Diabetes is a very serious metabolic disorder that prevents the normal breakdown and use of food, especially sugars (carbohydrates) by the body. It can damage the heart, blood vessels, kidneys, and neurological system and can cause a progressive loss of vision over many years.
In children, diabetes is caused by inadequate production of the hormone insulin by the pancreas. When that happens, the body is unable to properly metabolize sugars, which build up in the bloodstream; these sugars cannot be used by the body and are excreted in the urine. This leads to the major symptoms of diabetes: increased urination, thirst, and increased appetite, as well as weight loss.
While diabetes can begin at any age, there are peak periods at about ages five to six and then again at ages eleven to thirteen. The first sign is often an increase in the frequency and amount of urination. However, the other cardinal symptoms must be present as well for the diagnosis of diabetes: Your child will complain of being thirsty and tired, she will begin to lose weight, and her appetite will increase. If these symptoms are not noticed early in their course, some children may require hospitalization by the time a diagnosis is made in order to receive treatment with intravenous insulin and fluids to stabilize their condition.
Although there is no cure for diabetes, children with this disease can lead a nearly normal childhood and adolescence if their disorder is kept under control. It is essential to control diabetes properly in order to avoid complications. Regular insulin injections—usually two per day, just before breakfast and dinner—can keep blood sugar levels within a normal range and reduce the likelihood of symptoms. A diet high in complex carbohydrates with restrictions on refined sugar is important too. A child with diabetes may need to be reminded that insulin shots alone cannot control diabetes; she also has to pay attention to her diet, following the doctor's nutritional guidelines. At least thirty minutes of exercise a day can help your child manage her disease as well.
By working with your children in their middle years, you can help them gradually begin to take responsibility for caring for their disorder. They can start giving themselves insulin injections. They can also check the sugar in their blood at least twice a day, using simple, chemically treated test strips. By attending summer camps for diabetic children, they can see how other children with this illness have become more self-reliant in caring for the disease.
However, you need to oversee these self-care tasks to make certain your child is following your doctor's guidelines. If your child takes too much insulin, she can experience insulin shock, with symptoms that include clammy or tingling sensations, trembling, a rapid heartbeat, and a loss of consciousness. Conversely, if she takes too little insulin, the major symptoms of diabetes (weight loss, increased urination, thirst, and appetite) can return.
When a youngster does not assume self-care responsibilities in the middle years, you may find it even more difficult to introduce this concept during adolescence, when the desire for independence often overrules common sense. If your youngster develops good habits before her teenage years arrive, however, she has a much better chance of an easier young adulthood.
For more information about childhood diabetes, ask your doctor or contact the Juvenile Diabetes Foundation, 432 Park Avenue South, New York, New York 10016. In many communities, parent groups are available in which the parents of children with diabetes can meet to discuss their common concerns. Ask your pediatrician to recommend a book or two that can further familiarize you with diabetes; one of the best, which can be read by both parents and children, is An Instructional Aid on Insulin-Dependent Diabetes Mellitus by Luther B. Travis, M.D. (American Diabetes Association, Texas Affiliate, 8140 North Mopac, Austin, Texas 78759).
