Diabetes is one of the more common chronic diseases experienced by children and adolescents, approximately 151,000 people under the age of 20 in America have a form of diabetes.
Diabetes - Usually a lifelong (chronic) disease in which there are high levels of sugar in the blood. Diabetes can be caused by too little insulin, resistance to insulin, or both. People with diabetes have high blood sugar because their body cannot move sugar into fat, liver, and muscle cells to be stored for energy. There are two major types of diabetes.
The causes and risk factors are different for each type:
Type 1 diabetes - Can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown.
Type 2 diabetes - Makes up most diabetes cases. It most often occurs in adulthood. However, because of high obesity rates, teens and young adults are now being diagnosed with it. Many people with type 2 diabetes do not know they have it.
When diabetes is experienced during childhood it is often times assumed to be type 1 or, 'Juvenile-onset Diabetes.' In the last 20 years however, type 2 diabetes, formerly referred to as, 'Adult-onset Diabetes,' has been reported in American children and teenagers at an increasing rate. Studies performed in Europe revealed an increase in the frequency of type 1 diabetes, particularly among young children. What remains unclear is whether the frequency of type 1 diabetes is also increasing among American children.
Every single year in America, more than 13,000 young people are diagnosed with type 1 diabetes. Type 2 diabetes starts when a person's body develops a resistance to insulin and no longer uses it appropriately. As a person's need for insulin rises, their pancreas slowly loses its ability to produce enough amounts of insulin to regulate the levels of sugar in their blood.
Health care providers are finding an increasing number of children who experience type 2 diabetes, a disease more commonly diagnosed in adults over the age of 40. There has also been a significant increase in the prevalence of type 2 diabetes among children and teenagers found only in Native Americans. The epidemics of obesity and the low levels of physical activity among children, as well as exposure to diabetes while in the womb, might be major contributors to the increase in type 2 diabetes during childhood and a person's teenage years.
Type 2 diabetes in children and teenagers is already a sizable and growing issue in America. Increased doctor awareness, as well as monitoring of the magnitude of the disease, are needed. The standard guidelines for treatment and approval of oral hypoglycemic agents to lower a person's blood sugar are greatly needed for children and teenagers. Children and teenagers who have been diagnosed with type 2 diabetes are often between the ages of 10 and 19, are obese, and have a strong family history of type 2 diabetes - as well as insulin resistance. In general, children and teenagers with type 2 diabetes have poor glycemic control, meaning A1C levels of between 10-12%
People who are affected by type 2 diabetes belong to every ethnic group, although it is more commonly found among non-white populations. Native American children experience the highest prevalence of type 2 diabetes unfortunately. In the population of people between the ages of 15-19 years of age, the prevalence of type 2 diabetes includes:
By comparison, the prevalence per 1000 people of type 1 diabetes among United States residents between the ages of 0 and 19 years is 1.7 per 1000.
A referral center in Cincinnati, Ohio found an incidence of type 2 diabetes of 7.2 per 1,000 among African Americans and White Americans between the ages of 10 and 19 years. In comparison, the national incidence of type 1 diabetes among people between the ages of 10 and 19 years is 19 per 100,000 people. The majority of case reports in America found that type 2 diabetes accounted for between 8% and 46% of all new people who experience diabetes, both type 1 and type 2, who were referred to pediatric centers. The magnitude of type 2 diabetes on the population is most likely underestimated.
Signs and Symptoms of Diabetes in Children
The signs and symptoms of type 1 diabetes in children often develop rapidly and over a period of weeks. There are a number of signs and symptoms parents need to look for. The signs and symptoms can include the following:
Fatigue: If a child's cells are being deprived of sugar, they might become tired or lethargic.
Irritability or Unusual Behavior: Children who experience undiagnosed type 1 diabetes might suddenly appear irritable or moody.
Yeast Infection: Girls with type 1 diabetes might experience a genital yeast infection. Babies may develop diaper rash caused by yeast.
Blurred Vision: If a child's blood sugar is too high, fluid can be pulled from the lenses in their eyes. What this means is their ability to focus clearly can be affected.
Hunger Extremes: Without enough insulin to move sugar in a child's cells, their muscles and organs become depleted of energy - something that can trigger intense hunger.
An Increase in Thirst and Frequent Urination: As sugar builds up in a child's bloodstream, fluid is pulled from their tissues and has the potential to leave a child feeling thirsty. Due to this process, a child might drink and urinate more than they usually would.
Weight Loss: Even though a child with diabetes may eat more than usual in order to relieve the hunger they feel, they can also lose weight, at times rather quickly. Without the energy that sugar supplies them, their fat stores and muscle tissues shrink. Unexplained loss of weight is many times the first sign a parent will notice.
The Difficulty of Detecting the Prevalence of Type 2 Diabetes in Children
The reason it is hard to detect type 2 diabetes in children is because it may remain undiagnosed for an extended period of time. Children might not present with any symptoms at all, or mild ones related to diabetes and blood testing is required to achieve a diagnosis. It is hard to be sure it is type 2 diabetes because the criteria for differentiating between types of diabetes in children are confusing.
Children with type 2 diabetes may develop, 'ketoacidosis,' or acid buildup in their blood. Children with type 1 diabetes may be overweight and the overall prevalence of diabetes might still be low. What this means is that scientists will have to sample a rather large population of children to find a stable estimate of prevalence. It is important for parents to speak with their child's doctor if they notice any of the signs or symptoms of type 1 diabetes in their child such as extreme hunger, and increase in thirst or urination, blurred vision, weight loss, or fatigue.