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Juvenile diabetes refers to when diabetes develops in children. This article describes how to recognize when diabetes develops in children.

There are two major types of diabetes — type 1, in which patients don’t produce enough insulin (the hormone responsible for metabolizing glucose) and type 2, in which cells are no longer responsive to insulin. Juvenile diabetes is diabetes that occurs in young people under the age of 16 to 18 years.

Juvenile diabetes is quite common and is actually the most prevalent metabolic disease in children and young adults. In particular, type 1 diabetes is more common in young children as 90 percent of people who have type 1 diabetes are younger than 25. Additionally, there has been a constant rise in the levels of type 2 diabetes and insulin resistance in the young, owing to the rise in obesity.

Symptoms of type 1 diabetes

Symptoms that occur in children and teenagers with type 1 diabetes include:

  • Excessive thirst
  • Excessive hunger
  • Frequent urination
  • Fatigue or tiredness
  • Feeling irritable
  • Breath smells fruity
  • Blurred or impaired vision
  • Yeast infection (girls)
  • Weight loss

One strategy to identify type 1 diabetes in children is to be aware of the so-called "four Ts". They include:

  • Toilet — children use the bathroom frequently, infants have heavier diapers, bedwetting occurs.
  • Thirsty — children drink more fluids than usual and are always thirsty.
  • Tired — children feel more tired than usual.
  • Thinner — children lose more weight than normal.
Type 1 diabetes symptoms in children will develop rapidly, within a period of a few weeks. As a parent, you need to be diligent as studies have shown that only nine to 14 percent of parents can identify the four main symptoms of type 1 diabetes. Your child does not need to display all four symptoms for you to be concerned and take them to the doctor, as some many only have one or two.

Symptoms that occur in children and teenagers with type 2 diabetes include:

  • Extreme thirst
  • Extreme urination, particularly at night time
  • Feeling tired or irritable
  • Unexplained weight loss
  • Genital itching associated with yeast infection
  • Sores or wounds that heal slowly
  • Impaired or blurred vision
  • Dark, velvety skin

Unlike type 1 diabetes, type 2 diabetes symptoms develop over a much longer period of time and can take months, even years to get diagnosed.

If you notice any of these symptoms associated with either type 1 or type 2 diabetes, then make sure to take your child to the doctor. In some cases, children don’t receive diagnosis of diabetes until their symptoms are very severe already. If diabetes is uncontrolled for a long period of time, that can lead to several complications.

Complications of diabetes in children

Unfortunately, leaving type 1 diabetes untreated for a long period of time leads to the development of severe complications.

Diabetic ketoacidosis is one of the most severe consequences of untreated type 1 diabetes, and sometimes untreated type 2 diabetes. In fact, diabetic ketoacidosis is one of the leading causes of death in children with type 1 diabetes. Diabetic ketoacidosis develops because when there is no more glucose available for energy, our bodies start to break up fat molecules instead. However, that causes the production of ketones, which, at high levels, are toxic.

This is a common complication of type 1 diabetes as one study found that 80 percent of children under the age of two who were diagnosed with type 1 diabetes had already developed diabetic ketoacidosis. Diabetic ketoacidosis was found to be a missed diagnosis in children who either had a misdiagnosis of type 1 diabetes or had a delayed diagnosis. Thus, earlier diagnosis of type 1 diabetes can prevent the development of diabetic ketoacidosis​

Complications associated with type 2 diabetes include:

  • Kidney disease
  • Eye disease
  • High blood pressure
  • High cholesterol
  • Obesity

Diagnosis: How will you know if your child is diabetic?

Diagnosing children with signs or symptoms of diabetes involves doing a urine test (to look for sugar in urine) or a finger-prick blood test (to test the child’s blood sugar level). Since type 2 diabetes occurs in obese children, guidelines recommend that children over the age of 10 who don’t have symptoms of diabetes but are overweight should be closely monitored for type 2 diabetes if they also have any of these two risk factors:

  • Family history of type 2 diabetes
  • Ethnicity that is either Native American, Asian, African American or Pacific Islander.
  • The mother had type 2 diabetes when she was pregnant or had gestational diabetes (which is a type of diabetes that only occurs during pregnancy).

The prognosis for patients diagnosed early on is very good so it’s important to detect the disease earlier.

Treatment of diabetes in children

  • Currently, insulin is the standard of care for type 1 diabetes as no other medication is as effective. Generally, conventional therapy includes administration of insulin twice a day and regular health monitoring by a healthcare team.
  • Similar to adults with type 2 diabetes, treatment for type 2 diabetes in children involves lifestyle changes such as maintaining a healthy weight or losing weight, having a healthier diet (in particular, limiting intake of sugary foods and drinks) and exercising more.

  • Gepts, Willy. "Pathologic anatomy of the pancreas in juvenile diabetes mellitus." Diabetes 14.10 (1965): 619-633.
  • Johnson, Suzanne Bennett. "Psychosocial factors in juvenile diabetes: A review." Journal of Behavioral Medicine 3.1 (1980): 95-116.
  • Andersen, A. R., et al. "Diabetic nephropathy in type 1 (insulin-dependent) diabetes: an epidemiological study." Diabetologia 25.6 (1983): 496-501.
  • Fagot-Campagna, Anne, et al. "Type 2 diabetes among North adolescents: An epidemiologic health perspective." The Journal of pediatrics 136.5 (2000): 664-672.
  • Photo courtesy of SteadyHealth

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