Published onHealth Tip of the Week
Diabetes Awareness Month takes place in November in honor of the Nov. 14 birthday of Dr. Frederick Banting, who discovered insulin in 1921. It is a time every year to spread awareness about a very common chronic childhood condition. This year, diabetes detection is more important than ever. During the COVID-19 pandemic, there was a spike in the cases of children diagnosed with type 2 diabetes, when the body can’t use or make enough insulin.
Whether a child has developed type 1, the most common type in children, or type 2 diabetes, the signs and symptoms of diabetes require immediate medical attention, says Brynn Marks, MD, MSHPEd, pediatric endocrinologist and Director of Technology for the Diabetes Center for Children (DCC) at Children’s Hospital of Philadelphia (CHOP).
“When your body is not making enough insulin, you can get sick quickly,” Dr. Marks says. “Insulin helps the body to use the food we eat for energy. If there is not enough insulin around, the body creates different sources of fuel by breaking down fat or muscle, and that makes the body sick.”
What is type 1 diabetes?
In type 1 diabetes, the pancreas produces little or no insulin. Insulin is the hormone that helps the body to take up sugar, or glucose, from the blood into the cells and use it for energy. Without daily insulin, children with type 1 diabetes can experience damage to the heart, kidneys, eyes, nerves and circulatory system. For type 1 diabetes, it’s important to get help immediately, because the onset is rapid.
Type 1 diabetes cannot be cured or prevented by diet or exercise. Rather, there may be a genetic link in some families that cause the autoimmune system to attack and destroy insulin-producing cells. The exact cause of type 1 diabetes remains unknown. From 2003 to 2015, the latest data available from the Centers for Disease Control, the overall rate of type 1 diabetes in youth younger than 19 rose slightly from 20 to 23 cases per 100,000 young people.
What is type 2 diabetes?
Type 2 diabetes has increased in recent years among children and adolescents. In type 2 diabetes, the body produces insulin but is resistant to its effects. Without enough insulin available to move sugar, or glucose, from the blood into cells for energy, blood sugar levels rise and we see the classic symptoms of diabetes. Disease drivers include declining physical activity and rising obesity. Healthy lifestyle changes can delay or prevent type 2 diabetes. As in type 1 diabetes, type 2 diabetes can damage the eyes, heart, nerves, kidneys and more.
Common symptoms and signs of diabetes
The most common symptoms of both types overlap, Dr. Marks says, adding that diabetes symptoms typically appear fairly quickly, within the span of a few weeks or months. Symptoms include:
- increased thirst
- increased urination
- weight loss
- increased appetite
- blurred vision
- persistent nausea and vomiting
- abdominal pain
- excess drowsiness or fatigue
- irritability and mood changes
- yeast infections for girls
While these symptoms are similar for all children, Dr. Marks says they can be harder to recognize in a very small child. A child who is not toilet trained, for example, may not complain about frequent urination. It is important to note other common factors in infants, such as weight loss, fussiness and significantly increased thirst.
When the body does not have enough insulin, it will break down fat or muscle. This leads to the development of an alternative fuel source called ketones. If this process goes on for long enough, ketone levels rise leading to a dangerous condition known as diabetic ketoacidosis (DKA).
Type 2 Diabetes and the COVID connection
At CHOP, children showing symptoms of diabetes will have their blood sugar levels tested and undergo a comprehensive exam. The CHOP Diabetes Center for Children saw confirmed cases of type 2 diabetes doubled from 2019, prior to the start of the COVID-19 pandemic, to 2021.
This unexpected jump in cases may be linked to lifestyle changes during the pandemic. With opportunities for exercise and movement limited by pandemic restrictions and virtual schooling in recent years, Dr. Marks says children were less active overall. In addition, many kids lacked access to the balanced meals available in school cafeterias.
“We saw cases of type 2 diabetes more than double during the pandemic. It was pretty wild,” Dr. Marks says. “The most reassuring thing we can say is that cases have decreased with the return to in-person school.”
Get diabetes smart during national diabetes month
Preventing type 2 diabetes is important as cases continue to rise among children and adults. Factors that increase the chance of diabetes onset include inactivity, obesity or a family history of type 2 diabetes. To help lower the risk, lifestyle matters. Healthy lifestyle behaviors include:
- Eat healthy foods most of the time.
- Avoid overeating.
- Seek out whole fruits and vegetables.
- Avoid processed foods and snacks.
- Increase physical activity, ideally 30 minutes five days a week.
- Drink water instead of juice or soda.
Building a healthier lifestyle with tips like these may help prevent the onset of type 2 diabetes. CHOP is here to help you and your child stay on track with lifestyle habits and education for long-term health. If you have concerns about your child and diabetes, be sure to talk with your pediatrician or primary care provider. If your child is diagnosed with diabetes, the Diabetes Center for Children at CHOP is the leading pediatric endocrinology and diabetes program in the country, ranked No. 1 by U.S. News & World Report. Their comprehensive treatment program will care for your child and educate your family, guiding you and your child on the path to a full and healthy life.
Contributed by: Brynn E. Marks, MD, MSHPEd
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