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What Causes Type 1 Diabetes In Children

What Else Should We Know

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Although children with diabetes must do some special things, this disease does not stop them from enjoying the things they love to do. They can continue playing sports, going out with friends, and traveling.

If your friends child has type 2 diabetes, tell him he can count on you. Friendship is about enjoying being together, not having perfect blood sugar levels!

What Are The Causes Of Diabetes In Children

The causes of diabetes are not yet fully understood. The lack of insulin production in children with type 1 diabetes is due to the fact that the immune system of those affected attacks the insulin-producing cells in the pancreas and these are eventually completely destroyed.

That is why this type of diabetes is also considered an autoimmune disease. This self-destruction is caused by genetic reasons. Infections such as mumps, measles, and rubella are suspected to be the trigger for this autoimmune disease. The possible connection between breastfeeding too short, but also between children who receive cows milk too early and foods that contain gluten, is also being investigated.

The cause of type 2 diabetes is still largely unknown. In addition to genetic factors, an unhealthy lifestyle also plays a role. Due to its later development, usually around the age of 40, it was also known as adult diabetes in the past. However, more and more children also develop type 2 diabetes.

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Mechanism That Triggers Type 1 Diabetes

When our body is attacked by viruses, the T-cells of the body produce antibodies which help to fight against these viruses. Now sometimes, these antibodies act against the beta cells when both these types have the same property. Beta cells are the ones which help the pancreas to produce insulin. The process takes a long time and is this mechanism that triggers the onset of type 1 diabetes in any person. The viruses which can affect and destroy the beta cells are the ones which have the same type of antigens as the virus which has attacked the body. These include German measles, Rotavirus, mumps, and others.

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What Triggers Type 1 Diabetes

When my type 1 diabetes was diagnosed in 1962, scientists couldnt explain the cause of the disease or what triggered it. Fifty-seven years later, Im still waiting for researchers to tell me precisely why my pancreas stopped making insulin and my blood sugar shot up so high that I needed to be hospitalized.

Still, while researchers continue to search for a full explanation of what causes T1D, theyve solved more than a few diabetes-related mysteries. Theyve identified specific risk factors and come up with evidenced-based theories about what triggers this disease.

Many of the scientific detectives trying to track down culprits for T1D are also trying to explain why it is surging: T1D is increasing at a rate of 5.3 percent globally every year, by one estimate. Read on to learn more about what we know and dont know about why.

How Can You Manage Diabetes

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The key to managing diabetes is to keep blood sugar levels in a target range. To do this, your child needs to take insulin, eat about the same amount of carbohydrate at each meal, and exercise. Part of your child’s daily routine also includes checking his or her blood sugar levels at certain times, as advised by your doctor.

The longer a person has diabetes, the more likely he or she is to have problems, such as diseases of the eyes, heart, blood vessels, nerves, and kidneys. For some reason, children seem protected from these problems during childhood. But if your child can control his or her blood sugar levels every day, it may help prevent problems later on.

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What Makes Yale Medicines Approach To Treating Type 1 Diabetes Unique

Yale Medicines childhood Diabetes Program is one of the few places in the world that is studying the use of automated systems for delivery of insulin. Called the artificial pancreas , its a system of devicesnamely an insulin pump and a continuous glucose sensorthat work together to automate insulin delivery, so its less burdensome and intrusive for patients.

The artificial pancreas was approved by the FDA in 2015.

Also in development are advanced systems that are specifically designed for young children, who at Yale Medicine are treated with a holistic approach that involves a team of dedicated professionals in several fields. That clinical mission, supported by the Yale Center for Clinical Investigation, is why Yale Medicine constantly ranks in the top nationally among hospitals for type 1 diabetes care.

Not only do we treat patients, but were on the cutting edge of research that will change the way we manage diabetes, Dr. Weinzimer says. What weve learned from our studies already is that these things remove a lot of the burden and worry from people and improve their quality of life.

Whats The Difference Between Type 1 And Type 2 Diabetes

Type 1 diabetes occurs when your pancreas is unable to produce enough insulin to effectively process your blood glucose. This can be solved by exogenous insulin through a pump, syringe, or pen.

Meanwhile, type 2 diabetes occurs as a result of an underlying condition called insulin resistance, which is the buildup of excess dietary fat in cells that are not meant to store fat.

Your body is still producing enough insulin, but because of insulin resistance, your blood glucose spikes. This condition can be reversed by lifestyle changes.

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What Symptoms Should You Watch For

Even when you are careful and do all the right things, your child can have problems with low or high blood sugar. Teach your child to look for signs of low and high blood sugar and to know what to do if this happens.

  • If your child has low blood sugar, he or she may sweat a lot and feel weak, shaky, or hungry. But your child’s symptoms may be different. Low blood sugar happens quickly. A person can get low blood sugar within minutes after exercise or after taking insulin without eating enough.
  • If your child has high blood sugar, he or she may be very thirsty or hungry, have to urinate more often than usual, or have blurry vision. High blood sugar usually develops slowly over hours or days.

Young children can’t tell if they have low blood sugar as well as adults can. Also, after your child has had diabetes for a long time, he or she may not notice low blood sugar symptoms anymore. This raises the chance that your child could have low blood sugar emergencies. If you are worried about your child’s blood sugar, do a home blood sugar test. Don’t rely on symptoms alone.

Both low and high blood sugar can cause problems and need to be treated. Your doctor will suggest how often your child’s blood sugar should be checked.

How Is Type 1 Diabetes Diagnosed In Children

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Type 1 diabetes typically manifests during two age ranges. The first is in young children between the ages of 4 and 7, and the second is in young adults between the age of 10 and 14.

Though children can transition healthily into adulthood with type 1 diabetes, its important to identify this condition when it first manifests to prevent late-term complications like diabetic ketoacidosis .

If your child develops any of the following symptoms, we recommend taking them in for a check-up with their pediatric care doctor.

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What Will It Be Like For Your Child To Live With Type 1 Diabetes

Your child can live a long, healthy life by learning to manage his or her diabetes. It will become a big part of your and your child’s life.

You play a major role in helping your child take charge of his or her diabetes care. Let your child do as much of the care as possible. At the same time, give your child the support and guidance he or she needs.

How Do You Diagnose Type 1 Diabetes In Children

The criteria for screening of Type 1 diabetes in children include:

Overweight – A Body Mass Index > 85th percentile for age and sex or weight for age, sex, and height > 85th percentile or weight > 120% of ideal height

In addition to any two of the following risk factors:

  • Family history of type 2 diabetes in first or second-degree relative
  • Signs of insulin resistance or conditions associated with insulin resistance, such as hyperpigmentation of the skin , hypertension, increased trigyceride levels, polycystic ovary syndrome
  • Early puberty – age for initiation of screening is onset of puberty or 10 years

The primary test used to diagnose type 1 diabetes in children:

  • Random Blood Sugar Test – A blood sample is taken at a random time. Blood sugar values are expressed in milligrams per deciliter or millimoles per liter . A random blood sugar level of 200 mg/dL or higher suggests diabetes.
  • Glycated Hemoglobin Test – This blood test indicates anaverage blood sugar level for the past 2-3 months. In this test the percentage of blood sugar attached to hemoglobin is measured. HbA 1c serves as a marker for average blood glucose levels over the previous three months before the last measurement as this is the lifespan of red blood cells. An A1C level of 6.5 percent or higher indicates diabetes.

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Occurrence In The United States

The overall annual incidence of diabetes mellitus is about 24.3 cases per 100,000 person-years. Although most new diabetes cases are type 1 , increasing numbers of older children are being diagnosed with type 2 diabetes mellitus, especially among minority groups .

A study by Mayer-Davis et al indicated that between 2002 and 2012, the incidence of type 1 and type 2 diabetes mellitus saw a significant rise among youths in the United States. According to the report, after the figures were adjusted for age, sex, and race or ethnic group, the incidence of type 1 and type 2 diabetes mellitus during this period underwent a relative annual increase of 1.8% and 4.8%, respectively. The greatest increases occurred among minority youths.

Managing Type 1 Diabetes In Toddlers And Children

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The most important part of managing type 1 diabetes with your child is finding a daily routine of glucose monitoring and insulin injections that works for both of you.

Building these habits early and consistently is crucial to ensuring that your child is able to maintain safe blood glucose levels , and can make what might initially seem like a hassle into a normal part of your daily routine.

There are a number of different options for blood glucose monitoring and daily injections to prevent hyperglycemia as well as hypoglycemia.

For example, insulin pumps and continuous glucose monitoring devices have become increasingly popular, in some cases replacing the older methods of daily injections like fingersticks and an insulin syringe.

Every patient with diabetes is different, so you can work with your medical care team to figure out a strategy that works for you, and adjust as needed.

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Can Diabetes Be Prevented Or Cured

Currently, diabetes has no cure. But many researchers around the world are working hard to develop one.

Type 1 diabetes can be managed by insulin injections. If blood glucose is kept under control, then the complications of diabetes are less likely.

Better therapies are being developed, such as insulin pumps with continuous glucose monitors that check blood glucose every few minutes automatically. A new development is a combination continuous monitor and insulin pump. It adjusts the pump automatically to give insulin and keep the blood glucose level as close to normal as possible.

Insulin is produced by beta cells in the pancreas, and beta cell transplants are used in certain patients. These transplants can keep the glucose level more normal without taking insulin. There are risks associated with beta cell transplants. They are not for everyone yet.

Diabetes Calculator for Kids

The Diabetes Calculator for Kids is an electronic tool that calculates rapid acting insulin bolus dosage in 5 easy steps. Each chart is customized based on the child’s personal input and information that is generally provided by a doctor or diabetes educator.

How Will Your Child’s Treatment Change Over Time

Your child’s insulin dose and possibly the types of insulin may change over time. The way your child takes insulin also may change. This is especially true during the teen years when your child grows and changes a lot.

What and how much food your child needs will also change over the years. But it will always be important to eat about the same amount of carbohydrate at each meal. Carbohydrate is the nutrient that most affects blood sugar.

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What Are The Causes And Risk Factors Of Type 1 Diabetes In Children

The exact cause of juvenile diabetes is unknown but researchers have so far identified two main factors:

  • GeneticsType 1 diabetes in children is perceived as a chronic immune-mediated disease. It results from an autoimmune destruction of insulin-secreting pancreatic cells. The scientists suggest that the HLA genes explain approximately one-half of the genetic susceptibility for this disease.
  • Environmental Triggers– Studies suggest that environmental stresses increase insulin demand, thereby overloading islet cells and accelerating -cell damage.
    • Viral infections have also been implicated in the etiology of T1D. Enteroviruses, rotavirus or other either may have a cytotoxic effect or trigger an autoimmune process leading gradually to -cell destruction.
    • Dietary Factors– Early introduction of cow’s milk proteins has been found to be a subsequent risk of -cell autoimmunity and clinical disease. The American report also suggests that both early and late exposure to cereals is associated with an increased risk of -cell autoimmunity. According to a Diabetes Prediction and Prevention project study, early introduction of fruits and berries as well as of roots is associated with increased risk for advanced -cell autoimmunity.

The risks of acquiring type 1 diabetes are –

  • Being a child
  • Having a parent or sibling with the same
  • Exhibiting certain genes

Genes And Family History

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Several specific genetic markers have been identified, and if you have one or more of them, you might develop T1D. Since genes are inherited, family history is an important predictor for T1D. If you have a relative with T1D, your risk of developing it is 1 in 20.

of people with these genetic markers develop T1D. So its clear that other factors besides genes put people at higher risk for developing the disease.

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Young People And Diabetes

Although it can be diagnosed later in life too, type 1 diabetes is the most common form of diabetes found in children. We know that this can mean you have to make changes to how you and your family live your life, but were here to help.

Whether youre a parent in need of advice about schools and caring for a child with type 1, or a young adult looking for information about going to university and becoming more independent, weve got a range of resources to help you understand more about diabetes and how to manage it.

Treatment For High Blood Sugar Emergency

If your child does not take enough insulin, has a severe infection or other illness, or becomes severely dehydrated, his or her blood sugar level may rise very high and lead to diabetic ketoacidosis. Diabetic ketoacidosis is almost always treated in a hospital, often in the intensive care unit, where caregivers can watch your child closely and give him or her frequent blood tests for glucose and electrolytes. Insulin is given through a vein to bring blood sugar levels down. Fluids are given through the IV to correct the electrolyte imbalance. Your child may stay in the hospital for a few days until blood sugar levels are back in the target range and electrolytes have normalized.

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Heres How Type 1 And Type 2 Diabetes Differ

Sugar is an important source of energy for our body and is burned or stored in cells, depending on current need. We need insulin so that the sugar from the blood can enter the cells.

Type 1 diabetics produce too little insulin, which leads to a breakdown in sugar breakdown. At second variant of diabetes, patients initially produce enough insulin. The disease only develops over time. Insulin resistance developswhich is promoted by an unhealthy lifestyle combined with a high energy diet, lack of exercise, and obesity.

What You Should Know About Diabetes

What Tests Are Used To Diagnose Diabetes In Children

Type 1 diabetes in children Symptoms and causes

Your child should be tested for diabetes if they have symptoms of diabetes, or if you think they may be at risk for developing diabetes. Your doctor can diagnose diabetes using the following tests:

  • A glucometer: A hand-held device that tests your blood sugar levels using a small drop of blood from the tip of the finger.
  • A urine sample: A simple urine collection that your doctor will use to test for the presence of sugar in the urine.
  • For type 1 diabetes, it’s important to evaluate the acid levels in blood and urine.
  • An oral glucose tolerance test : A test that’s similar to what doctors do to test for diabetes during pregnancy that tests for type 2 diabetes.
  • Hemoglobin A1c: This blood test looks for chronic elevations in blood sugar in kids with type 1 or type 2 diabetes.
  • If your child does not yet have signs or symptoms, but you have concerns for increased risk for type 1 diabetes due to a family history or the presence of other autoimmune conditions like celiac or Addison disease, diabetes antibody testing and genetic risk testing can be done.

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