It can be a shock if your child is diagnosed with type 1 diabetes, but with an estimated 6500 Australian children aged 0–14 affected, you are certainly not alone.
Diabetes is one of the most common chronic childhood conditions. It can be overwhelming, confusing and worrying as you, your child and other members of the family adapt to such a life-changing diagnosis.
Type 1 diabetes is an autoimmune disease in which the immune system is activated to destroy the cells in the pancreas that produce insulin. It is not due to lifestyle factors and cannot be prevented or cured.
Lack of insulin leads to high levels of glucose in the blood, which can lead to both short-term health problems and long-term complications if not well managed. People with type 1 diabetes need insulin every day to keep them alive. Without insulin, the body burns its own fat, leading to a dangerous condition called ketoacidosis.
In children, type 2 diabetes is much less common than type 1 diabetes, but may be caused by an unhealthy lifestyle, poor diet, lack of exercise, obesity and sometimes genetic factors. There are only approximately 400 cases diagnosed each year amongst 10- to 24-year-olds.
When should I have my child tested?
It’s always better to be on the safe side when it comes to type 1 diabetes. Testing is advisable if your child suddenly displays these symptoms:
- Excessive thirst
- Asking to go to the toilet more frequently
- Feeling tired and lethargic
- Unexplained sudden weight loss
- Blurred vision
- Skin infections or cuts that heal slowly
The diagnosis of diabetes is a relatively simple process. A visit to the GP to explain your child’s symptoms should lead to a finger-prick blood glucose test in the office and a venous blood glucose test if the doctor has concerns.
If your child is diagnosed with type 1 diabetes, it is important to remember there is plenty of support to help manage it and to allow your child to live a healthy and happy life. Children with newly-diagnosed diabetes are often admitted to hospital for a few days where there is lots of support available from diabetes nurse educators, doctors, dieticians and sometimes, psychologists. Looking after a child with type 1 diabetes is best done by an experienced multidisciplinary team.
Your child should be involved in as much of the conversation as possible between you and their doctor to increase their understanding of type 1 diabetes. This will help with everyday management and enable them to become independent and take more responsibility as they transition to the teenage and young adult years.
Treatment and management
Your child will need to monitor their blood glucose level up to six times per day. An alternative is continuous glucose monitoring or CGM, which is now government-funded for Australians under the age of 21 who have type 1 diabetes.
Insulin is given by multiple daily injections into the skin or via an insulin pump. Keeping blood glucose levels in the optimum range is a careful balance between what food is eaten, insulin dose and physical activity levels.
Insulin pumps are similar in size to a mobile phone, battery operated and hold a small amount of insulin. Worn 24 hours a day under a child’s shirt or dress, a pump is programmed to deliver insulin into the body through a small plastic tube, enabling a more flexible lifestyle compared to injections, and allowing your child to have better control over their diabetes. Children with pumps can still play sport and in fact may have more stable glucose levels after exercise than children on multiple daily injections.
Having diabetes can be both a physical and psychological battle at times. In the early days, it’s not unusual for your child to feel down and isolated or despise the effort that management of their diabetes requires.
Seeing a diabetes educator, psychologist or social worker may help with this, as will the establishment of a diabetes management plan. It is helpful to ensure that your child’s school is fully informed and becomes a partner in the monitoring and management plan.
There will come a point in your child’s life between the ages of 16 and 18 when they will make the move from medical support services specific to childhood to adult medical care. While this can be daunting for you and your child, your health care professionals are experienced to help with this transition.
If your child develops type 1 diabetes, they will need regular monitoring and good management to stay healthy, but diabetes will not stop them from enjoying a happy and very active life.
A hypoglycemic episode or “hypo” is a low blood glucose level (below 4mmol/L) causing hunger, sweating, trembling, paleness, dizziness, headache and sometimes confusion or irritability.
Hypoglycemia can be caused by too much insulin, delaying or missing a meal, not eating enough carbohydrates, unplanned physical activity or alcohol consumption. It is treated with high sugar food or drinks such as jelly beans or orange juice initially, followed by a longer-acting carbohydrate food such as a slice of bread.