About Diabetes (diabetes mellitus)

What is Diabetes?

Diabetes is a disease characterised by an increase in blood glucose levels. Diabetes is a lifelong chronic metabolic disorder characterised by high blood sugar (or glucose) levels in the blood. This is called hyperglycaemia.

Glucose is usually regulated by the hormone insulin, produced in the pancreas within the abdomen.

It is vitally important for a child suspected of having diabetes to go to hospital as an emergency and be referred to a paediatric endocrinologist.

It is just as important to remember that while diabetes cannot be cured, it can be treated, controlled and managed.

Anatomy of Diabetes

Anatomy of Diabetes

The pancreas is a leaf-shaped organ located just below the stomach and responsible for the regulation of glucose levels in blood. This is done by the secretion of insulin hormone by islets of Langerhans present in the pancreas.

After a meal the blood glucose level rises causing the beta cells to release insulin into the blood, which instigates body cells to absorb glucose to be used as fuel.

In diabetes, little or no insulin is produced by the pancreas or the body cells are resistant to the action of insulin, causing increased blood glucose levels (hyperglycaemia).

Symptoms of Diabetes in Children

The main symptoms of diabetes in children and adolesecents are

  • Increased thirst and drinking
  • Hunger
  • Weight loss
  • Frequent urination
  • Tiredness
  • Fungal infections
  • Blurry vision, and
  • Dark pigmentation in certain parts of the body.

As the loss of insulin production progresses, the child may develop

  • Stomach pain
  • Vomiting and
  • Become very ill

Some children may need intensive care admission.

Sustained, uncontrolled high blood sugar (hyperglycaemia) can damage the heart, blood vessels, eyes, kidneys and nerves.

What is the Impact of Diabetes?

Diabetes is a chronic condition that requires lifelong medication and lifestyle modifications.

Regular monitoring of blood glucose levels will be required.

What are the Types of Diabetes?

Types of diabetes are:

  • Type 1 diabetes: Most children diagnosed as hyperglycaemic are said to have Type 1 Diabetes. Their bodies’ pancreas is producing little or no insulin to convert sugar into energy. It is also called insulin-dependent diabetes and is seen more commonly in children.
  • Type 2 diabetes: the body becomes resistant to insulin. It is also called non-insulin dependent diabetes and is seen more commonly in adults. Type 2 diabetes is considered ‘lifestyle related’.
  • Monogenic diabetes: (MODY - Maturity Onset Diabetes of the Young) is a genetic form of diabetes affecting about 5% of people with diabetes. Caused by a single gene abnormality that cause diabetes, in some forms, can be managed with tablets.
  • Secondary diabetes: this results from other conditions affecting the pancreas such as cystic fibrosis, hormonal disorders, adverse effects of drugs, insulin receptor abnormalities, and some of the genetic disorders.
  • Gestational diabetes: type 2 diabetes that develops during pregnancy. This occurs in some women, resolving soon after childbirth, but increases the risk of them developing the condition later in life.

What Causes Diabetes in Children

Type 1 Diabetes

is caused by an autoimmune response of the body’s own immune system, where it wrongly considers insulin producing beta cells of the pancreas as harmful and attacks them, destroying many of the cells.

This leads to lowered production of insulin. However, as the immune system does not target the body’s ability to accept insulin, insulin injections can be administered to make up for the low levels.

Type 2 Diabetes

Typically affecting older people Type 2 diabetes is being increasingly diagnosed in more Australian children presenting with weight issues

Lifestyle factors such as

  • An unhealthy diet
  • Sedentary lifestyle and
  • Obesity

Can contribute to the development of type 2 diabetes. Conversely it can be managed through diet, exercise and regular blood glucose monitoring.

Diagnosis of Diabetes

The only thing required to diagnose diabetes is

  • Random blood glucose and
  • Blood ketones

Blood Glucose Level GL 7-10 your doctor may want to contact QPE urgently to discuss the next steps in diagnosis

Your doctor may order the following tests to diagnose diabetes:

  • Urine test: This is done to check for the presence of glucose or ketones in the urine. Presence of glucose in the urine is highly suggestive of diabetes.
  • HbA1c test: This is a blood test that measures the amount of glucose accumulated over 3 months.
  • Oral glucose tolerance test: This is done to confirm type 2 diabetes. It measures how quickly glucose can be cleared from the blood. Following an overnight fast, your blood is tested for glucose. This is compared with periodic blood tests taken for the next two hours after drinking a sugar solution. Levels more than  1 mmol/L indicates diabetes, and levels 7.7700  to 11.0445 mmol/L  indicates pre-diabetes.
  • Fasting blood sugar test: Blood sugar level is tested after an overnight fast. Levels of 5.55  to 6.9375  mmol/L  is inferred as pre-diabetes, while levels more than 6.9375  mmol/L  on two or more separate tests on different days indicates diabetes.
  • Random blood sugar test: Blood is tested at a random time of the day for sugar levels. Blood glucose levels of 11.1 mmol/L or higher indicates diabetes.

Is Diabetes Curable?

Currently diabetes does not have a cure. Treatment will have to be continued throughout life to control the symptoms of the disease.

Timely treatment and lifestyle changes can help control the condition and its symptoms, and prevent serious complications associated with it.

What is a Treatment for Diabetes

The treatment options for diabetes depends on the type:

  • Type 1 diabetes: Insulin injections have to be taken as the body produces little or no insulin. You will have to maintain a strict diet and exercise plan to maintain a steady level of glucose in the blood.
  • Type 2 diabetes: Healthy eating and increased physical activity promoting a healthy weight is important. You may be also prescribed medication to regulate the levels of insulin in your body. These may be taken orally or as injections.

What’s involved in treating my child with Type 1 Diabetes?

  • Diabetes cannot be cured – yet.
  • It can be managed.
  • The management of Type 1 Diabetes involves a combination of insulin by injection or pump, exercise, diet management and regular blood sugar measurements.
  • Queensland Paediatric Endocrinology recommends that all newly diagnosed children with Type 1 Diabetes start on an insulin pump as soon as possible (within 1 month). This requires a short admission into hospital: Mater Children’s or Wesley in Brisbane or St Vincent’s in Toowoomba. If your child has been admitted into a public hospital, hospital transfer can be arranged.
  • While we advocate insulin pumps, some families choose multiple daily injections of insulin: our experienced diabetes educator teaches correct injection techniques.
  • Children with Type 1 Diabetes need regular specialist care as their medical needs change as they grow. Activities and illness also affect their treatments.
  • Queensland Paediatric Endocrinology provides the team back-up needed for your child to develop to their full potential.

What if Diabetes is Untreated?

If left untreated, blood sugar can reach abnormally high levels leading to a condition called hyperglycaemia. Uncontrolled diabetes can result in complications such as damage to tiny blood vessels of the eyes, heart, kidneys and brain, leading to heart disease, stroke, blindness and kidney disease.

Other problems include nerve damage, which can cause loss of sensitivity in various parts of the body, and poor blood flow to the feet, which can make them susceptible to poorly healing cuts and blisters that may require amputation.

Diabetes Treatment Research

Please ask us about new developments and research for treatments of diabetes

Are there Alternative Treatments for Diabetes?

Unfortunately there are no alterative treatment for Type 1 Diabetes.