Diabetes in children is complex and often misunderstood, stirring feelings of guilt and stigmatization among parents. Even as the rates of diagnosed cases of diabetes among children are on the rise, a cocktail of factors at play make it difficult for healthcare experts to articulate specific causes or pinpoint predisposition.
Type 1 diabetes mellitus is more common in children and teenagers. It’s an autoimmune disease that isn’t preventable, Vidhya Viswanathan, a pediatric endocrinologist at Advocate Health Care, tells SheKnows. Those with Type 1 don’t produce the insulin they need to convert glucose to energy.
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“People often confuse type 1 with type 2 and say things that are really hurtful, like if you had just eaten better when you were younger, you wouldn’t have got diabetes,” Viswanathan says. “That’s simply not true.”
While Type 1 is more commonly seen in teenagers, babies who are a few months old can also get it, she says. Meanwhile, adult onset diabetes or Type 2 is becoming more prevalent in children and can be linked with lifestyle, J Nina Ham, a pediatric endocrinologist at Children’s Healthcare of Atlanta, tells SheKnows. It is still a less common form of diabetes in children. Even though Type 1 was more commonly seen in Caucasian populations, people of all racial and ethnic backgrounds can get it, she added.
Children who don’t have access to good quality food or those that are overweight are more susceptible to this form of diabetes. There is a higher prevalence of Type 2 diabetes among African-Americans, Latinxs, South Asians and Native Americans, Ham added.
In the case of Type 2, patients produce insulin, but their body is not able to access it. “With Type 1, you don’t have the key that helps you unlock insulin,” Ham says. “With Type 2, you have the key, it just doesn’t fit into the lock.”
Excessive thirst and bed-wetting
Type 1 diabetes causes a spike in blood sugar levels that the kidney tries to filter out, Viswanathan explains. This leads to frequent urination and consequently, dehydration.
This sign may be less apparent in toddlers who are still wearing diapers, Ham cautions. But parents may find their potty-trained children increasingly wetting the bed at night.
It’s also common to hear that school-going children have been getting into trouble at school, with teachers deeming their frequent trips to the bathroom a way to skip classes, Ham says.
Low energy and changes in mood
Parents may also notice a sharp increase in appetite in their children. Since those affected with Type 1 diabetes do not produce insulin, their bodies aren’t able to use that food for energy, leading to tiredness and sometimes weight loss, Viswanathan says. She recalled a few parents sharing that their child would sleep immediately after coming home from school.
On the other hand, parents with toddlers may observe their young ones becoming increasingly irritable or fussy, Ham says.
“Infants can’t express that they’re hungry, thirsty or tired, which leads to changes in behavior, particularly if you had a happier toddler,” she says.
Patches of darkened skin
Children with undiagnosed Type 2 diabetes may have patches of darkened skin under their arms or on their neck, Ham says. This is a sign of insulin resistance as the body is not able to use the insulin it produces, she explains.
“We have parents come to us thinking these are rashes, but that is often not the case,” she says.
Life with diabetes
Diabetes in children is manageable. Those with Type 1 diabetes must follow a healthy diet with plenty of fruits, vegetables and protein sources, Viswanathan says. Children can also occasionally have candy or birthday cake.
“You have to be better about your food choices, but you can still live the life you want without restrictions,” she says, pointing to singer Nick Jonas who has been open about living with Type 1 diabetes since he was a teenager.
However, insulin therapy is required after every meal and can be taken through a needle, a pen device or an insulin pump, Viswanathan says. Those with Type 1 diabetes must count carbohydrates consumed for each meal and check their blood sugar level to estimate the dose of insulin they need after every meal.
Type 1 diabetes doesn’t go away and those with it will need insulin therapy for the rest of their lives. It becomes easier to manage as an adult, Viswanathan says, as adults tend to have finite schedules.
Those with Type 2 diabetes, depending on its severity, will need to take insulin and medication to keep blood sugar levels under control, Ham adds.