Hamburger

Call: 1-202-476-5000

 
Diabetes Program (Childhood and Adolescent)
Conditions & Treatments
Meet Our Team
Locations
Resources for Families
Contact Information
Request an Appointment
Best Children's Hospitals
 
 
Email This Page
Print This Page
 
 

Condition/Treatment

Diabetes, Type 1 and Type 2


What is diabetes?
Diabetes is a condition in which sufficient amounts of insulin are either not produced, or the body is unable to use the insulin that is produced. Diabetes can be defined as a metabolic disorder, because the disease affects the way the body metabolizes, or uses, digested food to make glucose, the main source of fuel for the body. Diabetes may be the result of conditions such as genetic syndromes, chemicals, medications, malnutrition, infections, viruses, or other illnesses. The three main types of diabetes include:
  • Type 1 diabetes-an autoimmune disease in which the body's immune system attacks the cells that produce insulin, resulting in no or a low amount of insulin. People with type 1 diabetes must take insulin daily in order to live.
  • Type 2 diabetes-a result of the body's inability to make enough, or to properly use, insulin. Type 2 diabetes may be controlled with diet, exercise, and weight loss, or may require oral medication and/or insulin injections.
  • Gestational diabetes-condition where glucose level is elevated and other diabetic symptoms appear during pregnancy in a woman who has not previously been diagnosed with diabetes. In most cases, all diabetic symptoms disappear following delivery.
How does diabetes affect blood glucose?
For glucose to be able to move into the cells of the body, the hormone insulin must be present. Insulin is produced in the pancreas, and, normally, is readily available to move glucose into the cells. However, in people who have diabetes, either the pancreas produces too little or no insulin, or certain cells in the body do not respond to the insulin that is produced. This causes a build-up of glucose in the blood, which passes into the urine where it is eventually eliminated, leaving the body without its main source of fuel.

What is maturity-onset diabetes in the young (MODY)?
Although often misdiagnosed as type 1 or type 2 diabetes, maturity-onset diabetes of the young (MODY) is a group of diseases characterized by inherited early-onset diabetes (between age 9 and 25) coupled with B-cell dysfunction (a cell that originates in the bone marrow and plays a major role in the body's immune response). Three genetic mutations have been identified that appear to cause three versions of MODY (MODY 1, MODY 2 and MODY 3).

Severity of the diabetes symptoms associated with MODY varies depending on the type of MODY diagnosed. MODY 2 appears to be the mildest form of the disease, often only causing mild hyperglycemia and impaired glucose tolerance. MODY 1 and 3 may require treatment with insulin, much like type 1 diabetes.

Back to Top

Type 1 Diabetes
The most common type of diabetes in children is type 1 diabetes. In fact, type 1 diabetes is one of the most common chronic diseases in children, according to the American Diabetes Association. It is estimated that one in every 600 children in the United States develops type 1 diabetes. Type 1 diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes in the United States.

What is type 1 diabetes?
Type 1 diabetes may also be known by a variety of other names, including:
  • Insulin-dependent diabetes mellitus (IDDM)
  • Juvenile diabetes
  • Brittle diabetes
  • Sugar diabetes
There are two forms of type 1 diabetes:
  • Idiopathic type 1 refers to rare forms of the disease with no known cause.
  • Immune-mediated diabetes is an autoimmune disorder in which the body's immune system destroys, or attempts to destroy, the cells in the pancreas that produce insulin.
Immune-mediated diabetes is the most common form of type 1 diabetes and is generally referred to as type 1 diabetes.

What causes type 1 diabetes?
The cause of type 1 diabetes is unknown. However, it is believed that people inherit a tendency to develop diabetes, and that some outside trigger may be involved. Type 1 diabetes is the result of the body's failure to produce insulin, the hormone that allows glucose to enter the cells of the body to provide fuel. This is the result of an autoimmune process in which the body's immune system attacks and destroys the insulin producing cells of the pancreas.

When glucose cannot enter the cells, it builds up in the blood causing the body's cells to starve to death. People with type 1 diabetes must take daily insulin injections and regularly monitor their blood sugar levels.


What are the symptoms of type 1 diabetes?
Type 1 diabetes often appears suddenly. In children, type 1 diabetes symptoms may resemble flu symptoms. The following are the most common symptoms for type 1 diabetes. However, each child may experience symptoms differently. Other symptoms include:
  • High levels of sugar in the blood when tested
  • High levels of sugar in the urine when tested
  • Unusual thirst
  • Frequent urination
  • Extreme hunger but loss of weight
  • Blurred vision
  • Nausea and vomiting
  • Abdominal pain
  • Extreme weakness and fatigue
  • Irritability and mood changes
The symptoms of type 1 diabetes may resemble other problems or medical conditions. Always consult your child's physician for a diagnosis.

What complications may be associated with type 1 diabetes?
Although type 1 diabetes can cause many different problems, there are several key complications, including the following:
  • Hypoglycemia (low blood sugar, sometimes called an insulin reaction) occurs when blood sugar drops too low
  • Hyperglycemia (high blood sugar) occurs when blood sugar is too high, and can be a sign that diabetes is not well controlled
  • Ketoacidosis (diabetic coma) loss of consciousness due to untreated or under-treated diabetes
Treatment for type 1 diabetes
Children with type 1 diabetes must have daily injections of insulin to keep the blood sugar level within normal ranges. Specific treatment for type 1 diabetes will be determined by your child's physician based on:
  • The child's age, overall health, and medical history
  • Extent of the disease
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Opinion or preference
Treatment may include:
  • Appropriate foods (to manage blood sugar level)
  • Exercise (to lower and help the body use blood sugar)
  • Regular blood testing (to check blood-sugar levels), as directed by your child's physician
  • Regular urine testing (to check ketone levels), as directed by your child's physician
Helping your child cope with type 1 diabetes
Depending on your child's age, a type 1 diabetes diagnosis can be devastating. The younger child may not quite understand all the life changes that may occur because of the diagnosis, such as glucose monitoring and insulin injections. After being diagnosed with type 1 diabetes, children may feel:
  • As if they are being punished
  • Guilty
  • Fearful of death
  • Hostility toward the parent
Although a child who is diagnosed with type 1 diabetes requires supervised medical care, a parent should avoid being overprotective. Through parental encouragement, self-care of the diabetes by the child, starting at the appropriate age, will foster improved self-esteem and independence.

Back to Top

Type 2 Diabetes
Type 2 diabetes is the most common type of diabetes, accounting for 90 to 95 percent of diabetes cases. There is an increase in the number of cases of type 2 diabetes in children and adolescents. The rise may be due to obesity and decreased physical activity among children. The risk for type 2 diabetes increases with age.

What is type 2 diabetes?
Type 2 diabetes is a metabolic disorder resulting from the body's inability to produce enough, or to properly use, insulin. It has previously been called non-insulin-dependent diabetes mellitus (NIDDM). Without enough insulin, the body cannot move blood sugar into the cells. It is a chronic disease with no known cure.

What causes type 2 diabetes?
The exact cause of type 2 diabetes is unknown. However, there is an inherited susceptibility that causes it to run in families. Although a person can inherit a tendency to develop type 2 diabetes, it usually takes another factor, such as obesity, to bring on the disease.

Prevention or delay of onset of type 2 diabetes
Type 2 diabetes may be prevented or delayed by following a program to eliminate or reduce risk factors - particularly losing weight and increasing exercise. Information gathered by the Diabetes Prevention Program, sponsored by the National Institutes of Health and the American Diabetes Association, continues to study this possibility.

What are the symptoms of type 2 diabetes?
The following are the most common symptoms for type 2 diabetes. However, each child may experience symptoms differently. Symptoms may include:
  • Frequent infections that are not easily healed
  • Frequent urination
  • Extreme hunger but loss of weight
  • Unusual thirst
  • Blurred vision
  • Extreme weakness and fatigue
  • Irritability and mood changes
  • Nausea and vomiting
  • High levels of sugar in the blood when tested
  • High levels of sugar in the urine when tested
  • Dry, itchy skin
  • Tingling or loss of feeling in the hands or feet
Some people who have type 2 diabetes exhibit no symptoms. Half of all persons with diabetes do not know they have the disease.

The symptoms of type 2 diabetes may resemble other problems or medical conditions. Always consult your child's physician for a diagnosis.

What are the risk factors for type 2 diabetes?
Risk factors for type 2 diabetes include the following:
  • Age (incidence increases with age)
  • Family history of diabetes
  • Being overweight
  • Not exercising regularly
  • Being a member of certain racial and ethnic groups, such as African-Americans, Hispanic Americans, and Native Americans
  • Low level HDL (high density lipoprotein, the good cholesterol)
  • High triglyceride level
Treatment for type 2 diabetes
Specific treatment for type 2 diabetes will be determined by your child's physician based on:
  • Your child's age, overall health, and medical history
  • Extent of the disease
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Opinion or preference
The goal of treatment is to keep blood-sugar levels as close to normal as possible. Emphasis is on control of blood sugar (glucose) by monitoring the levels, regular physical activity, meal planning, and routine healthcare. Treatment of diabetes is an ongoing process of management and education that includes not only the child with diabetes, but also family members.

Often type 2 diabetes can be controlled through losing weight, improved nutrition, and exercise. However, sometimes, these are not enough and either oral medications and/or insulin must be used.

Treatment may include:
  • Proper diet
  • Weight control
  • Appropriate exercise program
  • Proper hygiene
  • Insulin replacement therapy (under the direction of your child's physician)
Back to Top

Diabetes, Type 1 and Type 2 - Departments & Programs - Children's National Medical Center