What to know about type 1 diabetes
Here are some of the signs and symptoms to watch out for in your child
Did you know that more than half the people who live with type 1 diabetes develop it before age 18? Only a small proportion (five to 10 per cent) of all people with diabetes have type 1, and most cases occur in children or adolescents.
We’re marking the start of Diabetes Awareness month by checking in with Dr. Diane Wherrett, a pediatric endocrinologist at the Hospital for Sick Children, on the signs and symptoms of type 1 diabetes.
Here is what parents should be on the lookout for:
What are the first symptoms parents usually notice in their kids?
Typically, parents start noticing their kid going to the bathroom more often — they’re getting up to pee at night or they’re wetting the bed. And they’re thirsty all the time. Those are the early symptoms.
As things progress, a child with undiagnosed type 1 will start to lose weight. They will have low energy and get tired easily. They may lose their appetite, and eventually get nauseous and start vomiting. If symptoms reach this point, that child needs to get to an emergency department.
It’s important to recognize these symptoms because of the urgency around getting a diagnosis. If your child is peeing a lot, drinking a lot, losing weight and starting to feel sick — they need the test done that day, the diagnosis made that day, and the treatment started that day. Because before a child or teen is diagnosed, their symptoms of type 1 diabetes can progress quite quickly from mild to moderate to severe.
How is a diagnosis of type 1 confirmed?
Diagnosis is made by a blood test to measure sugars, and with other tests to look for more severe illnesses. Often, this happens in an emergency room, but a quick urine test can be done in a health-care provider’s office first.
Once a diagnosis is made, treatment is started right away, and that treatment is insulin — how much insulin is based on the child’s blood sugar levels.
What are some first steps parents should be aware of post-diagnosis?
Once diagnosed, all kids in Ontario should be referred to one of the pediatric diabetes centres in the province, each of which has care teams with physicians, endocrinologists, nurse educators, dieticians, social workers and psychologists.
Not only do teams help parents understand how to measure and regulate blood sugar, but they provide a wealth of information postdiagnosis.
The whole family needs to learn about the condition because the more people understand type 1 diabetes and how to manage it, the easier it will be.
Diabetes is manageable, but it’s a big job. As a parent, you need to think about how much insulin your child needs, based not just on what they’re eating, but also on what they’re going to be doing — are they going to be running around or sitting and watching Netflix? So, it’s a 24/7 job that takes thought and planning, and that can be stressful. This is why diabetes teams typically have a mental-health professional to help support parents and kids in managing diabetes.
Parents with younger children can closely monitor diabetes management, but what are some of the challenges with teens living with type 1?
Teens are completely capable of checking their blood sugar and they understand how to regulate their insulin, but they can be inconsistent. They may be doing a great job for a while, then something happens in their life, and they get distracted: They forget to check their blood sugar and maybe miss an insulin injection.
What’s more, teens don’t want to be different from their peers. They may be hesitant to share with friends or coaches that they have diabetes. They may not want to check their blood sugar or take insulin in front of other people. So, parents of adolescents will want to have good lines of communication regarding diabetes management.
You work with a lot of families who have a recently diagnosed child — how do you help them cope with the inevitable changes to their lives?
It can be hard for parents. They are mourning the loss of their previously perfectly healthy child, who still looks perfectly healthy, but now has this chronic condition with no cure. That’s a huge adjustment for the parents and the child. And they worry about the longterm health risks.
There is often a period of grieving and learning how to cope whenever anyone in your family develops any kind of health condition. I try to give families space to go through this period, let them know that people manage and it gets easier. People can do really well living with diabetes.
There are all kinds of people living with type 1 diabetes — professional athletes, musicians, physicians, politicians. People with type 1 do everything. Families need to have hope, and they need to know they’re going to be able to handle this and it’s going to go OK.
HEALTHY KIDS POSES HEALTH QUESTIONS TO EXPERTS AT SICKKIDS. ALWAYS CONSULT YOUR HEALTHCARE PROVIDER WITH SPECIFIC CONCERNS. TORSTAR IS IN A FUNDRAISING AND EDUCATIONAL PARTNERSHIP WITH SICKKIDS FOUNDATION TO HELP RAISE $1.5 BILLION FOR NEW FACILITIES.