Juvenile diabetes (commonly referred to as Type 1 diabetes) can develop at any age from infancy. It is a disease in which the blood glucose levels are above normal, causing problems with converting food to energy. After a meal, food is broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells use insulin, a hormone made in the pancreas, to help them convert blood glucose into energy.
How does it develop?
Juvenile diabetes develops when the pancreas cells stop making insulin; the body's defence system destroys the insulin-producing cells in the pancreas.
The lack of this hormone causes a build-up of glucose in the blood and disruption in the body's chemical processes. Unused glucose is excreted in large quantities of urine, which is passed frequently, causing thirst.
What are the symptoms?
In diabetes that is poorly controlled there will be too much glucose in the blood. As the cells are not able to use glucose or energy, the body has to use proteins and fats as an alternative source of energy. This can produce:
* frequent urination
* extreme thirst
* poor appetite and sudden weight loss
* tiredness and lack of energy
* blurred vision.
What tests are used to diagnose diabetes?
A diagnosis of diabetes can be confirmed by a blood test that measures the glucose in the blood, or a blood test for glucose after the child has fasted.
Managing a child with diabetes
Healthy eating, physical activity and daily insulin injections are the basic therapies for juvenile diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose levels must also be closely monitored through frequent blood glucose checking.
Daily care
The goal of diabetes management is to keep the child's blood glucose levels as close to the normal range as possible. The child will usually need to be administered with between four and five shots of insulin each day. Their blood glucose sugar levels will also need to be monitored to ensure that their insulin and food intake is regulated. These measurements vary in timing but are usually taken before meals and two hours after meals.
When blood glucose levels drop too low the child can become shaky and confused. Judgment can be impaired. The child can also become ill if their blood glucose levels rise too high.
Diet
Children with juvenile diabetes do not require special foods and there are few foods they cannot eat. However, their diet should combine a healthy variety of foods to allow them to pass easily through the body. Their fat intake should also be limited because diabetes and high cholesterol are two risk factors for developing heart disease.
Children with diabetes will need to balance what they eat with their dose of insulin so that their blood glucose levels do not swing too high or too low. To achieve this you need to ensure that:
* the child eats regular meals and that the dose of insulin given matches the amount of food consumed
* snacks must be matched with insulin, so extra injections will be needed to cope with these
* the mainstay of their diet is foods with high starchy carbohydrate and fibre as they release sugar slowly as they are digested.
Children with diabetes can also eat 'refined' carbohydrates such as sugar, honey and sweets with meals in small amounts without interfering with their blood glucose control. But it is not recommended for them to eat sugary foods as snacks as this can cause a sudden rise in blood glucose.
Important advice
Controlling diabetes is a constant balancing act of insulin, food and exercise to prevent any imbalance in the blood glucose levels. The child should always wear medical identification providing information for an emergency.
For further information go to www. diabetes.org.uk. NW
Researched and written by Marcella McEvoy
