Each year, more than 15,000 children are diagnosed with juvenile (Type 1) diabetes, and November is recognized as an awareness month for this condition in the United States. With juvenile diabetes, the pancreatic islet cells that make insulin are destroyed by the immune system; no insulin is made by the pancreas internally and must be administered externally.
All parents should be aware of the warning signs that accompany Type 1 diabetes. A major change in disposition, energy level, or appearance should always be a cause for concern. Other symptoms can include:
- Extreme thirst and frequent urination
- Difficulty concentrating or holding attention
- Drowsiness or lethargy
- Increased appetite
- Sudden weight loss
- Sudden vision changes
- Sugar in the urine
- Fruity odor on the breath
- Heavy or labored breathing
- Stupor or unconsciousness
If your child exhibits some or all of these symptoms, go to a physician immediately. The doctor may perform a random blood sugar test or a glycated hemoglobin (A1C) test, which determines blood sugar average throughout two or three months. If these result in a positive diagnosis, you should consult with your pediatrician and your endocrinologist.
You should also take the time to prepare a thoughtful, compassionate discussion with your child about his diagnosis. Your response will serve as a guideline for how your child will react. Calmly provide all the information you can. Reinforce the facts and guidelines discussed by your physician. All caregivers and family members should provide a uniform message and instructions. Emphasize the positive while maintaining the serious nature of the situation.
Because there is no cure for Type 1 diabetes, you should focus on the treatments that are available. Insulin is not a cure, but it does help manage the disease. Your child might be afraid that he will be unable to play or go to school, so help him to understand that the insulin will help with living a normal life. Have a family member demonstrate an example of taking medicine as part of a daily routine (like grandpa and his blood pressure pills) to de-stigmatize this new responsibility.
It may be a shift for your family to start regularly eating healthy foods, but the importance of a nutritious diet for your child cannot be understated. Instill the value of healthy eating right at the onset of diagnosis.
Encouraging the entire family to practice healthy eating habits will prevent your child from feeling left out or viewing healthy food as a punishment.
Counting carbohydrates (sugars, starches) to determine proper insulin dosages can become a game. (For example, ask your child, “How many carbohydrates are in one half-cup of mashed potatoes? Fifteen? You’re right!”) Encourage your child to learn carbohydrate counts with you. Look at the labels of snacks and other foods and remember portions. It may not be an easy habit to pick up, but it’s imperative for your child with juvenile diabetes, and it will benefit the whole family.
Regular exercise is also important and a natural way to help regulate diabetes. If your family time is usually spent in front of the TV, switch to playing outside. Family bike rides, active games, or simple walks around the neighborhood will make everyone healthier, help relieve stress, and provide a new way to bond. You want your child to view a commitment to diet and exercise as positive asset, not a consequence of being sick.
Monitoring blood sugar is often the hardest adjustment for a child. Again, positioning it as a game (“Let’s see what your glucose number is!”) instead of a burden may make it easier in the beginning. Spend as much time as it takes for your child to feel comfortable doing the finger prick to test her sugar levels. You might even have every family member perform a test to show your child that your family is “in this” together.
Finally, educate your child on the signs of low blood sugar, such as shaking, sweatiness, hunger, weakness, being lightheaded, headaches, fatigue, blurred vision, or rapid heart rate. When these symptoms occur, your child should drink fruit juice or another source of sugar and retest her blood sugar in 15 minutes, repeating this process until the reading is normal. Make sure your child is always prepared by carrying a source of fast-acting sugar at all times, as well as a glucagon emergency kit.
Facing juvenile diabetes is all about preparation and education. As both a doctor and mother, I have learned that children have a natural curiosity and a resilience that often surprises adults. With support and the tips above, living with juvenile diabetes can be manageable for you, your child, and your entire family.