When people here the word "diabetes," the majority automatically envision older individuals, possibly overweight, who are periodically pricking their fingers to test their blood sugar levels or popping a quick piece of candy when they feel their blood sugar levels getting low. What many people don't realize is that there are actually two types of diabetes and one effects people from infancy to their late thirties.

According to the National Institutes of Health (NIH), juvenile diabetes or type 1 diabetes in American children and adolescents is on the increase. The Juvenile Diabetes Research Foundation International (JDRF) adds that of the estimated 30,000 Americans diagnosed with type 1 diabetes each year, over 13,000 are children. More simply stated, one child is diagnosed with type 1 diabetes each and every hour. While type 1 diabetes accounts for only 5 to 10 percent of the diagnosed cases of diabetes, it is the leading cause of diabetes in children.

The NIH defines diabetes as a chronic disease in which the body does not make or properly use insulin (a hormone necessary in the process of converting glucose-sugar-and other food into energy for the body to use). Those with diabetes have increased levels of blood glucose due to a lack of insulin in their body or, in the case of insulin resistance, they fail to respond to the effects of insulin. This lack of insulin in the body causes high concentrations of glucose to accumulate in the blood, which then leaves the body in the urine. The result—the body loses its source of fuel.

There are two types of diabetes, type 1 and type 2. Type 2 diabetes typically occurs in adults who are overweight and over the age of 40. Type 1 diabetes, which will be our focus, may occur at any age but occurs most often in children and adolescents. Type 1 diabetes is classified as an autoimmune disease where the immune system destroys beta cells (the cells that are responsible for producing the insulin that regulates blood glucose) in the pancreas. With no insulin present, the sugar in the blood cannot be used for energy. People with type 1 diabetes must take injections of insulin daily to stay alive. The JDRF notes that knowing and recognizing the warning signs of type 1 diabetes can save a child's life. Warning signs (which can occur suddenly) include:

• Drowsiness, lethargy
• Extreme thirst
• Frequent urination
• Fruity, sweet, or wine-like odor on the breath
• Heavy, labored breathing
• Increased appetite
• Stupor, unconsciousness
• Sudden vision changes
• Sudden weight loss
• Sugar in urine

The JDRF adds that if your child shows any one of these symptoms, you should call your family physician immediately. Being aware of the symptoms of type 1 diabetes is vital since many of the symptoms can be mistaken for more common illnesses such as the flu.

Treatment for type 1 diabetes centers on doing things to keep the blood sugar level as close as possible to normal levels. Controlling those levels is done through careful self-monitoring of blood glucose and controlling the variables of food, exercise, and insulin. Even when type 1 diabetes is controlled, there are situations when one of the variables gets out of line. When the proper balance for an individual is thrown off, two emergency conditions may occur—hypoglycemia or hyperglycemia. Hypoglycemia (low blood sugar) is also referred to as an insulin reaction or insulin shock and may be caused by not eating enough food, not eating soon enough after a previous meal, engaging in physical activity without eating, or too much insulin. The JDRF notes the following symptoms of hypoglycemia:

• Blurred vision
• Cold and clammy skin
• Extreme hunger
• Fatigue/tiredness
• Headache
• Inability to concentrate
• Loss of consciousness
• Loss of coordination
• Mental confusion
• Pale, moist skin
• Rapid pulse rate
• Seizure
• Shakiness
• Shallow breathing
• Weakness/dizziness

• Blurred vision
• Frequent urination
• Increased thirst
• Loss of appetite
• Weakness or fatigue

Although type 1 diabetes is a serious disease, it can be managed and controlled. The NIH recommends that maintenance plans should include; checking blood glucose levels regularly, following a healthy meal plan (learning how carbohydrates such as bread and pasta can affect blood glucose levels), getting regular physical activity, and taking diabetes medications as prescribed.

As with any illness, recognizing the symptoms and getting an accurate diagnosis quickly is a key to successful treatment. Educate yourself about the symptoms of type 1 diabetes for the health of your own child as well as any others you may observe on a regular basis (since you'll be one of the first to see something that might be out of the ordinary). Your keen eye may help save a child's life.

As with any health related issues, consult with your family physician or health care provider concerning any questions or health issues present in your family.

Sources:
Juvenile Diabetes Research Foundation International—www.jdrf.org
National Institutes of Health—www.ndep.nih.gov/diabetes

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