What is diabetes?

Type-1 vs. Type-2 Diabetes

Diabetes is an illness that causes the body to not make enough insulin (Type-1 diabetes) or not utilize insulin efficiently (Type-2 diabetes). Here are the most important points parents should know about preventing the disease and treating the child with diabetes.

Type-1 Diabetes

Type-1 diabetes (which used to be called juvenile or insulin-dependent diabetes) can start anytime in infancy or childhood. Unlike in diabetes in adults and Type-2 diabetes, which can come on very gradually, in Type-1 diabetes in children the pancreas suddenly stops producing insulin, causing the child to get very sick very fast (over just a few days).

Signs and Symptoms

Child urinates frequently. In order to flush out the high blood sugar that’s accumulating in your child’s bloodstream, the kidneys produce more urine. This is often one of the earliest signs of diabetes.

Child often complains of thirst. Because the child is urinating so much and losing so much fluid, she will often complain of being very thirsty.

Dehydration and weight loss. Losing a lot of fluid very fast causes the child to get tired, lethargic, and dehydrated, with dry mouth, dry eyes, and dry skin, and to quickly lose weight.

Rapid breathing. The high blood sugar causes chemicals called ketones to build up in the blood, which, in turn, cause the child to breathe fast. You may even smell the ketones on his “fruity” breath.

Treatment

Once your pediatrician examines your child and puts all these clue together, your child will be hospitalized immediately, rehydrated with intravenous fluids, and given insulin to bring down the high blood glucose. This biochemical state is called diabetic ketoacidosis, and it is a medical emergency that doctors are trained to recognize right away. In an otherwise well or slightly ill child, you wouldn’t need to wonder whether he had diabetes. Because these symptoms occur so quickly, over a matter of days, you are unlikely to miss it.

Type-2 Diabetes

Unlike Type-1 diabetes, which is a genetic or immunologic non-preventable disease, Type-2 diabetes is nearly always due to preventable unhealthy lifestyle and nutrition habits. With Type-2 diabetes, the child’s pancreas still produces insulin, but because of a metabolic quirk the cells become resistant to the effects of insulin, which is why this type of diabetes is called insulin-resistant diabetes. There are millions of microscopic “doors” on each cell of the body, and insulin acts like a “doorman” to usher just the right amount of sugar into the cells for energy. In this type of diabetes, these “doors” don’t open efficiently, preventing insulin from doing its job. It could also be called an insulin inefficiency. 

Signs and Symptoms

Unlike those with Type-1 diabetes, most children with Type-2 diabetes don’t look or act very sick. Some may urinate a bit more frequently and be a bit more thirsty. (Drinking a lot of liquids in an otherwise well child is seldom a sign of diabetes, even though pediatricians frequently get the question, “He drinks a lot. Could he have diabetes?”)

The most common clue that your child may be pre-diabetic is a large waist size. Excess abdominal fat, also dubbed pre-diabetic fat, increases the risk of developing Type-2 diabetes because this excess fat churns out biochemicals that interfere with the action of insulin.

If your doctor suspects pre-diabetes, he may order blood tests, such as blood sugar, blood cholesterol, and a general lipid panel. Children, especially teens, with Type-2 diabetes are often more prone to develop the “highs” – high blood pressure, high blood sugar, high blood cholesterol – a cluster of biochemical problems known as the metabolic syndrome. 

Causes

The two most common causes of Type-2 diabetes are eating junk food and sitting too much. In fact, the epidemic of junk-food eating and too much sitting has led the Centers for Disease Control (CDC) (the government think-tank that predicts health trends) to issue a shocking prediction that unless American families change their eating habits and lifestyle, one in three children is destined to later become diabetic. This dire prediction refers to Type-2 diabetes.

Risk Factors

Genetic risk. Some cultures have a higher risk of developing Type-2 diabetes, including African Americans, Native Americans, Hispanics, and Pacific Islanders.

Obesity. The good news is that obesity is preventable. Because the risk of obese children developing Type-2 diabetes is climbing higher and higher, most pediatricians now describe obese children as pre-diabetic.

Look for the following risk factors in your child:

  • eats a lot of fast food and packaged foods
  • drinks a lot of sweetened beverages
  • has increasing waist size and extra abdominal fat
  • has a large, stocky body type
  • has a family history of diabetes, or one or both parents have a large body type
  • craves sweets and other refined carbs

Prevention

Here are the top 5 ways to prevent Type-2 diabetes:

  1. Follow Traffic Light Eating
  2. Avoid sweetened beverages.
  3. Avoid foods with high-fructose corn syrup.
  4. Follow the rule of two’s: eat twice as often, half as much, and chew twice as long. Grazers have steadier levels of blood sugar.
  5. Get lots of exercise. Children who move a lot tend to put on less excess abdominal fat. A lean waist is one of the top preventative medicines for Type-2 diabetes.