Type 1 diabetes in children

Insulin is a hormone needed for cells to absorb sugar from the blood. In type 1 diabetes, the body stops producing insulin and the baby then gets too much sugar in the blood. The treatment consists of getting insulin. With the treatment, the child can basically do everything that other children can do.

Symptoms of diabetes in children

A child who develops type 1 diabetes gets one or more of the following symptoms:

  • The child kisses more and more frequently.
  • The child may suddenly start peeing during the night, having previously not done so for a long period of time.
  • The child gets very thirsty and drinks more than usual.
  • The child is rapidly losing weight.
  • The child gets tired and can’t do anything.
  • The child feels sick or has a stomach ache.
  • The child becomes easily irritated.
  • The child looks blurred and gets visual disturbances.
  • The child smells of acetone from the mouth.
  • The child gets fungal infections in the mouth or abdomen.

 Children can get type 1 diabetes from being a few months old.

The disease can develop rapidly

The symptoms often develop from a few days to a few weeks. Young children can get serious symptoms after only a few days. It is common for the child to have an infection a few weeks before the disease breaks out.

High blood sugar levels can lead to ketoacidosis

When the child does not have enough insulin, blood sugar levels rise. The child can then get acid poisoning, called ketoacidosis. It is a serious condition that can be life-threatening if left untreated.

Read more about ketoacidosis further down in the text, in the chapter Complications and sequelae.

When and where should I seek care?

Contact a health care center or on-call clinic as soon as possible if you think your child has diabetes.

If it’s in a hurry

If the child is of general concern, immediately contact a health center or on-call reception. For example, it may be that the child seems very tired, does not make the same contact as usual and is uninterested in the surroundings.

If the care center or the on-call clinic is closed, seek care at an emergency room.

Investigations

Caregivers take both blood and urine tests to see if the child has diabetes.

A blood test to check blood sugar value

With a blood test called P-glucose, the doctor can see the baby’s sugar value in the blood at the time of sampling. Usually, a small stick in the finger is enough.

With a  blood test that measures the level of HbA1c, the doctor can see how blood sugar levels have averaged over the past two to three months. This blood test is sometimes called a long-term sugar test.

Other blood tests that can show if the child has diabetes

The blood is also examined to see if there are ketones in the blood. It is a substance that forms in the cells when they cannot absorb any blood sugar.

Another blood test can show if the child has antibodies against the cells that make up insulin.

The urine sample

Before the child leaves a blood sample they may be given a urine sample, a so-called U-glucose. The test shows if there is sugar in the urine. It is possible to squeeze urine out of the diaper if the baby uses the diaper.

The urine sample is also examined to see if it contains ketones.

Treatment for type 1 diabetes

The child needs hospital care when they become ill. The time spent in hospitals usually varies from one to a few weeks. The hospital has so-called diabetes teams that consist of healthcare professionals with specialized knowledge of the disease. You will have regular contact with the diabetes team.

The treatment consists of giving the child insulin and controlling the blood sugar value. The blood sugar value indicates how much sugar is in the blood, and with insulin, the cells can absorb the blood sugar. The child needs treatment for the rest of his life.

In the text Treatment for diabetes type 1 in children, you can read more about the treatment.

What happens in the body?

The cells in the body need the energy to function. The energy is transported in the blood, largely in the form of blood sugar. Blood sugar is also called glucose.

The blood sugar that is not absorbed by the cells is stored in the liver and in the muscles for later needs. The liver functions in this way as a sugar supply.

In order for the cells to absorb blood sugar, they need the hormone insulin. Insulin is formed in the pancreas and is released especially after eating and blood sugar levels rise.

The cells that make insulin are destroyed

Type 1 diabetes is a so-called autoimmune disease. This means that the body’s own immune system attacks its own tissues. 

In type 1 diabetes, the immune system has destroyed the cells of the pancreas. Then the pancreas can no longer produce insulin. The body’s cells cannot absorb blood sugar without insulin. The blood sugar then stays in the blood and the blood sugar value rises.

Ketones are formed when cells do not receive energy

The cells start to burn body fat when they get no energy from the blood sugar. When much fat is burned, acids called ketones are formed. Too many ketones can damage the body and lead to acid poisoning, called ketoacidosis. 

Read more about ketoacidosis further down in the text, in the chapter Complications and sequelae.

What is the cause of type 1 diabetes?

Type 1 diabetes is partly a hereditary disease. You inherit a tendency to develop an immune system that attacks and destroys the cells that makeup insulin. What makes the immune system attack the cells, however, is unclear.

Complications and sequelae

Diabetes can cause complications that occur quickly, but also complications that occur later.

Late complications rarely occur in children. With good treatment and care, it is also uncommon for children to have late complications as an adult.

Complications that happen quickly

These complications are due to the child having too high or too low blood sugar levels. Both are serious conditions that can be life-threatening:

  • Ketoacidosis can occur if the child has very high blood sugar levels and at the same time a lack of insulin.
  • Insulin sensitivity can occur if the blood sugar level drops sharply. Insulin sensitivity is also called hypoglycemia. 

Ketoacidosis if blood sugar levels are too high

If the baby has too little insulin in the blood, the cells cannot absorb the blood sugar. Then the child can get acid poisoning, called ketoacidosis. Ketoacidosis can quickly become life-threatening if left untreated.

The first signs are similar to the usual diabetes symptoms, for example, that the child needs to urinate often and becomes thirsty.

Always measure the baby’s blood sugar value if the baby is vomiting

One symptom of ketoacidosis is that the baby is vomiting. It can be misinterpreted as having the child become stomach upset. Therefore, always measure the child’s blood sugar value if needed, to find out if it is due to ketoacidosis.

The child also has the following symptoms:

  • The child is feeling ill.
  • The child gets a headache.
  • The child gets a stomach ache.
  • The child smells of acetone from the mouth.
  • The child breathes quickly.

Check your child’s blood sugar value and ketone content if the child has any of the symptoms above. Then follow the instructions you received from the diabetes team, based on the child’s blood sugar value. 

Getting ketoacidosis can take a long time

Have as a routine to measure the baby’s blood sugar value in the morning. It can vary how long it takes for the child to get symptoms, from hours up to several days. Ketoacidosis can also develop during one night. It may then be difficult to notice the first symptoms.

Ketoacidosis can come faster if the child has an insulin pump and it breaks down.

Insulin sensation – when the blood sugar value becomes too low

Common symptoms are the following:

  • The child becomes hungry.
  • The child becomes easily irritated.
  • The child becomes worried.
  • The child becomes cold-sweaty.
  • The child shakes or shakes.

Insulin sensation is serious. It usually happens if the blood sugar value becomes less than 3.5 mmol / l, but can vary widely between children. If the child does not receive energy in any form, they may become dumb and unconscious. How long it takes varies from child to child.

Insulin sensitivity is also called hypoglycemia.

Younger children may have other symptoms of an insulin sensation

Some children just get tired and want to lie down. Others can be inexplicably sad. You will learn how your child reacts to an insulin sensation.

The child needs to get the blood sugar value up

To break your insulin sensation and get your blood sugar levels up:

  • Let the child start eating something that increases blood sugar levels quickly, such as grape sugar. Take one tablet of 3 grams per 10 kilos of body weight.
  • Let the child rest for a while afterward.
  • Measure your blood sugar value after 10-15 minutes. If the blood sugar value has risen to a good level, the child may eat something. The child still needs to take insulin so that blood sugar levels do not rise too much.
  • Keep checking your blood sugar level until it does not vary too much between high and low values.

If the baby is not able to get grape sugar, the blood sugar value can be increased with a syringe containing the hormone glucagon. The drug is injected into the muscle on the front of the thigh. There are disposable syringes you can have at home, at preschool or school.

If the glucagon syringes do not help, the child must go to the hospital as soon as possible. There, the child receives a syringe with a sugar solution directly into the blood.

Blood sugar levels may vary around the clock

The nearest 24 hours after an insulin sensation the blood sugar value can vary greatly between high and low values. To get a stable value as possible, the child should eat and take insulin as usual.

Various causes of insulin sensation

Why the child gets an insulin sensation may be due to several things:

  • The child may have received too much insulin.
  • The child may have been given insulin with not having eaten properly afterward.
  • The child may have played very actively and moved a lot, without eating or drinking enough.  
  • The child has stomach disease with vomiting and diarrhea.

Talk to a diabetes nurse if you do not understand why the child has been given an insulin sensation.

Complications that may come later

A late complication is a damage to both small and large blood vessels. Damage to the small blood vessels can, among other things, lead to damage to the kidneys and eyes. Kidney damage due to diabetes is called diabetes nephropathy, and eye damage is called diabetic retinopathy.

An early sign that the small blood vessels have started to damage is that protein leaks into the urine through the kidneys. It is also called microalbuminuria. Therefore, the child’s urine is tested during the visits.

Support and help

It can be a daunting experience when one’s children fall ill with diabetes and are often affected by the whole family. The disease can awaken many thoughts and thoughts, and it can also feel painful with all injections and blood sugar checks.

A child who has diabetes may have other needs than children without diabetes of the same age. It can be difficult for you as a parent to know how to do in different situations. Talk to your diabetes team if you need advice.

For most, it becomes easier the more they learn about the disease, what affects the blood sugar value and what the child can do to keep the value at a good level. Having diabetes does not have to prevent the child from living a good life with the same activities as other children.

Meeting others can help

It can be helpful to meet others who have similar experiences. For example, many pediatric clinics have meetings once a year for parents of children with diabetes.

Here are more suggestions on where to get in touch with other parents and relatives:

  • The Diabetes Association has parent groups in some places. On their website, you will also find information about diabetes and reports on what it is like to live with diabetes.
  • Young Diabetes is the Diabetes Association’s association for people between the ages of 15 and 30 with diabetes. Both you and your child can contact them if you have any questions, for example to their Diabetes Buddy Inquiry Service.
  • In many parts of the country, the Diabetes Association has local diabetes associations where you can get support. Young Diabetes also has local associations for young people with diabetes.
  • Through the Child Diabetes Foundation, you can also meet other children who have diabetes, as well as their parents and relatives. The Children’s Diabetes Foundation also has local associations.

Young Diabetes and some children’s clinics arrange camps or meetings for children and adolescents with diabetes.

Economic compensation

You can receive financial compensation from the Social Insurance Agency, for example, compensation for childcare and nursing allowance.

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