Is your child at risk for Type 1 diabetes?
12/10/2020 by Stephanie Ahrens, A.P.R.N., C.N.P., M.S.N.
Type 1 diabetes affects 1.6 million Americans; yet, you may not be familiar with or know what signs and symptoms to watch for. This article will familiarize you with this condition.
Who does Type 1 diabetes affect, and what are the risk factors?
Type 1 diabetes, once known as juvenile or early-onset diabetes, commonly affects children and young adults, but it can be discovered at any age. More common ages of diagnosis are 4–7 and 10–14.
If a parent or sibling has Type 1 diabetes, or if you are born with certain genes, your risk increases. Research suggests that there also may be triggers, such as viral infections or exposure to other environmental factors that aren't yet clearly understood. The number of cases of Type 1 diabetes increases the farther away from the equator people live.
What happens in Type 1 diabetes?
Type 1 diabetes occurs when the body accidentally attacks its own cells. Specifically, in Type 1 diabetes, the body attacks cells in the pancreas. The pancreas makes insulin, which is a substance that helps move sugar from the blood stream into the cells to be used for energy. However, in Type 1 diabetes the pancreatic cells are damaged to the point that the organ is unable to produce enough insulin and eventually cannot produce any insulin. Without insulin to move it from the blood into the body's cells, circulating sugar builds up, leading to signs and symptoms of high blood sugar.
What are the signs and symptoms of Type 1 diabetes?
Symptoms often occur suddenly, and may include being extremely tired, increased thirst and urination, unintentional weight loss, blurred vision, yeast infections, itchy skin, nausea or vomiting, extreme hunger, fruity smelling breath, bed-wetting in a child who was previously potty-trained, and irritability. If you or your child exhibit any of those symptoms, you should contact your health care provider.
How is Type 1 diabetes diagnosed?
Blood work is essential in diagnosing Type 1 diabetes. Some tests that can show high levels of sugar in the body include:
- Hemoglobin A1c
This test gives an average of your blood sugar from the previous three months.
- Fasting sugar
This test measures sugar levels in the bloodstream after at least 12 hours of fasting.
- Random sugar, or oral glucose tolerance, test
This test measures your body's response to sugar.
Urine studies also may show high levels of sugar or ketones. Ketones indicate that the body is using fat to make energy, which it has to do in Type 1 diabetes. That's because the sugar it usually uses is stuck in the bloodstream and not being brought into the cells.
Other less common tests also may be part of the workup, including C-peptide, antibody and genetic testing.
How is Type 1 diabetes treated?
Since a body affected by Type 1 diabetes destroys the pancreatic cells needed to make insulin, all people with Type 1 diabetes eventually will need insulin. Sometimes people experience a "honeymoon phase," where the pancreas still can produce a small amount of insulin for the body to use, and little or no insulin may be needed to stabilize blood sugar levels. However, this typically only lasts a few months to a year until regular use of insulin is needed.
Insulin, which is the mainstay of treatment, can be delivered into the body in various ways, including pens, syringes, pumps or even the newer artificial pancreas systems. It is important that those living with Type 1 diabetes work closely with their medical team to find what insulin regimen and system is best. Other methods of treatment may include oral medications to help with blood sugar control and other conditions often seen along with diabetes, such as high blood pressure or high levels of cholesterol.
Eating a diet that is low in fat and high in fiber, and includes vegetables and whole grain, is important to regulate blood sugar. Meeting with a dietitian is recommended. Physical activity is important for all people, and those with Type 1 diabetes are encouraged to exercise regularly, as well. Exercise can lower blood sugar, so it is important to ask your health care provider to be cleared to do so and to discuss how to safely take part in exercise.
What are the complications of Type 1 diabetes?
In severe cases, the levels of blood sugar from Type 1 diabetes can lead to episodes of dangerously high or low sugar, diabetic ketoacidosis, coma or even death. If diabetes is not treated and the body continues to have high levels of sugar moving around in the bloodstream, it can damage many organs, including the kidneys, eyes, heart and even the nerves. Nerve damage from diabetes can lead to permanent damage and the need to remove the affected body part, often the feet or toes of those living with diabetes.
What is the prognosis for Type 1 diabetes?
It is important to recognize that with a Type 1 diabetes diagnosis comes a big lifestyle change for those living with it. This can be upsetting, frustrating and difficult. However, through hard work, dedication and working closely with their medical team, those living with Type 1 diabetes often go on to live full, active and healthy lives.
For more information, visit the Mayo Clinic Type 1 diabetes webpage.
Stephanie Ahrens is a family nurse practitioner and education assistant in the Department of Family Medicine. She practices at Mayo Family Clinic Northeast and Mayo Clinic Express Care. Her medical interests include obesity medicine and weight management, women's health, diabetes, and pediatric care.