From northernvirginiamag.com/family
By Christine Ashburn, MD
It’s a diagnosis no parent wants to hear: Diabetes. Yet more families are facing this reality as cases of type 1 and type 2 diabetes rise among children. As a board-certified paediatrician at Kaiser Permanente, I see this trend among my patients.
I want parents to be able to recognize the signs and symptoms to watch for at home, and to know that although a diabetes diagnosis can be scary, there are treatments that can help children live full, active and healthy lives.
Understanding the Two Types of Diabetes
- Type 1 diabetes, also known as juvenile diabetes, is an autoimmune disorder in which the body’s immune system attacks cells in the pancreas and prevents the pancreas from producing insulin, the hormone that regulates blood sugar. Children may be diagnosed at any age but most often, kids are diagnosed at ages 4–6 and in early adolescence.
- Type 2 diabetes develops over time. The body becomes resistant to insulin due to prolonged exposure to high sugar levels. Type 2 diabetes is often linked to obesity and inactivity. Kids may be diagnosed at any time but most frequently are diagnosed in their teen years.
Understanding Childhood Diabetes Trends
According to the U.S. Centers for Disease Control and Prevention (CDC), in 2002, the number of young people newly diagnosed with type 1 diabetes each year was 20 per 100,000. By 2018, that number increased to 22 per 100,000. Researchers are trying to understand why this is.
Type 2 diabetes is also rising in kids, and at a rate far more alarming than type 1 diabetes: In 2002, the number of young people newly diagnosed with type 2 diabetes per year was 9 per 100,000. By 2018, that number doubled to 18 per 100,000 per year.
The reason? Type 2 diabetes is largely driven by lifestyle factors such as diet, exercise and weight. We see children eating more processed foods, drinking sugary beverages such as juices and chocolate milk, and spending more time on screens than engaging in physical activity. These lifestyle habits have contributed to a childhood obesity epidemic, and being overweight is a key risk factor for type 2 diabetes. Unfortunately, a condition that in previous generations was considered an “adult” medical condition is now affecting our kids.
Spotting the Signs of Diabetes in Kids
Both types of diabetes share many symptoms. Symptoms of type 1 and type 2 diabetes may include:
- Excessive thirst to the point where the thirst is almost impossible to quench
- Frequent urination, including new bedwetting or accidents in previously potty-trained kids
- Fatigue
- Abdominal pain
- Emotional irritability due to highs and lows in blood sugar levels
- Unexplained or sudden weight loss (more common in type 1)
- Acanthosis nigricans: dark, thickened patches of skin, especially around the neck, armpits, or groin (more common in type 2)
If you notice these symptoms in your child, reach out to your child’s paediatrician. (Note: Some children won’t show symptoms of type 2 diabetes.) The paediatrician likely will order blood and urine tests, checking blood sugar levels; haemoglobin A1C levels; and sugar levels in the urine.
Family History and Diabetes
While we don’t fully understand why some kids get type 1 diabetes, we do know genetics plays a big role. If a parent, grandparent, or sibling has type 1 Diabetes, it significantly increases the risk for that child to develop it as well.
Kids with parents or grandparents who have type 2 diabetes are at high risk of developing the illness too.
Knowing your family’s medical history can be vital in ensuring an early diagnosis for your child. Tell your child’s doctor if you have a family history of either type of diabetes.
Preventing Diabetes in Children
Unfortunately, type 1 diabetes is not preventable.
Type 2 diabetes is preventable and can even be reversed with lifestyle changes. I recommend families engage in healthy habits together so that no one feels singled out.
In terms of healthy eating, I recommend parents help their children:
- Limit sugary drinks like soda, chocolate milk, and fruit juices
- Eat plenty of whole fruits and vegetables
- Avoid ultra-processed foods and sugary cereals
Movement is also essential to prevent type 2 diabetes. I recommend parents:
- Encourage daily physical activity beyond gym class and recess.
- Limit screen time to two hours or less per day
- Set timers to break up long stretches of video games, phone use or TV
Managing Diabetes in Kids
Diabetes complications can affect the whole body, in the short term and the long term. People with diabetes struggle with poor wound healing, vision issues, kidney disease and many other serious health conditions. The goal is to prevent diabetes from leading to complications in childhood and adulthood.
If your child is diagnosed with type 1 diabetes, insulin therapy is essential because the child has lost the ability to regulate their own insulin. Families help their children monitor blood sugar levels, count carbs and administer insulin.
While coping with the diagnosis is incredibly challenging, I want families to know that kids can live normal, healthy lives with diabetes. Kids can still play sports, go to school and enjoy their favorite foods as long as blood sugar levels are kept in check. (Read for more information about coping with type 1 diabetes.)
Type 2 diabetes may also require insulin or medications like metformin, especially in severe cases. With healthy eating, exercise and weight management, type 2 diabetes can be treated and even reversed over time. (Read for more information about coping with type 2 diabetes.)
Bottom line: Managing diabetes can be emotionally, physically and socially challenging or isolating. As a parent, try to lend as much support as you can, connect with other families impacted by childhood diabetes if you can, and be a good role model in terms of healthy eating, exercise and weight management.
Diabetes may be on the rise, but with knowledge and action, parents can help their kids lead healthy, full and vibrant lives.
Christine Ashburn, MD, is a board-certified paediatrician with the Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente Ashburn Medical Center
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