The Basics on Diabetes
It’s important to know the facts and myths about diabetes. This chronic disease affects all ages and can have very subtle symptoms.
By Angela E. Thomas
Of the more than 29 million Americans living with diabetes, about 208,000 are youth, 20 years and younger.
The physicians at Arkansas Children’s Hospital (ACH) estimate that about 1,000 children in Arkansas are living with diabetes. Dr. Jon Oden, a pediatric endocrinologist and chief of endocrinology at the hospital, said the prevalence of children being diagnosed with the disease has increased by 10 percent every decade.
There are two types of diabetes: type 1 and type 2. Our bodies break down the sugars and starches we eat into a simple sugar called glucose, which is then used for energy. Insulin is the hormone that our bodies use to move glucose from the bloodstream into the body. According to the American Diabetes Association, in type 1 diabetes, the body does not produce insulin. In individuals who have type 2 diabetes, the most common form, the body does not use the insulin properly which is referred to as being insulin resistant.
“Children with type 1 diabetes are diagnosed at an average age of 6 to 7 or later at age 14 or so. Children with type 2, in mid-adolescence,” Oden said. “We diagnose 14 or 15 new cases per month of children with both types.” He’s diagnosed infants as young as 10 to 15 months.
“The underlying cause of type 1 diabetes isn’t known; however, we do know that people with this form produce antibodies that ‘fight’ against specific cells, called beta cells. These beta cells are destroyed over months or years, so individuals eventually become unable to make insulin. We do not know where these antibodies originate, but they are located in the pancreas.”
It’s important to understand, Oden said, that diabetes is a lifelong disease. “The antibodies may be around for years and slowly become active,” he said.
Oden said they’ve seen several children who have been identified as high-risk. A child whose parents or siblings have diabetes is at risk. Parents will also bring their children in because they’ve noticed behavioral changes, such as bedwetting or unusual fatigue. These as well as weight loss and abnormal thirst and frequent urination can be symptoms of type 1 diabetes.
“Occasionally, we’ll see children whose blood sugars are higher than normal. So, we watch them over months and years as a part of a research program through the Juvenile Diabetes Research Foundation.”
About a quarter of the children who come into ACH are diagnosed with type 2 diabetes. “We have also seen a rise in the number of children with type 2 diabetes, which is concerning to our population,” Oden said.
The public associates type 2 diabetes with obesity; however, Oden said they see a number of patients who are only a little overweight.
“Certain populations are at a higher risk. Type 2 diabetes is a bit different. Half of the patients have no symptoms. Still others are picked up because they’re part of our weight maintenance program. And some come in due to an emergency or because they’ve gone in for physical exams.”
No matter the type of diabetes, patients are treated with insulin. Often type 1 patients begin with insulin shots and later move to an insulin pump, Oden said.
“The pump provides some semblance of convenience, and some patients’ families feel the pump provides better control,” he said. “Other children prefer shots because they’re not comfortable with being ‘attached’ to a machine.
Managing diabetes is a 24-hour task as children must test their blood sugar several times per days, especially before eating when they must also count carbohydrates, and take six or more injections daily depending on their activity levels.
Oden said it’s important that parents know there is nothing they could have done to prevent their children from become diabetic.
“Parents often have an undertone of guilt. You cannot get diabetes because you’re eating too much sugar or too many carbohydrates. Children may become type 2 diabetics due to genetics or weight gain, but I must emphatically say: it’s not about diet or exercise. There is nothing parents can do to stop it.”
They can, however, find assistance through one of the hospital’s resources. ACH has several classes to educate children and their parents in the management of their diabetes. There are one-on-one classes for those with type 2 and group classes for those with type 1.