Diabetes Mellitus

DIABETES IN INFANTS AND CHILDREN

Written by StopDiabetes

Can a baby have type 1 diabetes?

According to the most recent data, children under the age of three can have type 1 diabetes. Although no one agrees on the actual numbers, some research suggests that less than 1 percent of all children less than a year old develop type 1 diabetes; another statistic states that less than 2 percent of children under three years develop type 1 diabetes. The most recent data also suggests that there is a significant upward trend of type 1 diabetes at such young ages for some unknown reason. There may be several reasons, including and especially that there is a better understanding of the disease in infants (and therefore more diagnoses).

Why is it often a challenge to diagnose and treat an infant who may have type 1 diabetes?

There are several reasons that it is difficult to diagnose and treat a young infant who has diabetes. Initially, babies do not often have the “classic diabetic” early symptoms and signs of the disease. If they are diagnosed with type 1 diabetes, it is often a challenge to set up a therapeutic treatment for the infant (especially in terms of insulin dosage as the child grows), including if the mother is breastfeeding. Managing the child’s diabetes is also difficult because the child is growing and developing and is not able to take care of his or her needs. Thus, the parents, and often other members of the family, must be involved in the baby’s treatment. And finally, there is the psychological impact of how diabetes affects not only the child but also the child’s family, as the daily work of managing the disease is often difficult.

What is the youngest child known to develop type 2 diabetes?

As of this writing, and according to a study presented at the 2015 meeting of the European Association for the Study of Diabetes, the youngest child to develop type 2 diabetes was a three-and-a-half-year-old Hispanic female from Texas. Her initial symptoms were excessive urination and thirst, but her other medical history showed virtually nothing. In addition, although both parents were reported to be obese, there was no history of diabetes. But the child was in the top 5 percent of children her age in weight and height, putting her in the body mass index (BMI) obesity range (for more about BMI, see the chapter “Diabetes and Obesity”). Her blood tests also showed a high HbA1c level (also seen as A1C or A1c) but negative for antibodies that would mean she would have had type 1 diabetes. After treatment for six months with metformin (a common type 2 diabetes drug) at various levels and a change in diet and lifestyle, the girl had normal blood glucose levels and a “normal” HbA1c level. She stopped taking metformin. According to most researchers, this was a good sign. It may mean that type 2 diabetes is reversible in many young children—as long as they are diagnosed early and with certain modifications in eating, exercise, and lifestyle.

What is hyperinsulinism (hyperinsulinemia) in a newborn baby?

Hyperinsulinism (hyperinsulinemia) is just as the term implies—an excessive amount of insulin in the bloodstream. There are various types of hyperinsulinism, including congenital hyperinsulinism, a rare condition in which there is severe, persistent hypoglycemia in a newborn baby. In the United States, it is estimated that one in 50,000 newborns is affected by hyperinsulinemia, with symptoms ranging from sweating and lethargic behavior to irritability, jitteriness, and respiratory distress, all of which can mimic other conditions, which is why it is often difficult to diagnose.

Why is diabetes thought to be one of the most common chronic illnesses of young people?

According to several organizations that specialize in diabetes, diabetes is one of the most common chronic illnesses of young people. This is because it is estimated that 5 percent of all new diabetes cases are type 1, and most of those affected are children and adolescents. It is also estimated that more than 18,000 people under age 20 are diagnosed with type 1 diabetes each year. The numbers are also high in terms of type 2 diabetes—with estimates of more than 5,000 new cases of type 2 diabetes in young people each year. At this writing, these figures are often translated as meaning that one of every 350 children has diabetes, although some recent studies show this trend may be slowing.

What are the challenges of treating a toddler (one to three years old) who has type 1 diabetes?

The challenges associated with treating a toddler ages one to three who has type 1 diabetes is similar to that of an infant less than a year old. In addition, as children get older, they tend to refuse to eat certain foods, meaning there is a chance of hypoglycemia. Discipline and temper tantrums are also known to be issues at the toddler stage, possibly making it difficult for the parent to measure the child’s blood glucose levels. The best way to overcome such challenges is for the parent or guardian to better understand the disease (through education) and to get the overall support of a diabetes team and the child’s health care professional.

What are some challenges of preschool and early school-aged children (three to seven years old) to school-aged children (eight to 12 years old) who have type 1 diabetes?

A child (ages three to seven) with type 1 diabetes still needs help managing injections and blood glucose readings. But in many cases, children in this age group are ready to participate in certain activities that will help them manage their diabetes. In particular, many parents ask their child to participate in the testing and keeping records of the child’s glucose measurements, along with helping to make meals for the child. These responsibilities often make a child gain confidence in helping to manage diabetes.

For school-aged children (ages eight to twelve) with type 1 diabetes, the challenges are somewhat different, especially if they have been diagnosed with the disease at a later age. If the child has had diabetes for a while, the tasks include continuing to manage blood glucose levels with injections and maintaining nutritional balance. For those who are diagnosed at an older age, the challenge becomes learning to cope with not only a different way of eating but also taking medication each day. There is also the psychological challenge of managing the disease every day, dealing with their peers’ understanding (and misunderstanding) of diabetes, and realizing the disease will not go away.

Why is it often difficult for children (ages six to twelve) with type 1 diabetes while at school?

One of the most difficult challenges for children ages six to twelve with diabetes—type 1 or type 2—is managing their blood glucose levels while they attend school. Younger children’s challenges at school include assistance in administering insulin (including if the child uses an insulin pump) and supervision in managing glucose levels. For older children, school becomes more of a challenge as they increase their activities while keeping their glucose under control. In addition, there are often problems stemming from peers, many who may not understand diabetes and what challenges it entails.

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