Monday, April 11, 2016

J is for Juvenile Diabetes

There are a number of early symptoms that suggest a child might have type 1 diabetes.

Early symptoms

Mother comforting daughter in bed

  • frequent peeing (urination) in large amounts (polyuria)
  • increase in thirst (polydipsia)
  • dry mouth or throat
  • weight loss
  • increase in appetite (polyphagia)
  • feeling tired or weak

Other symptoms in toddlers or infants

  • diaper rash that doesn’t improve with medicated cream

More serious symptoms

These symptoms appear if the diabetes is not treated, or in some cases when it is undiagnosed.
  • weight loss
  • stomach aches
  • nausea and vomiting
  • heavy, rapid breathing (Kussmaul breathing)
  • drowsiness

What happens in children who aren’t making or taking any insulin?

As the child with diabetes eats, the food is broken down and sugar is still released during digestion. This sugar is absorbed into the bloodstream and is carried to the cells. But the pancreas doesn’t respond by making insulin, so the sugar can’t move into the cells. When the sugar remains locked out of the cells, a chain of events is set in motion. The child may become tired, because the cells are literally starved for energy. Meanwhile, sugar continues to build up in the blood. If this were allowed to continue, the blood would eventually become so thick, and syrupy that it wouldn’t flow through the veins. Fortunately, the kidneys do their job. They filter blood, and get rid of substances that might otherwise harm the body.

High sugar levels and the kidneys

When the kidneys sense a high level of sugar in the blood, they start getting rid of it through the urine. The point at which the kidneys allow sugar to enter the urine, is called the renal threshold.
  • When this excess sugar is eliminated, it also takes the water in which it is dissolved. As a result, the child urinates more often, and in larger amounts, just to get rid of the sugar. This is called polyuria.
  • The higher the blood sugar level, the more often the child urinates. This often leads to dehydration, so the body demands more water, and the child becomes increasingly thirsty. This is called polydipsia.
Children may complain of a dry sticky mouth, or sore dry throat. Parents report children gulping down jugs of juice, and large quantities of milk, or water. Sometimes parents think their child is urinating so much, because of the extra drinking, so they try to cut off the fluids. But, the child will continue to urinate often, because the body’s priority is to clear out the excess sugar. Drinking all this fluid, is the only way to avoid dehydration.
Excessive urination, and thirst are usually the first indications of the high blood sugar (hyperglycemia) of diabetes. Some children have to get up in the middle of the night to go to the bathroom (nocturia). Younger children may even start wetting the bed (enuresis)​. The loss of sugar in the urine, together with dehydration, and the inability to use blood sugar, can lead to weight loss, despite an increase in appetite (polyphagia). As the symptoms develop, children often feel tired, drowsy, and weak.

Symptoms in infants and toddlers

Early symptoms may not be as clear in infants, and toddlers. It’s difficult to recognize thirst in young children, who cannot speak. Regular growth spurts, can also bring changes in appetite. In these cases, children may quickly progress to more serious symptoms, before diabetes is recognized. One additional symptom found in those wearing diapers may be a fungal or yeast diaper rash, that doesn’t improve with the use of medicated cream. The fungus, or yeast, flourishes in the sugar excreted in the urine. In older girls, yeast infections (for example, vaginal discharge or itching) may also be a symptom.

Using fat for energy (more advanced symptoms)

The body needs energy to survive. When the pancreas doesn’t make insulin, or the insulin isn’t working, cells don’t get energy. Over time, the body starts to break down fat, and proteins, to be used as energy. When this happens, there is weight loss. In this process, the body also makes a potentially poisonous byproduct called ketones, or acetone. This is the same chemical, used in nail polish remover.
As soon as ketones are made, the kidneys recognize that they are poisonous, and filter them out through the urine. If the body can’t filter out the ketones as fast as they are being made, they begin to build up in the blood. This leads to symptoms such as stomach aches, and severe nausea. This buildup of ketones is called diabetic ketoacidosis (DKA). When the body can’t get rid of all the ketones through the urine, it can even start exhaling them, so that a fruity or unnatural smell, may be noticeable on the child’s breath. Heavy, rapid breathing, is one way the body attempts to get rid of more ketones. This is called Kussmaul breathing.
Ketoacidosis is a serious condition. It can lead to unconsciousness, and death. Fortunately, giving intravenous fluid, and insulin corrects the situation. In fact, this is the sickest, most children with diabetes will ever be. Once a child has been diagnosed with diabetes,
and the parents gain the tools and support they need to manage the disorder, diabetic ketoacidosis should be totally avoidable.
Today, diabetes is most often diagnosed before DKA has developed. If a child has classic symptoms of diabetes, this should trigger further testing. ​

16 comments:

  1. At least doctors know what to look for. Scary stuff.

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  2. Good info. Thanks for sharing them. All parents need to be aware of it...

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  3. that's very informative, every parent must have basic knowledge of such problems

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  4. Very informative and good to know for families with young children. Awareness is the first step towards taking control.

    Best wishes,
    Nilanjana.
    Ninja Minion, A-Z 2016
    Madly-in-Verse

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  5. great work ,scary but still requires our attention towards the health of our child ,thank you so much for your so positive effort
    god bless you

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  6. The symptoms that you have described happened to David while he was on a youth group trip when he was 14. He couldn't stop drinking and peeing. He felt horrible. They took him to the ER in Myrtle Beach and they said he was diabetic and he had to be in a hospital within 6 hours. There is a long story to go along with this. But, long story short, shortly after arriving back home in Anderson County, SC, he went into a coma. They didn't think that he would make it. Praise the Lord, he survived.

    I have, on a few occasions, smelled the fruity breath of ketoacidosis on him. That was a long time ago, though, before he went on the insulin pump.

    Thankfully, none of our children have diabetes, even though the odds are that one out of our 4 children would have it.

    Thanks for such an informative post, Denise. Have a blessed day.

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  7. My daughter developed Juvenile Diabetes very quickly at age 12, my niece at 7. It changed her life, and our lives dramatically, but she has gone on to prove that being diabetic does not define you, it is not WHO you are, it's just something you learn to live with. I am glad you shared these important symptoms so parents realize that something may be very wrong if this is happening to their child. A doctor's care is essential!
    Josie Two Shoes
    from Josie's Journal

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  8. Really great information Denise! Is most of this the same for adults? (maybe you already covered this?) Thanks for sharing such vital information for kids and parents to know. Since your mom brother and sister all had/have diabetes, were you diabetic as a child or later?

    Love you, praying for your tests today and all your other petitions at the Lighthouse and on your precious heart! May God bless you and your dear loved ones! ~ Peggy

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  9. Wow....this is an incredible, informative post Denise.

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  10. Wow, lots of useful information for parents! I remember reading The Babysitters Club as a child and one of the characters had juvenile diabetes. I think the author approached that subject very well, and it informs the kids of the symptoms.

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  11. Fascinating. Believe it or not, it explains some of the symptoms i've been seeing in our diabetic cat.

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  12. This info pediatricians should probably have posted in their offices or fact sheets for their patients. A lot of parents might not catch this until it got totally out of control.

    betty

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