Happy American Diabetes Month!
November is American Diabetes Month, with the purpose of increasing awareness of this growing health issue. It is a good opportunity to learn about the different types of diabetes and treatments used to manage them. There are several types of diabetes, but this article will focus on the two most common types in children: Type 1 and Type 2.
What is diabetes?
Diabetes occurs when the body does not make or use insulin properly. Insulin is a hormone that moves sugar from the blood to the body’s tissues, where it is used for energy for growth, activity, learning and all bodily functions. Sugar in the blood comes from carbohydrates in the diet, which are found in fruits, grains (bread, rice, pasta, cereal, tortillas, etc.), legumes (beans and lentils), starchy vegetables (potatoes, peas, and carrots), dairy foods (milk and yogurt) and sweets. When the sugar cannot be moved to the body tissues, it increases in the blood. Elevated sugar in the blood can lead to significant health problems, like kidney disease, poor healing and vision changes.
What is Type 1 diabetes?
Type 1 diabetes is an autoimmune disease that affects the pancreas, causing it to stop making insulin. It was previously called juvenile-onset diabetes, because it is most often diagnosed in young people. However, it can occur at any age. The exact causes of Type 1 diabetes are not yet known, but there is likely a predisposition to diabetes or other autoimmune disease, in addition to a trigger. People with diabetes or other autoimmune disease in their family are at increased risk for developing Type 1 diabetes. Research is being done to identify those at risk, understand the events precipitating onset, and detect diabetes early.
Type 1 cannot be caused or prevented by diet, exercise or other health practices. However, it can be effectively managed with appropriate medical care. Treatment of Type 1 diabetes requires the patient to pay close attention to diet. Patients also have to check their blood-sugar levels multiple times per day and take insulin throughout the day with food and to correct high blood-sugar levels. A person with well-managed Type 1 diabetes can expect to have a long and fulfilling life, unhindered by the diabetes diagnosis.
What is Type 2 diabetes?
Type 2 diabetes is an acquired resistance to insulin. It was previously known as adult-onset diabetes, because it was primarily diagnosed in adults. However, more children are now being diagnosed with Type 2 diabetes.
Initially, the pancreas makes insulin, but the body does not respond to it, resulting in increased sugar in the blood. If Type 2 diabetes is not well-controlled, the pancreas loses its ability to make insulin. Risk factors for Type 2 diabetes include family history and being overweight.
While there is a strong genetic component to the development of diabetes, it may be prevented or delayed by maintaining a healthy body weight through a balanced diet and regular physical activity. Type 2 diabetes is often treated with one of a variety of medications that improve how the body responds to insulin. Fewer of these medications have been studied and approved for children. People with Type 2 diabetes sometimes need insulin to treat it as well. In addition to appropriate medications, changes to the diet and physical activity are an important part of treatment. With appropriate weight loss, some people with Type 2 diabetes can reduce the amount of medication required for blood-sugar control.
Many people newly diagnosed with diabetes have some knowledge of it. However, some may receive well-intentioned advice from friends and family who have misunderstandings about the condition. Such misunderstandings may include that people with diabetes should not eat certain foods, that they do or do not require certain medications, or that the management of a child’s diabetes will be the same as that of adult. However, the different types of diabetes require different treatment plans. The treatment regimen developed by the patient’s medical team is designed specifically for the patient, taking into consideration the age of the patient and the type of diabetes the patient has. The newly diagnosed patient’s treatment regimen may be quite different from others for patients already diagnosed.
Nutrition plays an important role in managing both Type 1 and Type 2 diabetes. The goal of nutrition in Type 1 diabetes, or any insulin-dependent diabetes, is to match the amount of insulin given with the amount of carbohydrates in the food consumed, in order to keep the blood sugar in a safe range. Alternatively, the goal of nutrition in management of Type 2 diabetes is to provide a moderate amount of nutritious carbohydrates, balanced with protein, to prevent spikes in blood sugar and improve insulin sensitivity. Often, changes are suggested to help the patient move toward a healthy body weight, which may help improve how the body responds to insulin. All children, including those with diabetes, should be encouraged to eat a balanced diet, including lots of fruits and vegetables, whole grains, low-fat dairy or other calcium-fortified milk alternative, and a variety of protein sources (i.e., meat, chicken, fish, eggs, nuts, beans and dairy), with limited intake of processed snacks and sweets. Growing children require nutritious sources of carbohydrates for adequate growth. While pure-sugar beverages like juices, regular sodas and other sugary drinks, as well as pure-sugar candies like sucking candies and gummies, should not be given except to correct low blood-sugar levels, nutritious sources of carbohydrates in the diet should not be highly restricted.
In summary, treatment of diabetes is specific to the individual. It is important to understand the type of diabetes you or your family member has, and the treatment plan recommended. It is always appropriate to ask the patient’s health care team questions if you hear about different treatment ideas, but please discuss any changes you’re considering before making them. Then, the whole team can adequately participate in your child’s care.