Type 1 diabetes in children

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to convert sugar (glucose) into energy. Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence.
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Type 1 diabetes

Various factors may contribute to type 1 diabetes, including genetics and exposure to certain viruses. Despite active research, type 1 diabetes has no cure.

Signs and symptoms:

  • Increased thirst and frequent urination.
  • Extreme hunger.
  • Weight loss.
  • Fatigue.
  • Blurred vision.

Causes:

Glucose is a main source of energy for the cells that make up your muscles and other tissues. Glucose comes from two major sources: the food you eat and your liver. During digestion, sugar is absorbed into the bloodstream. Normally, sugar then enters cells with the help of insulin.


The hormone insulin comes from the pancreas, a gland located just behind the stomach. When we eat, our pancreas secretes insulin into bloodstream. As insulin circulates, it acts like a key by unlocking microscopic doors that allow sugar to enter cells. Insulin lowers the amount of sugar in our bloodstream. As our blood sugar level drops, so does the secretion of insulin from our pancreas.


Our liver acts as a glucose storage and manufacturing center. When our insulin levels are low — when we haven't eaten in a while, for example, our liver releases the stored glucose to keep our glucose level within a normal range.


In type 1 diabetes, our immune system — which normally fights harmful bacteria or viruses — attacks and destroys the insulin-producing cells in the pancreas. This leaves with little or no insulin. Instead of being transported into our cells, sugar builds up in our bloodstream.

The exact cause of type 1 diabetes is unknown. Genetics may play a role. Exposure to certain viruses may serve as a trigger as well.

Risk factors:

Although the exact cause of type 1 diabetes is unknown, family history may play a role. Your risk of developing type 1 diabetes increases if you have a parent or sibling who has type 1 diabetes.

Screening and diagnosis:

Various blood tests can be used to screen for diabetes, including:

  • Random blood sugar test: A blood sample will be taken at a random time. Regardless of when you last ate, a random blood sugar level of 200 milligrams per deciliter (mg/dL) or higher suggests diabetes.
  • Fasting blood sugar test: A blood sample will be taken after an overnight fast. A fasting blood sugar level between 70 and 100 mg/dL is normal. A fasting blood sugar level from 100 to 125 mg/dL is considered prediabetes, which indicates a high risk of developing diabetes. If it's 126 mg/dL or higher on two separate tests, you'll be diagnosed with diabetes.

Complications:

Short term complications:

  • Hyperglycemia.
  • Diabetic ketoacidosis.
  • Hypoglycemia.

 

Long term complications:

  • Heart and blood vessel disease.
  • Nerve damage (neuropathy).
  • Kidney damage (nephropathy).
  • Eye damage.
  • Foot damage due to nerve damage in the feet or poor blood flow to the feet.
  • Skin and mouth conditions like skin problems, gum infections.
  • Osteoporosis.

 

Treatment:

Type 1 diabetes is treated with insulin. Many types of insulin are available, including rapid-acting insulin, long-acting insulin and intermediate options. Examples include regular insulin (Humulin R, Novolin R, others), insulin isophane (Humulin N, Novolin N), insulin lispro (Humalog), insulin aspart (NovoLog) and insulin glargine (Lantus).


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