13 November 2018
Diabetes, whatever the type, is a serious long-term condition which requires careful medical and lifestyle management. This year, the theme of World Diabetes Day (14th November), is the family and diabetes. So I will be discussing childhood diabetes in this blog.
Before we dive into the specifics of childhood diabetes, a bit of a foundation of what diabetes actually is!
What is Diabetes?
Diabetes is a complex health condition which affects the entire body. It is characterised by the body’s inability to manage the level of glucose in the blood, due to a problem with the hormone, insulin, which is produced by our pancreas.
When our blood glucose remains too high, for too long, it can cause complications throughout the body which can affect the eyes, nerves in the feet and hands, kidney function as well as the major blood vessels of the heart.
Which is why, getting a diagnosis early and learning how to manage your condition whilst also enjoying your life is so important!
Type 1 Diabetes
Type 1 Diabetes, previously known as insulin-dependent diabetes, affects over 6,000 children aged 0-14 years in Australia (statistic from 2013), with multiple new cases being diagnosed daily across the country!
Type 1 Diabetes is an autoimmune condition, meaning something has gone wrong with the immune system and it is now attacking its own cells, in this case the cells in the pancreas that produce insulin. Therefore, for people living with type 1 Diabetes, injecting insulin is essential for life! Insulin not only helps lower our blood glucose which rises after we eat a meal (for example), it is also essential for every single cell just to survive.
Diagnosis of Type 1 Diabetes
Type 1 Diabetes is most commonly diagnosed in childhood, from the toddler years, through to adolescence, with some infrequent occasions of diagnosis in adulthood. If you’re a parent, it is important to be aware of the 4 Ts that may indicate Type 1 Diabetes:
Toilet – excessive urination
Thirst – excessive thirst
Thinness – recent weight loss
Tired – fatigue
If you notice these symptoms, get to your nearest doctor for immediate medical attention.
Managing Type 1 Diabetes in children
Although there is no cure for Type 1 Diabetes, it can be managed in the long-term with multiple daily insulin injections or an insulin pump, blood glucose monitoring and a healthful diet, regular exercise and adequate sleep each night.
Research has suggested that families with young children with Type 1 Diabetes may be more likely to experience mealtime stress due to the unpredictability of feeding a young child and subsequently difficulty managing their insulin and blood glucose levels.
Alongside your GP, endocrinologist and diabetes educator, a dietitian is critical to helping you and your family navigate the world of optimal nutrition for Type 1 Diabetes, which may include education about carbohydrates and learning how to carbohydrate count to dose insulin appropriately and prevent dangerously high or low blood glucose levels.
A dietitian can also help with managing food around exercise and assisting in balancing the medical need for food in the presence of insulin in the blood or with a low blood glucose level and the association of food for reward which can create issues in the long-term for a child’s relationship with food
Type 2 Diabetes
Type 2 Diabetes is also known as “lifestyle-acquired” diabetes, and is caused by insulin resistance. So there is not a deficiency in insulin, it is just the body’s insulin receptors are no longer sensitive to it, causing the blood glucose to be trapped in the blood instead of entering the cells.
Whilst Type 2 Diabetes is not as common in children and teenagers, it can still occur amongst children who have grown too fast. Family history is also a common factor that plays into the risk of developing Type 2 Diabetes.
Diet, exercise, sleep and screen time all play an important role in helping to manage Type 2 Diabetes and reduce any medical risks to children in the long-term. Dietitians help to families create healthy behaviours not restrictive diets to help their child manage their conditions within the unique context of their family.
The third form of diabetes is known as gestational diabetes, which only occurs during pregnancy, and will disappear following the delivery of the placenta.
Diabetes & Mental Health
Whilst most people think of physical health concerns when we say the word “diabetes”, it is reported that up to 50% of people with diabetes also have a mental illness such as depression or anxiety which may make it more difficult to maintain daily diabetes care and therefore compromise physical health also.
There is also the emergence of a unique kind of eating disorder in adolescents and adults living with Type 1 Diabetes, although it is not officially recognised yet, colloquially known as “diabulimia”, which involves skipping insulin doses resulting in dangerously high blood glucose levels in hopes of losing weight and pursuing an unachievable “thin ideal”. This condition is very serious and requires a multi-disciplinary team with a thorough understanding of both diabetes and eating disorders for best management.
For more information about mental health and diabetes, see the SANE guide.
Working alongside your GP, endocrinologist, credentialed diabetes educator and a dietitian can help manage all forms of diabetes through both medical and lifestyle changes. You may also like to involve an exercise physiologist, podiatrist, optometrist and psychologist throughout your journey to get specialised and tailored advice to each condition and each family’s lifestyle.