What is diabetes?
Diabetes occurs when the level of sugar in the blood becomes higher than it should. There are two main types, called Type 1 diabetes and Type 2 diabetes.
Type 1 diabetes is the most common form of diabetes in children: 90-95 per cent of children under 16 with diabetes have this type. Type 1 diabetes is also known as juvenile, early onset, or insulin-dependent diabetes. The number of children affected by Type 2 diabetes is, however, beginning to rise and is seen in children who are overweight.
Type 1 diabetes is classified as an autoimmune disease - this means that the body's immune system 'attacks' the body's own tissues. The immune system destroys the insulin producing cells in the pancreas so insulin can no longer be made. This then causes the blood glucose level in the blood to go very high.
What causes diabetes?
As with adults, the cause of childhood diabetes is not well understood. Most children with Type 1 diabetes do not have a family history of diabetes. Research does, however, suggest that it is probably caused by a combination of genetic factors and environmental triggers.
What are the signs and symptoms of diabetes?
Type 1 diabetes usually develops quite quickly, so the symptoms tend to
come on over a number of days or weeks. The main symptoms are:
- thirst
- tiredness
- weight loss
- needing to urinate frequently.
Symptoms that are also seen in children include:
- tummy ache
- headaches
- behaviour problems.
How is diabetes treated?
After a child is diagnosed with Type 1 diabetes they are usually treated by a specialist diabetes team who devise an individual treatment regime for the child. Because most of their insulin producing cells have been destroyed, most children will need insulin treatment. Many will receive fast-acting insulin during the day and slow acting insulin at night. As well as insulin treatment, one of the most important ways of managing the condition is to keep blood sugar levels stable and avoid hypoglycaemia ('hypos') - this is when the blood sugar becomes too low. A number of factors can cause 'hypos', such as having too much insulin, not having enough food or doing too much exercise. Children who are having a 'hypo' can deteriorate quickly and can become unconscious if they aren't given a sugary snack or drink, followed by a starchy food (such as a sandwich).
Children with diabetes also need to eat a balanced, healthy diet that includes three main meals a day and two to three snacks. Children are able to eat sweets, but this does need to be carefully managed and often requires them to adjust the amount of insulin they have. Exercise and physical activity is also important, but it can lower blood sugar levels and cause a 'hypo', so children often need a snack beforehand and will need to carry something sugary with them.
A child with diabetes in a childcare setting
For parents, it is important that they feel safe in the knowledge that their chosen childcare provider has a good basic knowledge of the condition. Many parents become 'experts' in managing their child's diabetes and it may be difficult for them to hand over the responsibility to someone else.
Staff need to be familiar with the symptoms of low blood glucose, be able to monitor the child's blood sugar levels, be aware of their dietary restrictions and closely monitor their levels of activity. A detailed management plan, drawn up by the parents and staff, will ensure that the child receives proper care, especially in the event of a 'hypo'. A good management plan will include details of required meal and snack times, a list of symptoms the child is likely to display when having a 'hypo', what treatment is required, and what to do in the event of an emergency.
Most children with diabetes will need insulin in the morning and evening, but some will also need it at lunchtime. It is important that caregivers are trained to give injections, as young children are unlikely to be able to do it themselves.
Further information
Contact Diabetes UK on 0845 120 2960 or visit the website www.diabetes.org.uk
