Diabetes

Evidence 

https://pubmed.ncbi.nlm.nih.gov/36526322/ 

Ann Carrigan, Rebecca Lake, Sophia Zoungas, Tony Huynh, Jennifer Couper, Elizabeth Davis, Timothy Jones, David Bloom, Jeffrey Braithwaite, Yvonne Zurynski  

Type 1 diabetes (T1D) is a chronic and incurable autoimmune disease, diagnosed in early childhood and managed initially in paediatric healthcare services. In many countries, including Australia, national audit data suggest that management and care of T1D, and consequently glycaemic control, are consistently poor. This can lead to adverse outcomes such as cardiovascular disease and nephropathy. T1D treatment is complex, multidisciplinary, multiagency, and life-long and should involve patient-centred, developmentally appropriate care. Although an emerging body of literature describes T1D models of care, their components, implementation determinants and associated outcomes are poorly understood. 

https://www.racgp.org.au/afp/2016/june/type-2-diabetes-mellitus-in-children-and-adolescents 

Kung-Ting Kao, Matthew A Sabin  

T2DM in children and adolescents is a serious medical concern that is more aggressive than the adult-onset form, more challenging to diagnose, and has limited available treatment options. It is also associated with high rates of complications related to diabetes and obesity. 

A family-based approach is required to comprehensively address all medical, lifestyle and psychosocial aspects of care, as well as involvement of specific services such as paediatrics, diabetes education, nutrition, psychology and social work as a multidisciplinary team so as to streamline their care to maximise compliance and optimise outcomes. 

Education 

Diabetes is a condition in which a child's body no longer produces an important hormone known as insulin that controls the glucose (sugar) in the blood. Diabetes can be diagnosed at any point in a child’s life or indeed in adult life. There are two main types of diabetes, type 1 diabetes and type 2 diabetes which are different conditions, however they both change the body’s use of insulin.  

Type 1 diabetes in children happens when the pancreas is unable to produce insulin. Without this insulin, the sugar cannot travel from the blood into the cells and blood sugar levels rise, a child needs insulin to survive, therefore the missing insulin needs to be replaced. Type 1 diabetes is often diagnosed during childhood or during the teen years, although it can start at any age.  

Some symptoms to look out for if your child may have Type 1 diabetes are: 

• increased thirst   

• frequent urination, possible bedwetting  

• irritability or changes in behaviour  

• blurred vision  

• extreme hunger  

• unexplained weight loss  

• tiredness  

• fruity smell breath  

• possible yeast infection  

These symptoms can develop quickly over a few weeks. Children will usually have four main symptoms, but many children will have only one or two or sometimes no signs at all.  

The treatment for type 1 diabetes currently requires insulin use for life. The amount of insulin used needs to be balanced against the carbohydrates eaten, any physical activity and the blood glucose level at any one time as shown from blood sugar monitoring.  

Type 2 diabetes is not as common in young children, but it occurs when insulin is not working properly and the body becomes used to it or if the pancreas stops making enough. It affects the way the body processes the sugar, if untreated this causes the sugar to build up in the bloodstream instead of fuelling the cells that make up muscle and tissue.  

Some symptoms to look out for if your child may have Type 2 diabetes are: 

• urinating more often, particularly at night  

• increased thirst  

• tiredness  

• unexplained weight loss  

• possible yeast infection around the genitals  

• cuts and wounds slow to heal.  

• blurred vision due to dry eyes  

Generally, type 2 diabetes symptoms develop slowly and may take months or years to diagnose. It is typically more common in adults. When diagnosed in children it is generally associated with obesity, therefore as the rate of obesity in children increases, type 2 diabetes in children increases as well.  

Type 2 diabetes can be managed with a change in diet, increase in exercise and maintaining a healthy weight, medication may also be needed. Without treatment, type 2 diabetes progresses faster in young people than in adults and often leads to diabetes complications.  

Children who develop diabetes have an increased risk of health challenges later in life, some of these may be: 

• heart and blood vessel disease including high blood pressure, high cholesterol, heart disease and stroke 

• kidney damage 

• eye damage 

• nerve damage  

• osteoporosis 

Empowerment  

Recognising the possible signs and symptoms can enable a child to be tested early and receive an early diagnosis. Even though there is no cure for type 1 diabetes, it can be effectively managed due to the developments in blood sugar monitoring and administering insulin, as a result the management and quality of life for diagnosed children has improved.  

A child being diagnosed with diabetes can be a frightening and overwhelming experience, especially at first. When the child is young, parents and caregivers must learn how to monitor blood sugar levels, count carbohydrates, and administer injections. Depending on the child’s age, with time and experience the child will be able to take on a more active role.  

Useful Links  

Special thanks to Diabetes Australia for content sharing and providing support for families.  

https://www.diabetesaustralia.com.au/kids-and-teens/ 

The Kids Research Institute  

https://www.thekids.org.au/our-research/research-topics/diabetes-type-1/ 

The Royal Children’s Hospital, Victoria 

https://www.rch.org.au/kidsinfo/fact_sheets/Diabetes_/ 

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