Specialties & Conditions Diabetes
Diabetes
With an active outpatient practice, our specialists at the Lurie Children's Division of Endocrinology care for children with all types of diabetes. Type 1 diabetes mellitus is the most common type of diabetes in children and teens. Type 2 diabetes has also become a health problem for children and teens in recent years.
Families use our outpatient centers in Lincoln Park and other suburban locations, in addition to our affiliation with the Chicago Children's Diabetes Center at La Rabida Children's Hospital. We also care for inpatients at our main hospital and the neonatal intensive care unit at Prentice Women's Hospital.
Type 1 Diabetes
Type 1 diabetes affects 3-4% of school-age children in the United States, and the numbers are increasing yearly. In Type 1 diabetes, the immune system is triggered to act against the insulin-producing beta cells of the pancreas, leading to an inability to produce insulin. Insulin is important because it is the hormone, or chemical messenger, needed to control blood the sugar, also known as blood glucose. Insulin allows glucose to enter the cells of the body from the blood, to be used as energy. When the immune system attacks the beta cells in Type 1 diabetes, they are no longer able to make insulin, which leads to high blood sugar levels. High blood sugar levels can be dangerous and even life-threatening.
Since the body can’t absorb insulin taken as a pill, insulin must be injected under the skin. This can be done give giving multiple injections of insulin per day, or by wearing an insulin pump that continuously delivers insulin throughout the day.
Early Symptoms/Worsening Symptoms
These are early symptoms of type 1 diabetes in a child:
- Increased urination
- Increased thirst
- Increased hunger
Over the course of several days to several weeks if a diagnosis is not made, the child’s symptoms worsen:
- Dehydration
- Irritability
- Fatigue
- Weight loss
- Nausea
- Vomiting
- Confusion and potentially a coma
How Is Type 1 Diabetes Diagnosed?
Physical signs and symptoms are important in diagnosing diabetes. If diabetes is suspected, a blood sample is taken to test the glucose and blood mineral levels (electrolyte levels). A high glucose level is needed to diagnose diabetes. If testing also shows ketoacidosis (a buildup of ketones and acid in the blood), the child will receive IV fluids and an insulin infusion through the IV. Otherwise, insulin will be given subcutaneously (injected under the skin). The child will stay in the hospital for approximately two days so that the family and other caregivers can learn about diabetes and day-to-day management.
How Is Type 1 Diabetes Managed?
Insulin
Type 1 diabetes is managed by giving the child insulin throughout the day to replace the insulin that they are not making on their own. Insulin dosing varies based on the child’s age, size, what the child has eaten, and how active the child has been. Insulin can be given by injections or via an insulin pump.
Blood Glucose Monitoring
Children with diabetes must also monitor their blood glucose levels, so that they know how much insulin to give and whether current dosing is accurate. This monitoring is typically done by wearing a continuous glucose monitor (CGM) but this also can be done by pricking their finger.
Food and Activity
Insulin is not a cure for diabetes, but part of a management program for the disease. The child’s food and physical activity need to be coordinated with the insulin doses. Carbohydrates in food increase glucose levels, and activity can decrease glucose levels. This helps keep the amount of glucose in the blood at a safe level. Children with diabetes can eat all foods and do all of the same activities as children who do not have diabetes. However, they need to monitor their blood glucose levels and take extra steps to ensure they remain in the recommended range.
Wearing a medical alert bracelet or necklace also helps keep the child safe by helping to ensure they get correct treatment in emergencies.
With a good care team, children can learn to manage the disease and enjoy normal lives. Taking good care of diabetes in childhood helps to reduce complications in adult life.
Type 2 Diabetes
In type 2 diabetes, cells in the body become resistant to insulin. The pancreas still makes insulin, but cells don't respond to it, or in some cases there isn’t enough insulin. Glucose is not able to enter the cells to help make the body’s fuel.
Children with type 2 diabetes usually are overweight and have a close relative with type 2 diabetes. Some ethnic groups, including African Americans, Mexican Americans, and Native Americans, have a higher risk of developing type 2 diabetes.
How Is Type 2 Diabetes Diagnosed and Treated?
An important way to protect your child from type 2 diabetes is to make changes when they are at risk. If your child is overweight or obese, start now with changes in diet and exercise. Ask your healthcare providers for help. This can benefit the entire family.
Type 2 is diagnosed similarly to Type 1 diabetes, with an elevated glucose level, but ketoacidosis is less common. Often insulin is necessary at diagnosis, but pills given by mouth, or other injected medications, may also be used.
Treatment for type 2 diabetes also focuses on helping the child lose weight by making diet changes and increasing physical activity.
Long-Term Outlook
With a comprehensive treatment plan, children with diabetes typically live long and healthy lives. Families dealing with diabetes do need to pay attention to the immediate threats and form good long-term habits.
Basic care helps keep the blood glucose level from getting too high (hyperglycemia) or too low (hypoglycemia). Untreated high glucose can lead to diabetic ketoacidosis. Ketoacidosis may lead to coma or death if it is not treated immediately. When the blood glucose level gets too low, the child may pass out and needs urgent help.
Over time, diabetes can damage blood vessels and nerves in the body. The eyes, skin, he art, kidneys, and feet are some of the areas that can be seriously damaged. Careful daily management helps prevent such complications.
Experienced Team
We help families manage diabetes in all age groups— from the care of infants and preschoolers, to challenges facing school-age children, to issues of teens working toward independence, and finally young adults who are responsible for self-management. Our team includes pediatric endocrinologists, certified diabetes educators, advanced-practice nurses, dietitians, registered nurses, social workers and psychologists to give your child the most comprehensive care possible. Helping families manage diabetes care is a major focus of our program at the Division of Endocrinology and its affiliated program at La Rabida Children’s Hospital.
Our caregivers provide a comprehensive, personalized diabetes treatment program. We help you manage the daily basics of diabetes care. You are encouraged to use our follow-up outpatient education sessions, regular phone contact, MyChart updates, telemedicine opportunities, and teaching tools. We provide education, monitoring, resources, and support to help your family all along the way.
Research
Research in diabetes is ongoing. Much of the research is directed at finding a cure for diabetes, both for those likely to develop the illness and those who already have it. Other research is directed at maximizing the benefits and outcome of treatment.
Diabetes care changes frequently. Ongoing diabetes research and advances have helped to expand and improve products and offer simpler or more successful strategies to manage diabetes.
Resources
The following websites may also offer useful information:
Programs
Learn more about the Lurie Children’s approach to treating diabetes by reading about our Diabetes Program.
For more information about the Chicago Children's Diabetes Center at La Rabida Children's Hospital, call 1.800.770.2232, or e-mail the program at ccdc@larabida.org.
Teens and families can also read about our SAILS (Supporting Adolescents with Independent Life Skills) program and the transition from pediatric to adult care.
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