As a board-certified pediatrician at Kaiser Permanente, I regularly talk to parents who are worried their child might have diabetes. It’s a scary diagnosis for sure, but with proper, careful management, children with a diabetes diagnosis live happy, healthy, active lives.
Diabetes in children can manifest in various ways, and it’s important to recognize the signs early to manage the condition effectively. Here is information about Type 1 and Type 2 diabetes in children.
Type 1 Diabetes
Type 1 diabetes is an autoimmune condition where the body’s immune system attacks insulin-producing cells in the pancreas. In patients with Type 1 diabetes, the pancreas loses the ability to make enough insulin to meet the body’s needs.
Symptoms of Type 1 diabetes often develop quickly and can include:
• Frequent urination and bedwetting (polyuria).
A toilet-trained child may start waking up several times during the night to use the bathroom. An occasional, one-time-a-night wake up to urinate usually isn’t cause for concern, but if your toilet-trained child who typically sleeps through the night needs to urinate multiple times a night, consider this a red flag for Type 1 diabetes.
• Increased, frequent thirst (polydipsia).
Some children may regularly drink a few bottles of water during the school day, and that is a great way to stay hydrated. But if your child suddenly needs a water bottle every hour or finishes a bottle of water and then wants a second one and then a third one and then a fourth one, reach out to your child’s doctor.
• Frequent hunger (polyphagia).
If your child is eating significantly more than usual and doesn’t feel full after a meal, and has increased urination and/ or increased thirst, a diagnosis of Type 1 diabetes may be considered. Parents may have a difficult time telling the difference between a growth spurt that causes their child to have an increased appetite, and a medical problem. Reach out to your child’s doctor with any concerns about increased hunger to ensure an accurate diagnosis
Other symptoms of Type 1 diabetes may include unintentional weight loss despite eating more and feeling more tired than usual.
Children can be diagnosed with Type 1 diabetes at any time, but there are peak periods: We tend to diagnose children in early childhood to age 5, and during puberty.
If your child has symptoms of Type 1 diabetes, reach out to your child’s doctor as soon as possible. An early diagnosis is vital to preventing complications. We can usually make a diagnosis by doing a test that measures glucose control over the last three months (HbA1C), a blood glucose test, and/or an antibody blood test.
Parents are rightfully concerned when they learn their child has Type 1 diabetes. They feel as if their child is doomed! I tell parents that when diabetes is under control and well-managed, their children can have happy, active lives. I tell families about the children I know with a diabetes diagnosis and how well they are doing. I also tell them that working with an endocrinologist is important to develop meal plans, learn how to check glucose levels and learn how to administer insulin. Families should know that everyone is rooting for them!
Type 2 Diabetes
Unfortunately, as the childhood obesity epidemic is widespread in the United States, we are seeing an increase in the number of children diagnosed with Type 2 diabetes. Type 2 diabetes develops in overweight children at the onset of puberty.
People with Type 2 diabetes produce insulin but are unable to use insulin effectively.
Symptoms may not develop as suddenly and as obviously as symptoms in kids with Type 1 diabetes. But as with Type 1 diabetes, children with Type 2 diabetes may have increased thirst, increased urination, increased hunger, and increased fatigue. (Note: these symptoms are rare but possible). They may have changes in the texture of their skin – such as dark discoloration in body folds and creases – and high blood pressure.
Knowing that oftentimes children will have no symptoms of Type 2 diabetes, doctors will regularly screen children. We monitor the child’s weight and learn about family history. If we consider your child at high risk, we can check a blood glucose level to see if your child has Type 2 diabetes.
If your child is diagnosed with Type 2 diabetes, your child’s care team will focus on encouraging your child to maintain a healthy weight. We will talk about ways to get enough exercise, eat fewer fatty foods and starchy foods and incorporate more whole foods into the diet.
In addition, Metformin is approved for kids with Type 2 diabetes.
I reassure parents that we can prevent complications from Type 2 diabetes by encouraging the child to live a healthy lifestyle. Developing healthy habits early in life is often easier than trying to make big changes as adults.
Your child’s doctor is here to help and to listen to all concerns. If you are worried that your child may have diabetes, connect with your child’s doctor who will make sure your concerns are addressed appropriately.
Dr. Dayna Ukwuoma is a board-certified pediatrician with the Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente South Baltimore County Medical Center.
Dr. Dayna Ukwuoma is a board-certified pediatrician with the Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente South Baltimore County Medical Center.
