Specialties & Conditions Diabetes
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.
With an active outpatient practice, our specialists in Lurie Children's Division of Endocrinology care for children with all types of diabetes. Families use our outpatient centers in Lincoln Park and other city and suburban locations as part of 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
In children with type 1, their immune system is triggered to act against beta cells. Beta cells are found in the pancreas, the organ that produces insulin. Insulin is a hormone needed to control our blood sugar or "glucose." Glucose is what we need for energy. Insulin allows glucose to enter from the blood into the cells of our body. As a result of the immune attack against the beta cells, the pancreas of type 1 diabetics is no longer able to make insulin, resulting in high blood sugar.
The body can’t absorb insulin taken as a pill, but it will absorb insulin injected under the skin. A child with type 1 diabetes needs one to four or more injections of insulin every day. Instead of receiving or giving themselves injections, many children wear an insulin pump. The pump delivers insulin throughout the day.
Type 1 diabetes affects 3-4% of school-age children in the United States, and the numbers are increasing yearly. With a good care team, children can learn to manage the disease and enjoy normal lives. Taking good care of childhood diabetes is always important to reduce complications in adult life.
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
- Possibly even a coma
How Is Type 1 Diabetes Diagnosed?
Physical signs and symptoms are important in diagnosing Diabetes. 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 the urine and blood samples show ketoacidosis, 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 two to three days so that the family and other caregivers can learn about diabetes and the day to day management.
How Is Type 1 Diabetes Managed?
Since these children are not making enough insulin, we replace the insulin they would normally make each day. Type 1 diabetes is managed by giving the body insulin throughout the day. What the child has eaten and how active the child has been are always important.
The amount of glucose in the blood needs to be checked several times a day. Wearing a medical alert bracelet or necklace helps the child get correct treatment in emergencies.
Insulin
Anyone with type 1 diabetes needs to receive insulin to survive. Insulin is a hormone that helps cells make energy from food. Insulin helps to move glucose (sugar) from food into the cells of the body, where energy is created. Without insulin, the blood level of glucose is too high, which can be dangerous.
Food & 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. This helps keep the amount of glucose in the blood at a safe level. Keeping a logbook is important.
Blood Glucose
To know if the insulin dose we give is correct, children need to check blood sugars (glucose) throughout the day. If it is high, they need more insulin, and if low, it can be a result of too much insulin. Food also plays a role in this because foods with carbohydrates increase our sugar or glucose levels.
Children need to check sugars many times and this can be done with fingerstick tests and continuous glucose monitors which are used along with the fingerstick tests.
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 there isn’t enough insulin. Glucose doesn’t 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 American Indians, have a higher risk of developing type 2 diabetes.
How Is Type 2 Diabetes Diagnosed?
An important way to protect your child from type 2 diabetes is to make changes when he or she is 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, but ketoacidosis is less common. Often insulin is necessary at diagnosis, but sometimes pills given by mouth may be used.
Treatment for type 2 diabetes focuses on helping the child lose weight and increasing physical activity and exercise. Sometimes, pills or insulin therapy make the child’s care plan more effective.
Long-Term Outlook
Families dealing with diabetes need to pay attention to the immediate threats and 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 avoid such complications.
Experienced Team
We help families with diabetic children of all ages — from the care of infants and preschoolers, to challenges facing school-age children, to issues of teens working toward independence and young adults being 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 and the Division of Endocrinology and its affiliated program at La Rabida.
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, and teaching tools. We provide education, monitoring, resources, and support to help your family all along the way.
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.
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. Learn more about Lurie Children's Diabetes Research Study.
Our study on Transitioning to Adult Diabetes Care is also related to our diabetes research.
Resources
The following websites may also offer useful information:
