Children Get Diabetes, Too!

By Marion Cooper RN, CDE, IBCLC, RLC

In Canada, the number of children diagnosed with Type 1 and Type 2 Diabetes is rising. It is difficult to escape headlines that “diabetes is becoming a worldwide epidemic”, or “the number of adults with type 2 diabetes has doubled since 1980.” What is easy to overlook is that the incidence of diabetes is also increasing in children.

Diabetes Mellitus was first described by ancient Egyptians 3,000 years ago. The diagnosis referred to sweet urine and was described as a disease of flesh melting into the urine. Understanding of diabetes was slow to evolve, but we now know it is a disease that can be treated, but not cured.

There are 3 main types of diabetes. Type 1 Diabetes usually occurs in children or young adults – but can occur at any age. The body stops producing insulin, a hormone needed to control the amount of glucose (sugar) in the blood stream. The treatment is replacing the insulin the body is no longer making with injected insulin. The cause is still unknown but may occur after a virus. Approximately 10% of people with diabetes have Type 1.

Type 2 Diabetes usually occurs in adults over the age 40; the body does not produce enough insulin or the insulin is not working effectively. It is related to genetics, excess weight, aging and sometimes, medications. The treatment includes diet and activity, pills and sometimes insulin. Approximately 90% of people with diabetes have Type 2.

The third type of diabetes is gestational diabetes – a condition that occurs in pregnancy. It is temporary. Children born to mothers with gestational diabetes are at increased risk of developing diabetes later in life.

Diabetes is one of the most common chronic diseases in children. In recent years, there has been an increase in both Type 1 and Type 2 Diabetes in children. The reason for the increase of Type 1 Diabetes is unknown. The increase of Type 2 Diabetes in children is related to the change in lifestyle in recent years. More children are overweight, less active and consume more calories than in the past. If a child has a family history of diabetes, these lifestyle factors can trigger diabetes. Some studies report that Canada has the highest incidence of Type 2 Diabetes in children in the world, surpassing even the United States.

If you notice symptoms such as rapid weight loss, increased urination, increased thirst, or extreme tiredness in your child or adolescent, see your family physician. Type 1 Diabetes can be quickly diagnosed with a laboratory test and physical examination. The sooner treatment starts, the sooner the child will feel better and be less likely to become extremely ill.

Children with Type 2 Diabetes may have the same symptoms, milder symptoms or no symptoms. Children should be checked for Type 2 Diabetes if they have two of the following risk factors: a family history of Type 2 Diabetes, their mother had gestational diabetes, the child is overweight, has high blood pressure, has high cholesterol, or is in a high-risk population. Ethnic groups at higher risk include Aboriginal, Asian, Spanish and African people.

Once a child or adolescent is diagnosed with diabetes, support and treatment will come from the family physician and a diabetes team. The team includes an endocrinologist, paediatrician, local pharmacist, nurse educator, registered dietitian and a social worker. Support can also come from caregivers, teachers and friends. Parents need reassurance that they are not to blame for their children developing diabetes. With support, follow-up, a healthy lifestyle, medication, and regular check-ups, complications of diabetes can be minimized or avoided.

Children will be taught to care for their diabetes with the help of their families. They will learn how to avoid, recognize and treat blood sugar levels that are too high or too low.

In the Grey Bruce area, the paediatric diabetes team is in Owen Sound at the Grey Bruce Regional Health Centre. Some families may be referred to other centers in London or Kitchener.