Pediatric Diabetes – Caring for a Diabetic Child

In pediatric diabetes, beta cells (special pancreatic cells that make insulin) are destroyed. Insulin is needed in the body to help cells absorb blood glucose for energy. Therefore, without insulin, blood sugar levels rise and can lead to serious health complications.

If you are caring for a diabetic child or teen, it is vital to ensure they are following treatment in order to keep blood glucose levels within the target healthy range. On the other hand, your child’s healthcare team will provide treatment using a diabetes care plan specially tailored for them.

Doctors and researchers are working on a diabetes cure. However, until a cure is found, following a diabetes treatment plan is the only key to a healthy, long life.

Pediatric Diabetes Care Plan

A pediatric diabetes care plan outlines the instructions you, your child, and your caregivers should follow. The plan is designed to help maintain your child’s blood glucose levels within the healthy range.

Parts of a pediatric diabetes care plan.

A diabetes care plan has four main parts:

  1. Checking pediatric blood glucose levels
  2. Administering insulin
  3. Getting physical activity on a regular basis
  4. Eating a balanced, healthy diet while keeping track of carbohydrate intake

Your child’s health care team helps teach you, your child, and your caregivers how the plan works and how you can adhere to it. Although you may have to learn a lot in the beginning, soon enough you’ll master the ins and outs.

What really happens in childhood diabetes?

     1. Monitoring pediatric blood glucose levels

One of the most important aspects of managing pediatric diabetes is checking blood glucose daily or as recommended. This can be done in two main ways:

     2. Using a CGM (continuous glucose monitor)

A continuous glucose monitor is a wearable device designed to take blood sugar level measurements every few minutes throughout the day. It features a tread-like sensor that is secured in place just under your child’s skin. Most sensors need to be replaced every ten days. The device provides blood glucose readings so often, allowing you and your child’s healthcare teamwork more effectively to keep blood sugar within a healthy range.

  • Using a blood glucose meter

In most cases, it is recommended that children with type 1 diabetes check their blood sugar levels at bedtime and just before meals. This is 3 times a day, but in some cases, it could be necessary to do it more often. Your child’s personalized diabetes care plan will guide you on how often blood sugar measurements should be checked and what should be done if the blood sugar is too low or too high.

Your child’s diabetes management team uses the blood sugar level trend to adjust the insulin plan over time.

Moreover, the team also uses a hemoglobin A1c or HbA1c test (glycosylated hemoglobin test) to monitor your kid’s blood sugar. The results represent the average blood glucose levels in the 2 or 3 months prior to the test. The HbA1c test helps determine how well your child’s diabetes care plan is working.

It is recommended that diabetics keep the A1c at 7% or below to lower the chances of complications.

     3.  Taking insulin

All diabetic kids and teens need to take insulin to ensure that blood glucose is absorbed by their cells and used for energy. Your child’s healthcare team will create an insulin schedule customized for your child’s specific condition.

 How can children get insulin?

  • With an insulin pump

An insulin pump continuously administers insulin through a tiny tube secured just under the child’s skin.

  • By injection

In most cases, children need 4 or more insulin injections daily. The needle is tiny and the shorts are not very uncomfortable or painful. The diabetes management team will guide you on how you can help your kid cope with insulin injections.

The team will also teach you, your child, and your caregivers how to use the insulin pump or do injections.

Healthy diet

Pediatric Hypoglycemia TreatmentDiabetic kids need the right balance of insulin, exercise, and food to maintain their blood sugar levels within the target range. Therefore, it is essential to understand the effects of different foods on your kid’s blood sugar.

The healthcare team will guide you on healthy eating for your child and how to count carbohydrates in snacks and meals. Knowing the number of carbohydrates your child drinks and eats helps you figure out the amount of insulin they require. Moreover, it gives your kid the flexibility to eat and drink as much and as often as they like.

Just like anyone else, your diabetic kids’ diet should include food items that are high in nutrients and low in calories and fat, such as:

  • Whole grains
  • Fruits
  • Lean protein
  • Vegetables

Your child’s diabetes management team will help you create a custom meal plan that takes your child’s health goals and food preferences into consideration and incorporate occasional treats.

Regular physical activity

Kids need exercise in order to feel good, strengthen their bones and muscle, and keep their blood sugar levels under control. Studies show that regular physical activity helps insulin work more effectively. You can motivate your child to engage in physical activity by exercising with them.

It is essential to keep in mind that physical activity can affect your child’s blood sugar for several hours after exercising, or even overnight. Therefore, you should monitor your child’s blood sugar levels more keenly whenever they begin a new activity in order to understand how their body reacts to the new activity. This will help you determine whether it’s necessary to adjust their insulin doses or meal plan to compensate for the change in activity levels.

The bottom-line

Your child’s healthcare provider will occasionally check your kid’s blood pressure, thyroid function, cholesterol levels, growth, liver function, kidney function, and any other signs of trouble. Sometimes, despite the best efforts problems may arise.

Some complications of pediatric diabetes need to be addressed immediately or they could easily become serious or life-threatening, including hyperglycemia (high blood sugar), hypoglycemia (low blood sugar), DKA (diabetic ketoacidosis)

As you care for a diabetic child, the care team and detailed care plan will help guide you. Following your child’s diabetes health care plan and keeping in touch with your child’s healthcare team is the key to keeping your child healthy.

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6 Signs of Childhood Diabetes

Diabetes is an increasingly prevalent chronic disease among children. However, recognizing the signs of diabetes is a challenge for most parents. Childhood diabetes might not be recognized until the child is very ill primarily because the changes are usually subtle and the onset is quite slow.

Although discovering that your child is suffering from diabetes can be distressing for any parent, it is better to find out early enough than to miss the signs of diabetes completely.

What are the signs of diabetes in children?

  1. Unquenchable Thirst

Children with undiagnosed diabetes are constantly thirsty.Signs of diabetes in children This is mainly because as blood glucose builds up in the bloodstream, more fluid is pulled from the body tissues. Moreover, these children may crave cold drinks and sweets. In case the water in the blood is not sufficient, the body extracts water from surrounding tissues. Therefore, the body becomes dehydrated and the thirst mechanism kicks in.

  1. Frequent Urination

The urge to urinate a lot is one of the most common early signs of childhood diabetes. In this case, your child goes to the restroom more often than normal or starts wetting the bed all of a sudden even though they were toilet trained before.

Since the child is drinking more, they will also visit the restroom more. However, there can be other reasons for frequent urination such as the inability of the child to empty the bladder completely, urinary tract infection, or Daytime Urinary Frequency Syndrome which is formally known as Pollakiuria.

  1. Rapid Loss in Weight

This is an extreme symptom of diabetes in children mainly because children rarely lose weight. In this case, the child still loses weight even when they continuously consume plenty of food. Weight loss is usually caused by an inadequate supply of energy in the body. Therefore, the body extracts energy from reserved fat stores.

Besides making the immune system weaker, excessive weight loss in children might also result in weakness and tired feelings. Drastic weight loss in children is a very dangerous sign whether diabetes is involved or not and the child should be taken to the doctor immediately.

  1. Yeast Infection

Excessive weight loss makes the immune system weaker and prone to plenty of infections. The child might develop rashes on the skin due to yeast infection. Therefore, it is vital to give your child plenty of water to drink and feed him/her a healthy diet.

  1. Extreme HungerSigns of Juvenile diabetes

A child suffering from diabetes might eat constantly without gaining weight. This can be attributed to the inability of the body to utilize food and in effect, the food simply flows through the child’s digestive system.

  1. Blurred Vision

The decreased level of fluid in the blood and body tissues including the eye lenses might create vision difficulties. This might cause various eyesight problems including blurred vision. Unfortunately, the child might be unable to detect or even complain about problems with their eyesight.

Untreated diabetes might have serious consequences for the child. Some of the short-term risks include hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), and increased ketones in the urine (ketone acidosis).

Some of the lifelong or long-term risks include; nerve and vascular damage, amputations, blindness, and increased risk of stroke and heart attack. Besides identifying the signs of diabetes in children, it is also the parents’ responsibility to ensure that the child gets a proper diagnosis and also takes medication as instructed by the doctor.

Other Signs of Childhood Diabetes

A breath that smells sweet and like fruit is one of the warning signs of childhood diabetes. This symptom can also be sneaky in that it may be explained as absent from the fruity flavored toothpaste that youngsters use as of late or from the nutritious fruit snacks that they’re fed.

The sweet scent of their breath is really a consequence of diabetic ketoacidosis, which is the body’s attempt to get rid of acetone through the respiratory system.

Sweet-smelling breath is often a signal that poisonous ketones (acid by-products of fats being broken down for power) are constructing up inside the entire body. This symptom out of many signs of childhood diabetes is really an indicator that they urgently need diabetes medication.

Get Childhood Diabetes under Control!

Good eating habits and regular exercise, even for your children (and for yourselves as role models) goes a very long way to stabilizing Childhood Diabetes.

Symptoms of Diabetes in Children

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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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The Obesity Epidemic and Juvenile Diabetes

In recent years, there has been a sharp increase in the number of people with type 1 diabetes who are also obese. Even though obesity has been strongly linked to the pathogenesis as well as initiation of type 2 diabetes and a risk factor for complications, very little is known about its role in the development and progression of type 1 diabetes.

Recent studies suggest that obesity plays a role in the development of cardiometabolic complications, dyslipidemia, and insulin resistance in type 1 diabetes.

These co-morbidities may require to be addressed using therapeutic strategies in the context of insulin therapy which has been shown to promote weight gain. Therefore, there’s an urgent need for guidelines for the management as well as prevention of type 1 diabetes.

These clinical recommendations are being developed using a trans-disciplinary research approach addressing molecular mechanisms, metabolism, neuropsychology, novel therapeutics, and lifestyle.

Can diabetes lead to obesityWhat is the relationship between obesity and juvenile diabetes?

Type 1 diabetes, which is also known as juvenile diabetes, is a chronic immune-mediated condition that is characterized by the loss of beta cells in susceptible subjects.

Beta cells are mainly responsible for producing insulin in the pancreas. The main genes contributing to juvenile diabetes susceptibility are located in the HLA (Human Leukocyte Antigen) class 2 locus on chromosome 6.

The Human Leukocyte Antigen genes have been linked to about 50% of the familial clustering of juvenile diabetes.

Obesity and overweight are related to type 1 diabetes in various aspects. In addition to being a risk factor for juvenile diabetes, obesity can also be a challenge when it comes to managing and treating the disease.

Moreover, obesity and overweight increase the risk of micro and macro-vascular complications in juvenile diabetes. Such challenges typically arise in adolescence and may become even more common in adults.

Essential points

  • Obesity has been known to be a predisposing factor and concurrent phenotype for type 2 diabetes. However, its physiological attributes, consequences, and prevalence in juvenile diabetes are poorly understood.
  • As the prevalence of type 1 diabetes increases in the United States and many other parts across the globe, it is important to develop specific guidelines for the treatment and prevention of obesity and the achievement and maintenance of optimal glycemic control in type 1 diabetes.
  • The characteristics and role of energy balance in juvenile diabetes are not completely defined and are likely to be affected by both medical therapy and glycemic control.
  • Studies show that potential driving mechanisms of obesity in juvenile diabetes include microbiome, epigenetics, genetics, enteroendocrine hormones, and effects on various organs, organelles, cells, and tissues.
  • Developing well-defined weight management approaches in people with juvenile diabetes requires a multi-disciplinary research strategy that includes expertise in endocrinology, epidemiology, translational metabolism, exercise physiology, clinical psychology, nutrition, advanced analytics, and mathematical modeling.

The impact of obesity and overweight on juvenile diabetesDiabetes bracelet

It is evident that more studies need to be conducted to understand the role of the whole activity spectrum which includes sedentary behavior, sleep, and physical activity on youth with type 1 diabetes who are obese or overweight.

For example, although research clearly shows that fear of hypoglycemia can be a barrier to engaging in physical activity, its effects can be compounded for young adults who are obese or overweight and have a negative activity toward exercise.Juvenile diabetes bracelet

  • Sedentary lifestyle

Youth with type 1 diabetes may also be predisposed to weight gain as a result of supplementing carbohydrates to avoid hypoglycemic events as a result of physical activity. Addressing the role of sedentary behavior, especially reducing screen time, is one intervention strategy that can help expend calories without affecting variability in blood sugar levels.

  • Poor sleep quality

Obesity and overweight may have negative effects on sleep, especially in youth with type 1 diabetes. A 2006 study on adolescents and children revealed that sleep duration has an inverse relationship with obesity in youth, and being overweight increases the risk of a wide range of sleep problems.

Studies show that variations in blood sugar and nocturnal hypoglycemia alter sleep patterns in young adults with type 1 diabetes and thus they face a higher risk for obesity and poor sleep quality than those without diabetes.

Diabetes educators and nurses play a very important role in helping children and adolescents develop appropriate lifestyle behaviors to tackle the prevalent issue of obesity and overweight in youth with type 1 diabetes.

Although clinical care in juvenile diabetes has focused more on accurate carbohydrate counting and good metabolic control, weight control has been grossly overlooked.

Caregivers and healthcare professionals have paid less attention to issues related to sedentary behavior, sleep, and physical activity.

Read about Smartphone Diabetes Management Apps!

The bottom line

Given the high incidence of obesity and overweight in children and youth with type 1 diabetes, additional studies are needed to explore the consequences and antecedents of excessive weight in type 1 diabetes.

Although this article has identified viable lifestyle modifications for weight management including sedentary behavior, sleep, and physical activity, there’s a need for further research to inform effective intervention strategies for this vulnerable population.

Check out the TOP 5 Diabetes Carb counter Apps HERE!

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Toddlers with Diabetes: Caring for the Littlest Patients

Type 1 diabetes usually occurs when the immune system, which is responsible for fighting toxins and other harmful organisms, attacks insulin-producing beta cells in the pancreas. The reasons behind this are not well understood but researchers believe that environmental factors (such as exposure to viruses) or genetics could be responsible for triggering this autoimmune response.

Warning Signs and Symptoms of Diabetes in Toddlers

It’s particularly important to understand that some of the signs of diabetes can be easily mistaken for normal daily-life occurrences, such as increased thirst on a warm or hot day. Therefore, if your toddler has any of the diabetes warning signs outlined below, it is vital to immediately contact your doctor, who can either diagnose or rule out diabetes.

  1. Dehydration or increased thirst

diabetes in toddlersExcess blood glucose draws fluid from cells and this causes dehydration or increased thirst. Although your child consuming more fluids could have a wide variety of natural causes, including being especially active or hot weather, it can also be a sign of diabetes or other conditions, especially if it is combined with other signs or is prolonged.

  1. Increased or frequent urination

You may notice that your child needs to use the bathroom more often or more frequently bedwetting. If your toddler is not potty-trained you may find that you have to change more diapers.

  1. Severe diaper rash

A more severe diaper rash can have several causes including a yeast infection or food allergy. However, it could also be a sign of diabetes especially if it does not respond to common treatment routines such as the use of barrier creams or more frequent diaper changes.

  1. Weight loss

Your toddler may lose appetite persistently resulting in weight loss or they may show an increased appetite and still lose weight. Loss of appetite tends to be the more common sign in toddlers.

  1. Persistent vomiting

If accompanied by weakness or drowsiness, persistent vomiting could be an early warning sign of diabetes in toddlers.

  1. Blurred vision

High amounts of glucose in the blood can draw fluids from the eye lenses, which can cause issues such as problems in focusing. For instance, if you notice that your child is unable to see properly, let your doctor know, as it is one of the most common signs of diabetes in toddlers.

  1. Unexplained fatigue or tiredness

Unexplained fatigue or tiredness without any reason may be a result of cells not getting enough blood sugar for energy.

Cuts and sores that take unusually long to heal are also common signs of diabetes.

Diagnosing diabetes in toddlers

If your doctor suspects diabetes, they may suggest tests to check your child’s blood sugar level. Some of the common tests performed on toddlers to help diagnose or rule out diabetes include:

  1. Random blood sugar test: A blood test done at any random time to determine blood glucose levels.
  2. Fasting blood sugar test: This test requires blood samples to be taken after fasting overnight.
  3. Glycated AIC (hemoglobin) blood test: This test helps determine the percentage of blood sugar attached to hemoglobin.
  4. Oral glucose tolerance test: The test is usually done when your doctor suspects type 2 diabetes.

Your doctor will explain the entire testing procedure and you can also interpret the results together.

Treating diabetes in toddlers

If your baby is diagnosed with diabetes, treatment and management can begin right away. Your healthcare provider can help you create a diabetes care team; including a dietitian, diabetes educator, and doctor. This team works closely with you to help monitor your child’s blood sugar level and maintain it within the recommended range.

Although diabetes does not have a cure, with consistent care and treatment, your toddler can go on to have a perfectly normal life. Diabetes treatment mainly depends on whether your toddler has been diagnosed with juvenile diabetes (type 1 diabetes) or type 2 diabetes. However, the treatment regimen may include:

  • Taking insulin: For toddlers with juvenile diabetes, life-long management of the condition with insulin is necessary. In some cases, indoor outdoor trampoline for toddlerstoddlers with type 2 diabetes may also require insulin. Although insulin is often administered as an injection, it can also be administered through pumps. Your doctor will guide you on how to use a pump or give injections, and when your child is old enough you and your doctor can show them how to it themselves.
  • Blood sugar monitoring: It is recommended that you check your child’s blood glucose levels regularly, at least 4 times a day to ensure they are within the recommended range.
  • Regular exercise; Ensure that your child gets at least 1 hour of physical activity each day. You can make it more interesting by getting involved and making it part of the family routine. You can do this in many different and exciting ways, For instance, you can take your family on hikes, play ball together, bounce around on an outdoor trampoline or play tag.
  • A healthy diet: Adopting a healthy diet and timing meals properly is a critical element of any diabetes treatment regimen. Your dietitian or healthcare provider will create a tailor-made meal plan for you to adhere to.
  • Medication: Toddlers with type 2 diabetes may be given medications like liraglutide (which stimulates the pancreas to make and release more insulin, especially after meals) or metformin (which helps reduce the amount of blood glucose released into the bloodstream by the liver).
  • Counting carbs: For toddlers with type 1 diabetes, your physician will explain how calories in food are counted in order to calculate your toddler’s dose accurately.

The bottom line

Diabetes typically requires lifestyle changes and consistent care that can be a challenge to explain and implement with toddlers. Despite being a life-long condition that requires keen attention and management, diabetes can be treated and support is available to help make sure patients remain healthy and productive throughout life.

If you have any questions about your child’s health or treatment plan, be sure to consult your healthcare provider.

Juvenile diabetes in toddlers

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