs.

Here are some recommendations:

  1. Carbohydrates

The three main types of carbs are sugar, starches, and fiber, which can come in form of bread, pasta, fruits, beans, or starchy vegetables. Carbohydrates are converted into sugar in the digestive tract before being absorbed into the bloodstream hence raising your blood sugar level.

Therefore, it is important for people with juvenile diabetes to manage their carbohydrate intake. If your blood sugar levels are low, choose fast-acting carbohydrates that will be easily digested and then absorbed into your bloodstream.

Start with 15g of carbohydrates then recheck your blood glucose and have another 15g if the level is still low.

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Fast-acting carbs (15 grams) include:

  • 4-6 crackers
  • ¼ cup of fresh fruit juice
  • 4 ounces of fresh fruit (1 small fresh fruit)
  • 1 tsp of honey
  • 2 tsps of raisins

  1. Fruits

If you are using a juvenile diabetes diet plan, fruits should be counted as carbs because they’re natural sources of sugar. You can opt for frozen or fresh fruits. However, it is important to keep in mind how many carbs are in specific portions of fruit in order to properly manage your insulin and blood sugar levels.

Examples of fruits that contain carbohydrates (portions that contain 15g of carbohydrates)

  • 3 ounces of fresh/frozen grapes
  • ½ cup of canned fruit
  • 4 ounces of fresh fruit (1 small fresh fruit)
  • 1 cup of melon or grapes
  • ½ cup of fresh fruit juice

Remember, you don’t have to limit your intake to only 15g per snack or meal. However, you should note the number of carbohydrates in specific servings based on your blood glucose management plan and insulin needs.

  1. Vegetables

Sugar, in form of starch, naturally occurs in a wide variety of common vegetables including peas, corn, and potatoes. However, starchy vegetables are higher in carbs compared to other vegetables and should be consumed in moderation and properly accounted for especially when calculating the carbohydrate intake of type 1 diabetes patients.

On the other hand, non-starchy veggies have a lower impact on the blood sugar level and are richer in phytochemicals, fiber, and minerals. Therefore, you can eat up to 3 cups of non-starchy vegetables per meal without having a big effect on your blood sugar levels.

More than 3 cups of non-starchy vegetables can be counted as 15g of carbohydrates and anything less than 3 cups should be considered “free”. Examples of non-starchy vegetables include:

  • Onions
  • Beets
  • Asparagus
  • Green leafy veggies
  • Carrots
  • Sprouts
  • Peppers
  • Celery
  • Cucumber
  • Tomatoes
  • Sprouts

Always choose frozen or fresh vegetables without added sauces or salt.

Portions of starchy veggies that contain 15g of carbohydrates include:

  • ½ cup of peas
  • 3 ounces of baked potato
  • ½ cup of squash
  • ½ cup of boiled potatoes or sweet potatoes
  • ½ cup of corn

  1. Whole grains

These are considered fibrous and nutritious starch and it is recommended that about 50% of grains consumed should be whole. Whole-grain bread, bran cereal, and brown rice are great sources of whole grains.

Be mindful of your total intake in a single meal and read labels to ensure your blood sugar is properly regulated with the medication you are using.

  1. Fats and proteins

Healthy fats are important for optimal heart and brain functioning while proteins are very important in repairing wounds and maintaining muscle. Proteins can be found in meat, eggs, and beans. Healthy fats include seeds, nuts, and avocado.

Fats and proteins don’t directly raise blood sugar levels. However, experts recommend that people with juvenile diabetes limit their intake of fatty or processed meats, which are high in sodium and saturated fat.

Although these items do not affect blood sugar directly, consuming them in high quantities can have harmful effects such as heart disease, which is a common complication of type 1 diabetes.

When Should You Eat?

Knowing when and what to eat is extremely important.

It is recommended that juvenile diabetes patients eat smaller meals while progressively snacking throughout the day in order to make their blood sugar easier to manage and monitor while preventing spikes.

A certified diabetes educator or registered dietitian and your doctor can help you calculate the insulin needed to support your carbs intake while avoiding blood sugar lows and highs.

Nuts, vegetables, and fruits travel easily and are particularly great to have on hand especially when you need them.

Physical activity and exercise lower blood sugar. Therefore, it’s important to measure blood sugar levels before and after engaging in any physical activity. This lets you know how much you have to eat in order to maintain healthy blood sugar levels.

The bottom-line

Living with juvenile diabetes or type 1 diabetes means you must be more mindful of what you eat and its impact on your body. Your nutritionist, dietitian, and a doctor can help you create a meal plan that works specifically for you.

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Symptoms and Causes of Juvenile Diabetes

Has your child just been diagnosed with Juvenile diabetes?

Juvenile diabetes mellitus is more commonly called Type 1 diabetes. It is a metabolic syndrome and blood glucose levels are too high due to a deficiency of insulin secretion in the pancreas.

What does this mean to you and your family? There may be some changes ahead including changes to diet and day-to-day routines and of course managing insulin.

Signs and Symptoms of Juvenile DiabetesIt may help to know you are not alone. Type one diabetes is one of the most common childhood diseases, with most people being diagnosed before they are 16 years old. We don’t yet know why, but around the world, type 1 diabetes rates are increasing annually, particularly in younger age groups.

One of the biggest challenges families and children with type 1 diabetes live with is the daily routine of attention to diet, time schedules, blood glucose testing, and insulin regimens.

All of these are monitored to keep blood glucose levels under control – something the body does naturally in most people. The risk of juvenile diabetes is higher than any other serious chronic disease of childhood.

Symptoms of Juvenile Diabetes

The symptoms of juvenile diabetes, (also known as type 1 diabetes) and type 2 diabetes are very similar.

  • It’s not always obvious that a child has type 1 diabetes. Symptoms appear in childhood problems that occur in everyday life. Nausea and vomiting may be misinterpreted as the flu.
  • Irritability, fatigue, and apathy can be attributed to the behavior of all children at one time or another.

The discovery of juvenile diabetes may occur during a visit to a doctor for other diseases such as vaginal yeast infection for girls or even a routine examination.

Rapid weight loss is one of the first symptoms of diabetes, especially if the child has also increased hunger in particular after eating. Other symptoms include :

Juvenile diabetes, along with other types of disease is not a contagious disease. Another misconception about the disease is the traditional belief that eating sweets can cause diabetes directly. In a sense, eating too much candy can also cause diabetes, because doing so can lead to obesity. But eating sweets alone does not cause diabetes. Stress, however, is a cause of juvenile diabetes or any type of diabetes.

Juvenile Diabetes is believed to be an autoimmune disease. There is also a strong hereditary component to childhood diabetes. The disease tends to run in families. Brothers and sisters of children with diabetes have at least 100 times the risk of developing juvenile diabetes as a child in a family unaffected.

Signs and symptoms of childhood diabetes Researchers believe an environmental trigger or virus causes the body to attack the beta cells in the pancreas. Once these cells are destroyed the body can not produce insulin.

Juvenile diabetes is a chronic health problem for children. There are many myths and misinformation about diabetes. There is also confusion between juvenile diabetes, (also known as type 1) and type 2 diabetes. The symptoms of both are largely the same, however, the cause and treatment are very different.

Diabetes is the leading cause of adult blindness, end-stage renal disease (ESRD), gangrene, and amputation. Being overweight, lack of exercise, family history, and stress increases the likelihood of developing diabetes.

When the blood sugar level is high and constant that leads to kidney failure, cardiovascular problems, and neuropathy. Patients with diabetes are four times more likely to have coronary heart disease and stroke.

Learn how vitamin D can help juvenile diabetes HERE!

Symptoms of Diabetes in Children

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