Childhood Diabetes


According to the American Diabetes Association, 1 in every 400 children has diabetes, and that number’s on the rise. “We’re seeing more Type 1 and Type 2 diabetes than ever before,” says Claresa Levetan, MD, chief of endocrinology at Philadelphia’s Chestnut Hill Hospital. She goes on to quote a sobering statistic: “If you were born after the year 2000, you have a 1-in-3 chance of developing Type 2 in your lifetime.” And over the past 20 years, Type 1 has increased 70 percent in children younger than 5.  

Diabetes Defined
Type 1 diabetes (T1D) is an autoimmune disease in which the pancreas stops producing insulin. Though this condition, formerly known
as juvenile diabetes, is far more common in children, “It can affect anyone at any stage of life,” says Nanette Gerst, executive director of the South Jersey chapter of JDRF, a national nonprofit that focuses on T1D. 

Type 2 diabetes (T2D), unlike T1D, is influenced by lifestyle habits (think diet and exercise) and closely correlates with obesity rates. In Type 2 diabetics, the pancreas produces insulin yet the body develops a resistance to the peptide hormone, explains Kimberly Shoe.

Childhood diabetes symptoms

Terri Lipman, PhD., assistant dean and professor at the University of Pennsylvania School of Nursing, spells out the three classic symptoms for diabetes:

  • Excessive thirst
  • Excessive urination
  • Excessive hunger

Scott Kasper of Mt. Laurel, NJ, is a father of three, including two boys with Type 1 diabetes. His red flag went up when his oldest son, then 10, needed his water glass refilled over and over at a restaurant. Because this occurred after a sports practice, Kasper and his wife weren’t unduly concerned, but they eventually took the now-16-year-old to see the doctor when he became uncharacteristically irritable over a period of weeks. Kasper’s youngest son was diagnosed at just 13 months old; the telltale sign in this case was that the baby’s newly changed diapers quickly became so wet, they hung around his knees.

Neither Kasper nor his wife have T1D, and in general a genetic predisposition to the disease is much more prevalent in people who develop T2D. Family history and a BMI percentile greater than 86 are prime diabetes risk factors, as is the presence of prediabetes. Patients with prediabetes have elevated blood sugar levels that aren’t yet high enough to be classified as T2D, though they are at greater risk of developing Type 2 if they don’t make changes to their diet and exercise habits, says Kimberly A. Shoe, nurse practitioner and certified diabetes educator at Nemours/Alfred I. duPont Hospital for Children in Wilmington, DE. However, this group is also in a position to prevent diabetes. “With lifestyle modifications you could reduce your risk by 70 percent,” says Dr. Levetan.

Next page: all about insulin


Insulin and other treatments

Treatment for both types of diabetes involves careful diet management, blood sugar monitoring and insulin-level balancing. Type 1 patients need insulin right away, while Type 2 patients will eventually need insulin, says Dr. Levetan. Insulin can be delivered through a syringe, a pen (similar to an EpiPen used to treat allergic reactions) or an insulin pump (a portable device that provides a continuous insulin flow and reduces the number of injections needed).

“It is a very common misconception that diabetics are not allowed to have sugar,” says Shoe. In fact, they can eat whatever they choose but must adjust their insulin intake accordingly. A diabetic’s diet revolves around counting carbohydrates (bread, pasta, potatoes, sweets and naturally occurring sugars, like those in fruit). Exercise and stress must also be factored into the equation to determine the proper dosage of insulin.

Kids can learn to monitor their own blood sugar, count carbohydrates and administer their insulin injections, but they should not be left on their own to manage the disease. “We counsel parents to be advisory and have some level of supervision as long as the children are in the home,” says Lipman. “It should be a family-managed disease.”

Scott Kasper confirms that family management is key. “My boys are sports maniacs,” says the cofounder of and cyclist for Hope on 2 Wheels, a cycling team whose mission is to raise funds for JDRF and inspire kids with diabetes to live healthy lives. Two hours in advance of their soccer and lacrosse games, Kasper’s kids start checking their insulin levels and eating protein to make sure their blood sugar will be well balanced during vigorous exercise. “Whether they’re running a marathon or going on an overnight, kids with diabetes can do anything,” says Shoe. “They just have to have good planning.”

Suzanne Koup-Larsen is a contributing writer to MetroKids.


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