November marks the observance of National Diabetes Month, a time to raise awareness about diabetes, including its prevention, management, and the effects of this increasingly prevalent autoimmune disease. Type 1 diabetes, often referred to as juvenile diabetes, is a significant chronic condition affecting children and adolescents, and it currently has no known cure.
Type 1 diabetes occurs when the body fails to produce enough of the hormone insulin, which is essential for converting food into energy. Insulin facilitates the movement of glucose—derived from food—from the bloodstream into cells where it is utilized for energy. This process typically occurs in specialized cells known as beta cells located in the pancreas. In cases of type 1 diabetes, however, the immune system erroneously attacks and destroys these beta cells, preventing insulin production. Consequently, glucose remains trapped in the bloodstream, leading to elevated blood sugar levels, or hyperglycemia, which can inflict damage on the body.
Without sufficient insulin, the body resorts to breaking down stored fat for energy, resulting in the production of ketones. While ketones can provide an alternative energy source, they are acidic and can be harmful when present in high concentrations. Symptoms of type 1 diabetes are predominantly linked to the body’s inability to utilize glucose effectively, leading to a range of signs including increased thirst, frequent urination, extreme hunger, and often unintended weight loss. Other symptoms such as headaches, irritability, and blurred vision may also arise when blood sugar levels reach critical highs.
Immediate medical attention is essential if a child exhibits symptoms of a diabetic emergency, which may include nausea, vomiting, abdominal pain, rapid breathing, a distinctive fruity odor on the breath, and drowsiness or loss of consciousness. These symptoms can sometimes mimic those of the flu, making it critical for parents to seek medical evaluation if their child displays flu-like symptoms alongside increased thirst and urination.
Diagnosis of type 1 diabetes typically occurs when a child presents with classic symptoms and elevated blood sugar levels. The diagnosis may also involve a test called hemoglobin A1c (HbA1c), which reflects average blood sugar levels over the past three months. Alternatively, an oral glucose tolerance test (OGTT) can measure blood sugar before and after consuming a sugary drink.
To determine whether a child has type 1 or type 2 diabetes, healthcare providers consider various factors including age and the presence of autoantibodies in the bloodstream. The presence of these proteins indicates an immune response against the beta cells, signifying type 1 diabetes.
Managing type 1 diabetes involves normalizing blood sugar levels, a task that requires meticulous monitoring. Blood glucose can be tracked using a blood glucose meter or a continuous glucose monitor (CGM), which provides real-time glucose readings. Insulin therapy is vital and can be administered through multiple daily injections using pens or syringes, or via an insulin pump that delivers insulin through a small tube under the skin.
Diet plays a crucial role in managing diabetes. Insulin doses must align with carbohydrate intake, and physical activity is essential for maintaining healthy blood sugar levels. Some insulin pumps are equipped with features that adjust insulin delivery during exercise and sleep, helping to prevent hypoglycemia.
For those seeking advanced options, an automated insulin delivery system (AID), often referred to as an “artificial pancreas,” offers a solution. This system allows the insulin pump and CGM to communicate, adjusting insulin levels based on real-time glucose data.
If parents suspect their child may have symptoms of type 1 diabetes, prompt consultation with a pediatrician is essential. A healthcare professional can accurately assess blood sugar levels and initiate treatment if necessary. Though advances in screening now allow for the assessment of type 1 diabetes risk before symptoms manifest, it is crucial to seek professional medical advice rather than relying on home testing devices.
While type 1 diabetes cannot be completely prevented, emerging medications show promise in delaying its onset for some individuals at high risk. For those displaying early signs of blood sugar irregularities, an FDA-approved medication can delay progression to full-blown type 1 diabetes by an average of two years.
Healthcare professionals such as Chineze Ebo, MD, FAAP, a Pediatric Endocrinology fellow at Cincinnati Children’s Hospital Medical Center, and Brittany S. Bruggeman, MD, FAAP, a pediatric endocrinologist at the University of Florida, emphasize the importance of early recognition and intervention. As awareness grows, parents are encouraged to stay informed about type 1 diabetes to better support their children’s health.