Diabetes types and disease management
Type 1 diabetes
Type 1
is the most common type of diabetes that occurs in children and adolescents, affecting
1 in 500 school-age children. Certain people are born with the genetic risk
of developing type 1 diabetes. If their immune system is triggered against the
cells that make insulin (the beta cells in the pancreas, an organ located near
the stomach), these beta cells are damaged and destroyed.
When around 80%–90% of these cells are damaged, symptoms of diabetes begin.
Early symptoms include increased urination, increased thirst, and hunger.
Over the course of several days to several weeks, if diagnosis is not made, the
symptoms worsen and lead to dehydration, irritability, fatigue, weight loss,
nausea, vomiting, and possibly coma.
People with type 1 diabetes need insulin to survive. Insulin is a hormone
that helps the body's cells make energy from the food that is eaten. Insulin
works by helping transport the glucose (or sugar) from food into the cells of
the body where energy can be made. Without insulin, glucose levels rise
dangerously high in the blood.
Insulin can not be
absorbed in an oral form. The only way to deliver insulin today is
by an injection. People with diabetes may take one to four or
more injections of insulin every day or use an insulin pump to
deliver the insulin constantly throughout the day.
Food and exercise need to be matched to insulin doses to help keep the blood
glucose levels in safe ranges. Blood glucose monitoring is done several times
throughout the day to help evaluate the effectiveness of the insulin given and
help determine the dose of insulin. Insulin is not a cure for diabetes.
Research in diabetes is ongoing. Much of the research is directed at finding
a cure for diabetes, both for those destined to get it and those who already
have it. Other research is directed at maximizing the benefits and outcome of
treatment. Because of this research, the care of diabetes is changing
frequently. Ongoing research and advances have helped to expand and improve
products and offer simpler or more successful strategies to manage diabetes.
Type 2 diabetes
While historically much less common in young people, during the last ten
years type 2 diabetes has begun to occur at an alarming rate in children and
teens. Type 2 diabetes occurs when the cells in the body becoming resistant to
insulin. The pancreas is still capable of making insulin, but the cells of the
body don't respond to the insulin, not allowing the glucose from the food eaten
to enter the cells.
Children with type 2 diabetes are usually overweight and have a close
relative with type 2 diabetes. The risk is higher in certain ethnic groups (in
African-Americans, in Mexican-Americans, and in Native American Indians).
Treatment can often consist of weight loss and exercise. Oral medication can
also be used. Insulin is sometimes necessary.
Diabetes program at Children's Memorial
When a child is diagnosed with diabetes, the
child and the family may experience shock, anger, sadness and disbelief. Most often,
the family has little to no experience with diabetes
and doesn't know how to manage it.
At diagnosis, the child and their family meet with members of the diabetes
team for medical consultation, diagnosis, education, advice, guidelines and
support. A comprehensive, individualized educational program is developed with
the family.
Initially, they learn the basics of diabetes care, followed up
by outpatient education sessions, a parent-support group and phone contact.
Physicians,
nurse practitioners, nurses, and a nutritionist, social worker and medical psychologist
are available to assist with all aspects of learning to live with this
new diagnosis. Many of the team members are qualified as certified diabetes
educators or are in the process of certification. All are focused on the special needs
of children, adolescents and families with diabetes.
Children who are diagnosed at other facilities and who are new to our
diabetes program also meet with members of the diabetes team to help develop
their individualized plan of care.
This is done in our regular outpatient areas and in
Elizabeth's Place
, a special outpatient education
facility within the main campus at Children's Memorial Hospital in Chicago. The facility
is stocked with a variety of educational materials.
All children followed in the diabetes program have access to the entire team,
and the programs offered can help youngsters live successfully with diabetes.
The diabetes team also arranges teen retreats, holiday events, support groups,
exhibitor fairs, research and lecture programs. Our goal is to help families
develop the skills and diabetes treatment plans that help make diabetes more
manageable.
Diabetes management plans include education, support, and medical follow-up
in our outpatient program. Intensive management programs are offered and include
multiple daily injections and insulin pumps.