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How does diabetes affect children and teens?

In 2017, the National Institutes of Health reported that 208,000 children and teens under 20 years had a diagnosis of either type 1 or type 2 diabetes in the United States.

Each year, they say, the prevalence of type 1 increases by 1.8 percent and type 2 by 4.8 percent.

From 2011 to 2012, 17,900 people under the age of 20 years received a diagnosis of type 1 diabetes, and 5,300 children aged 10 to 19 years received a diagnosis of type 2 diabetes.

There is concern that young people who develop diabetes will face health challenges throughout their life.

Being able to recognize the signs and symptoms and can help achieve an early diagnosis, which in turn gives a chance of a better outcome.

Fast facts on diabetes in childrenHere are some key points about diabetes in children. More detail and supporting information is in the main article.

  • Type 1 and 2 diabetes are both increasing among young people in the U.S.
  • They are different conditions, but both involve problems with the use of insulin.
  • The symptoms of type 1 diabetes often emerge in children over just a few weeks, but type 2 develops over a longer period.
  • If type 1 diabetes is not spotted, the child can develop diabetic ketoacidosis (DKA).
  • The complications of uncontrolled type 2 include kidney and eye disease.

Diabetes in children

A baby having their blood glucose level tested

A study found that incidence of type 1 diabetes in children aged up to 9 years increased by 21% between 2001 and 2009.

Type 1 and type 2 diabetes are different diseases, but they both affect the body’s use of insulin.

Type 1 diabetes in children, previously called juvenile diabetes, occurs when the pancreas is unable to produce insulin.

Since insulin is not present, sugar cannot travel from the blood into the cells, and high blood sugar levels can result unless they are treated.

Treatment involves lifelong insulin use and blood sugar monitoring, with diet and exercise management to help keep blood sugar levels within the target range.

Type 2 diabetes is less common in young children, but it can occur when insulin is not working properly, which then leads to a reduced production of insulin. As a result, glucose can accumulate in the bloodstream.

The condition can often be managed through a change in diet, increasing exercise, and maintaining a healthy weight, but sometimes medication, such as metformin, is needed.

Symptoms

Some symptoms are common to both types of diabetes.

Type 1

The most common symptoms of type 1 diabetes among children and adolescents include:

  • increased thirst and urination
  • hunger
  • weight loss
  • fatigue
  • irritability
  • fruity smell on the breath

Some may also experience an increase in hunger and blurred vision. Girls might develop a yeast infection. Weight loss is often a common symptom before diagnosis.

Diabetes U.K. urge people to be aware of “4 Ts” in children:

  • Toilet: Using the bathroom frequently, infants having heavier nappies, or bedwetting from a previously dry child
  • Thirsty: Drinking more fluids than usual but being unable to quench thirst
  • Tired: Feeling more tired than usual
  • Thinner: Losing weight

A video providing more information on the 4 Ts can be viewed below:

Type 2

Symptoms of type 2 diabetes include:

  • urinating more often, especially at night
  • increased thirst
  • tiredness
  • unexplained weight loss
  • itching around the genitals, possibly with a yeast infection
  • slow healing of cuts or wounds
  • blurred vision, as the eye’s lens becomes dry

There may be other signs of insulin resistance, such as dark, velvety patches of skin, called acanthosis nigricans, and polycystic ovarian syndrome (PCOS).

Symptoms of type 1 diabetes in children tend to develop rapidly over a period of a few weeks. Type 2 diabetes symptoms develop more slowly and may go undiagnosed for months or years.

Parents should take their child to the doctor if they notice any of the above symptoms.

Early signs

According to a 2012 survey from Diabetes U.K., only 9 percent of parents were able to identify the four main symptoms of type 1 diabetes. A more recent survey by the charity found that this percentage had increased to 14 percent.

In too many cases, children with type 1 diabetes are not diagnosed until they are seriously ill, and in a few tragic cases, this delay in diagnosis can even be fatal.”

Barbara Young, chief executive of Diabetes U.K.

Health professionals, too, may fail to identify the signs of diabetes in children.

One of the most serious consequences of undiagnosed type 1 diabetes is diabetic ketoacidosis (DKA).

Diabetic ketoacidosis (DKA)

Children with a delayed diagnosis of type 1 diabetes—and very rarely, a delayed diagnosis of type 2 diabetes—can develop diabetic ketoacidosis (DKA).

DKA is the leading cause of mortality in children with type 1 diabetes.

If there is a serious lack of insulin, the body cannot use glucose for energy. Instead, it begins to break down fat for energy.

This leads to the production of chemicals called ketones, which can be toxic at high levels. A build-up of these chemicals causes DKA, where the body becomes acidic.

Early diagnosis and effective management of diabetes can prevent DKA, but this does not always happen.

A study of children aged 8 months to 16 years who had been diagnosed with type 1 diabetes found that by the time children under the age of 2 years received their diagnosis, 80 percent of them had already developed DKA.

Another investigation, published in 2008, found that among 335 children under the age of 17 years with new-onset type 1 diabetes, the initial diagnosis was incorrect in more than 16 percent of cases.

Of these, 46.3 percent received a diagnosis of a respiratory system infection, 16.6 percent were diagnosed with perineal candidiasis, 16.6 percent with gastroenteritis, 11.1 percent with a urinary tract infection, 11.1 percent with stomatitis and 3.7 percent with appendicitis.

Furthermore, the incidence of DKA was found to be more frequent among children who received an incorrect—and therefore delayed—diagnosis of type 1 diabetes.

Type 2 complications

For younger people with uncontrolled type 2 diabetes, the progression is much faster than for adults, and they seem to be at higher risk for complications earlier in life, such as kidney and eye disease than children with type 1 diabetes.

There is also a greater risk of high blood pressure and high cholesterol levels, which raise their risk for blood vessel disease.

Type 2 diabetes in children is nearly always associated with obesity, which may contribute to these higher risks. Because of this, early detection of type 2 diabetes and attention to managing overweight in younger people is crucial.

Don’t miss the symptoms

Children and adolescents with diabetes usually experience four main symptoms, but many children will have only one or two. In some cases, they will show no symptoms.

If a child suddenly becomes more thirsty or tired or urinates more than usual, their parents may not consider diabetes a possibility.

Doctors too, since diabetes is less common among very young children, may attribute the symptoms to other, more common illnesses.

It is important to be aware of possible signs and symptoms of diabetes so that it can be diagnosed and treated early.

Diagnosis

If a child is showing any of the 4 Ts, parents should take them to the doctor and insist on a screening test for type 1 diabetes.

This consists of a urine test to look for sugar in the urine or a finger-prick test in which the child’s blood is analyzed to determine their glucose level.

Barbara Young, Chief Executive of Diabetes U.K., says this is important because “onset can be so quick that a delay of a matter of hours can be the difference between being diagnosed at the right time and being diagnosed too late.”

The American Academy of Pediatrics (AAP) recommends more widespread screening, especially among those who have a close family member with diabetes.

The American Diabetic Association (ADA) recommends testing asymptomatic children aged over 10 years who are overweight (over 85 percentile for body mass index or over 120 percent ideal weightfor height) if they have any two of the following risk factors:

  • family history of type 2 diabetes in a first- or second-degree relative
  • high-risk ethnicity (Native American, African American, Latino, Asian American, or Pacific Islander)
  • signs of insulin resistance
  • maternal history of diabetes or gestational diabetes during the child’s gestation

The outcomes for children with type 1 and type 2 diabetes are greatly improved with early detection.

Source: www.medicalnewstoday.com