Diabetes in childhood
diabetes; insulin; sugar; blood; hypo; hypoglycaemia; diabetes; mellitus; glucose; insulin-dependent; ketoacidosis; juvenile-onset; IDDM; mature-onset; diabetes; insipidus; urine; hypos;
Children who have been diagnosed with diabetes, and their families, need to learn many new things – how to measure blood glucose levels, give injections and how to balance food and activity – all of which they will find difficult to start with. Diabetes will have to be managed for all of the child’s life, but diabetes need not prevent a child from living a full and active life.
If a person who is known to have diabetes becomes confused, obviously unwell, drowsy or unconscious, that person needs urgent help. She may have very low levels of blood glucose (hypoglycaemia) or ketoacidosis (very high levels of blood glucose with dehydration and other blood chemistry problems).
Note: All children and young people who have diabetes should have their own diabetes management plan worked out with their doctor and their diabetes team.
This topic has information about types of diabetes, early signs of diabetes, and problems caused by diabetes.
- In this topic, the word 'diabetes' will usually mean 'type 1 diabetes mellitus'.
- Glucose is the type of carbohydrate (sugar) that is made and used in the body. The term 'blood sugar' is often used when talking about diabetes, but in this topic the correct word 'glucose' will be used.
- The topic 'Diabetes - managing diabetes in childhood' has information about day-to-day management, and living with diabetes.
Diabetes (diabetes mellitus) is a condition where the body cannot use energy from the carbohydrates (sugars) in food. It is caused by having no insulin or not enough insulin.
- Insulin is a hormone made in the pancreas, which helps glucose (which is made from food) go from the blood stream into the body's cells. Most cells get their energy from glucose.
- In this way, insulin controls the level of glucose in blood.
- Without insulin, glucose builds up in the bloodstream and overflows into the urine. High glucose levels in the blood and the urine are the first signs of diabetes.
There are two main types of diabetes mellitus – type 1 and type 2.
Type 1 Diabetes mellitus usually starts in childhood, adolescence or early adult life.
- It is sometimes called juvenile-onset diabetes, or insulin-dependent diabetes mellitus (IDDM)
- The insulin-making cells (ß islet-cells) in the pancreas have been destroyed and do not make insulin.
- The causes of type 1 diabetes mellitus are complex and include some genetic factors, and and environmental factor possibly a viral infection which 'triggers' the body’s own immune system to destroy the insulin making cells (an auto-immune disease).
- Type 1 Diabetes mellitus is not directly passed from a parent to a child. Most people who get type 1 diabetes do not have parents, brothers or sisters who have it.
- Type 1 Diabetes mellitus can be managed with balancing insulin injections (usually needed 2 to 6 times each day or the use of an insulin pump), exercise and diet. However it cannot yet be cured.
Type 2 Diabetes mellitus mainly affects older people, and it is sometimes called 'mature-onset diabetes'.
- The pancreas makes insulin, but the insulin does not work normally.
- Type 2 Diabetes mellitus is also partly caused by genes, plus other things in the person's lifestyle, such as being overweight and inactive. It often occurs in other people in the same family.
- Younger people can get type 2 diabetes, especially if they are very overweight. With the increasing levels of childhood obesity, the numbers of younger people with type 2 diabetes is rising.
- People with type 2 diabetes mellitus usually do not need insulin. Weight loss, diet control, exercise and often other medicines are usually used to control blood glucose levels.
Gestational diabetes is diabetes mellitus which occurs during pregnancy (see the topic 'Gestational diabetes').
Diabetes insipidus is a completely different health problem, caused by the lack of a hormone which controls how much urine is produced in the kidneys. It is not discussed in this topic. There is information on the Better Health Channel (Victoria) 'Diabetes insipidus'
common is diabetes in children?
- Type 1 Diabetes mellitus occurs in about 1 in 700 children in Australia. In adults, about 1 in 25 have type 2 diabetes mellitus.
- Type 1 Diabetes mellitus usually begins between 5 and 12 years of age, although it can occur in younger children.
- Most people with type 1 diabetes mellitus will have it diagnosed before the age of 30 years.
type 1 diabetes mellitus
The start of diabetes may not be noticed, especially in younger children.
The first signs of diabetes usually are:
- increasing thirst
- passing lots of urine (wee). Some children start to wet the bed again at night.
- weight loss
- glucose in the urine (sometimes this is the only sign).
Some children become quite ill (ketoacidosis – see below) before it is recognised that they have diabetes. They may start vomiting and become drowsy, dehydrated, and possibly comatose. In extreme cases, a child could die before the reason for their illness is worked out. However, if a child who is very ill is taken to a doctor or hospital, it is easy to diagnose diabetes with a simple test of their blood glucose level. Children usually become better very quickly with emergency treatment – starting with lots of fluid through a drip (intravenous infusion).
When children are diagnosed with diabetes, they will usually spend several days in hospital learning how to manage diabetes with the help of the diabetes team.
- The goals of treatment are:
- to keep the level of blood glucose as close as possible to the levels of a person who does not have diabetes
- to have a balance between insulin doses, food intake and physical activity
- to avoid blood glucose levels that are too high or too low
- to help the child grow and develop normally.
- Children and their family will need to learn how to use insulin. This includes:
- doing blood tests
- learning what the test results mean
- working out how much insulin to give
- giving the injections.
- With this specialist management, a child who has diabetes will be well, and able to do almost all of the things that other children of their age can do.
The specialist diabetes team includes a doctor (often an endocrinologist - a specialist doctor who treats people with disorders of the endocrine glands such as the pancreas), a nurse, a dietitian and a diabetes educator.
There is information about initial diagnosis and on-going care on the Diabetes Australia website 'diabeteskidsandteens'
- As yet there is no cure for diabetes. There is a lot of research going on world-wide to find a cure, including trying to find ways of transplanting insulin-making cells.
- Management of type 1 diabetes mellitus is through regular checking of blood glucose levels, and managing diet, insulin and exercise. The person with diabetes will need insulin every day for the rest of his or her life.
- Diabetes is not life-threatening if it can be well managed, so it is important to work out good patterns of management early in life.
health problems from diabetes
If type 1 or type 2 diabetes mellitus are not well managed, the complications later in life can be severe. It is important to be aware of the potential complications, as they are usually preventable with good management.
There is information about the health problems that can occur due to diabetes on the Diabetes Australia website 'diabeteskidsandteens'
(high blood glucose)
Hyperglycaemia usually develops slowly, although it can happen more quickly if the child is ill.
- The symptoms of hyperglycaemia are similar to those that occur before diabetes is diagnosed.
- Increased thirst
- Frequently passing urine
- Drowsiness and tiredness
- Laboured breathing (rapid deep breathing ('Kussmaul respiration'), where the person seems to push the air out).
- If the hyperglycaemia is not recognised and treated, it can lead to ketoacidosis, which is a serious emergency.
- Each family needs to have a plan to manage hyperglycaemia for their child. This includes working out why the child has hyperglycaemia, so that the correct treatment can be given, and working out ways to avoid this happening.
There is more information about hyperglycaemia on the Diabetes Australia website 'diabeteskidsandteens'
Ketoacidosis develops when the body, which is starved of glucose (because it cannot get from the blood into the cells), starts to break down fats for energy.
- The products of this breakdown of fats are called ketones, and the levels of ketones in blood and urine rise.
There is information about ketoacidosis on the Diabetes Australia website 'diabeteskidsandteens'
What is a hypo? (hypoglycaemia)
Hypoglycaemia is when blood glucose levels get too low (below about 4.0 mmol/L) usually as a result of:
- missed or delayed meals or snacks
- being unwell and not eating properly
- doing strenuous activity without eating extra food
- not taking the correct dose of insulin (taking too much)
- drinking too much alcohol.
There is more information about hypoglycaemia on the Diabetes Australia website 'diabeteskidsandteens'
A person with type 1 diabetes should always carry a source of fast-acting sugar.
It is not possible to prevent all episodes of high or low blood glucose. Many things can affect control, for example it may not always be possible for a child to eat exactly on time, and it can be difficult to control blood glucose when a child is unwell with what would otherwise be a minor illness such as gastro or the flu. It is important to monitor blood glucose regularly, and to develop a plan with the child’s diabetes team for times when control is difficult.
For more information see the topic Diabetes: managing diabetes in childhood This topic includes information about managing insulin, diet, blood glucose monitoring, exercise, school and special occasions.
- Diabetes Australia - South Australia (DA-SA) is an independent, not for profit, charitable organisation providing a range of services and products designed to meet the needs of people with diabetes.
159 Sir Donald Bradman Drive Rd, Hilton SA 5033
- telephone: 1300 136 588
- The Queen Elizabeth Hospital Diabetes Centre
- Diabetes Australia:
- National Diabetic Services Scheme (NDSS) is funded by the Australian Commonwealth Government and administered in South Australia by DA-SA. It provides an easy, low cost way for people with diabetes to buy essential diabetic supplies. Lifetime registration is free. You need to fill in a registration form, get it signed by your doctor and return it to DA-SA.
- Juvenile Diabetes Research Foundation in Australia
A non-profit organisation dedicated to finding a cure for diabetes and preventing its complications through research
- telephoonel 1300 363 126
Diabetes Australia 'diabeteskidsandteens'
Juvenile Diabetes Research Foundation (Australia)
Information in other languages
Australian Diabetes Council
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your child's sex.