Managing and Coping Childhood and Adolescent Diabetes Monday, November 4, 2013

Did you know that about 215,000 people younger than 20 have diabetes in the United States? In fact, the most common type of diabetes in children is type 1 diabetes and according to the American Diabetes Association, it is also one of the most common chronic diseases in children. However, the number of cases of type 2 diabetes in children has increased, which may be due to obesity and decreased physical activity.

November serves as American Diabetes Month to help raise awareness of this ever-growing disease and to focus the nation’s attention on the issues surrounding diabetes.

Diabetes is a group of diseases characterized by high blood glucose levels that result from defects in the body’s ability to produce and/or use insulin. These metabolic disorders affect the way the body metabolizes, or uses, digested food to make glucose, the main source of fuel for the body.

Breaking Down Diabetes Types:

Type 1 diabetes is an autoimmune disease in which the body’s immune system attacks the cells in the pancreas that produce insulin, resulting in either no insulin or a low amount of insulin. Children will often need injectable insulin because the body is no longer making it.

Type 2 diabetes is a result of the body’s inability to make enough, or to properly use, insulin. Type 2 diabetes can sometimes be controlled with diet and exercise, but most children will need medication.

Children may experience symptoms of diabetes differently, but some of the more common symptoms may include: excessive thirst, frequent urination, irritability, stomach pain, and unexplained weight loss. Once a child is initially diagnosed with diabetes, Children’s National Health System’s endocrinology outpatient dietitian, Erika Davies, MS, RD, LD said treatment depends upon the type of diabetes.

Diabetes Treatment at Children’s National:

Within the Division of Endocrinology and Diabetes at Children’s National, our type 1 patients see their endocrinologist every three to four months. At each visit, blood sugar numbers are analyzed and insulin recommendations are made. Davies emphasized that the patient and her family visit a registered dietitian at least once a year to ensure the child is eating the appropriate foods. “It is critical that they eat a balanced diet for optimal blood sugar management,” Davies said.

For type 2 patients, Davies noted that an emphasis is put on exercise and diet changes to produce weight loss that is often needed to lower overall blood sugar. These patients meet with their doctor every three to four months for evaluation and regularly meet with a registered dietitian and possibly a physical therapist to check on progress.

Davies explained that since type 1 diabetes is an autoimmune disease, there is currently no way to prevent the disease once it starts to progress. However, she noted that type 2 diabetes can be prevented in children with proper diet and exercise.

As an American Diabetes Association (ADA)-recognized education provider, Children’s National helps children, teens, and their families understand how to manage and cope with all aspects of diabetes through the Washington Nationals Diabetes Care Complex, which opened on June 5, 2013. The complex includes state-of-the-art outpatient treatment rooms and an education center, where families can participate in simulation labs to learn about proper nutrition and physical exercise.

How Parents Can Help:

If children are having a difficult time coping with their diabetes diagnosis, Davies noted that Children’s National has a team of psychologists that families can speak with about their feelings surrounding diabetes. “Support groups can also be very beneficial for both the child and the parent,” she said.

With the holidays approaching, parents may find managing their child’s diabetes to be stressful. “Don’t stress out too much on the actual holiday,” Davies said. “Try to keep the schedules as normal as possible.”

She also recommended trying to balance out the volume of foods high in carbohydrates with more exercise and vegetables during this time. “Eat the high-carb food in small portions so that you can have a little bit of a bunch of different foods,” Davies said.

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