Diabetes in children: Diagnosis and Treatment


Mostly diabetes in children are of Type 1. Type 1 Diabetese is an autoimmune disease in which your child's body no longer produces insulin or may produce insufficient amount of insulin.

Mostly diabetes in children are of Type 1. Type 1 Diabetes is an autoimmune disease in which your child's body no longer produces insulin or may produce insufficient amount of insulin. The missing insulin have to be replaced as it is essential to survive. Type 1 diabetes in children is known as juvenile diabetes or insulin-dependent diabetes.

Diagnosis of Diabetes in Children:

 
Several blood sugar test can be done to diagnose type 1 diabetes in children. These include:

Random blood sugar test:

This is the primary screening test for type 1 diabetes in which a blood sample is taken at a random time regardless of when your child last ate. Random blood sugar level of 200 milligrams per deciliter (mg/dL) or higher indicates type 1 diabetes in children.

Glycated hemoglobin (A1C) test:

Average blood sugar level for the past two to three months can be calculated in this test. The test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells. A1C level of 6.5 percent or higher on two separate tests indicates type 1 diabetes in children.

Fasting blood sugar test:

In this test blood sample is taken after your child fasts overnight. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 1 diabetes in children.

To distinguish between type 1 diabetes and type 2 diabetes some additional test are done. This include:

  • Urine tests to check for the presence of ketones, which also indicates type 1 diabetes rather than type 2.
  • Blood tests to check for antibodies that are common in type 1 diabetes.

To ensure good diabetes management of your child his or her A1C levels should be checked regularly. Blood and urine tests can be done periodically  to check your child's Cholesterol levels,thyroid function and Kidney function to avoid future complications of type 1 diabetes.In addition, regularly assess your child's blood pressure and growth. Your child will need regular eye examinations.

Treatment of Diabetes in Children:

Treatment for type 1 diabetes is lifelong and includes blood sugar monitoring, insulin therapy, healthy eating and regular exercise for children also. Diabetes treatment plan chances with growth of your child and hence it is more challenging to manage type 1 diabetes in children.

You will have to work closely with your child's diabetes treatment team , doctor, diabetes educator and dietitian  to keep your child's blood sugar level as close to normal as possible.

Blood sugar monitoring:

Your child's blood sugar target range changes as your child grows. Frequent testing is the only way to make sure that your child's blood sugar level remains within his or her target range. At least four times a day, you  need to check and record your child's blood sugar.

Insulin Therapy:

Children with type 1 diabetes must use insulin injections to control their blood sugar.
When your child's doctor talks about insulin, he will mention three main things:

  • Onset is the length of time before it reaches your bloodstream and begins lowering blood sugar.
  • Peak time is the time when insulin is doing the most work in terms of lowering blood sugar.
  • Duration is how long it keeps working after onset.

Insulin injections and insulin pumps are the two methods of insulin administration. Insulin injections are given multiple times daily, while insulin pumps deliver a steady dose of insulin throughout the day. Insulin cannot be taken as an oral pill or tablet because the stomach destroys it before it can reach the bloodstream.
Several types of insulin are available.

  • Rapid acting starts to work in about 15 minutes. It peaks around 1 hour after you take it and continues to work for 2 to 4 hours.
  • Regular or short acting gets to work in about 30 minutes. It peaks between 2 and 3 hours and keeps working for 3 to 6 hours.
  • Intermediate acting won't get into your bloodstream for 2 to 4 hours after injection. It peaks from 4 to 12 hours and works for 12 to 18 hours.
  • Long acting takes several hours to get into your system and lasts for about 24 hours.

Your child's doctor may start with two injections a day of two different types of insulin. Later this may progress to three or four shots a day. Most insulin comes in a small glass bottle called a vial. It can be drawn  with a syringe that has a needle on the end, and give your child the shot. Some now comes in a prefilled pen. One kind is inhaled. You can also get it from a pump, a device you wear that sends it into your child's body via a small tube. Your doctor will help you to pick the type and the delivery method that's best for your child.