Helping parents make sense of a complicated disease

Adult-onset diabetes, juvenile diabetes, gestational, type 1, type 2… a bewildering list of terms for parents who may have grown up in an era when type 2 diabetes wasn’t even on the diagnostic radar. According to the U.S. Centers for Disease Control (CDC), more than 186,000 children and teens in the U.S. are currently diagnosed with diabetes (either type 1 or type 2). The CDC also reports the likelihood that many kids have undiagnosed diabetes. What does this mean for a parent with a child at risk for diabetes, or one already diagnosed with the disease? Let’s take a look.

Type 1 Diabetes

Previously known as juvenile diabetes, type 1 diabetes is usually diagnosed in children and young adults. With type 1 diabetes, the body does not produce insulin, a hormone needed to convert sugar (glucose), starches and other food into energy. According to the Juvenile Diabetes Research Foundation, symptoms may occur suddenly, and include one or more of the following:

• Extreme thirst
• Frequent urination
• Drowsiness, lethargy
• Sugar in urine
• Sudden vision changes
• Increased appetite
• Sudden weight loss
• Fruity, sweet or wine-like odor on breath
• Heavy, labored breathing
• Stupor, unconsciousness

Treatment for type 1 diabetes involves checking blood glucose levels using a tiny bit of blood from a skin prick, followed by the administration of insulin or other medications via injections or an insulin pump.

Type 2 Diabetes

A bit more complicated to diagnose than type 1, type 2 diabetes occurs when the body either doesn’t produce enough insulin or the cells ignore the insulin produced. Type 2 diabetes is more common in African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders, as well as the older population in general. Experts believe that the increasein childhood obesity, combined with the low levels of physical activity among many young people, as well as exposure to diabetes in the womb (called gestational diabetes), could be major contributors to the rise in incidence of this disease during childhood and adolescence.

Children and teens diagnosed with type 2 diabetes are generally between 10 and 19 years of age, obese, have a strong family history for type 2 diabetes, and have insulin resistance. It’s difficult to detect type 2 diabetes in children, as symptoms may develop slowly. In fact, you can have type 2 diabetes for years and not even know it, according to the Mayo Clinic. Parents should beon the lookout for:

• Increased thirst and frequent urination
• Increased hunger
• Weight loss
• Fatigue
• Blurred vision
• Slow-healing sores or frequent infections
• Areas of darkened skin

According to the American Diabetes Association, the first treatment for type 2 diabetes often consists of meal planning for blood-sugar control, weight loss and exercise. If these measures are not enough to lower blood sugars, the next step is to take oral medications to control blood glucose levels.

A Diagnostic Challenge and Research

Each child with diabetes has different needs and requires an individualized care plan. In people with type 1 diabetes, things are pretty clear cut: The pancreas does not produce adequate insulinand insulin shots are needed to metabolize sugars from meals. People with type 2 diabetes, however, produce insulin, but their bodies don’t adequately respond to it. Some people with type 2 diabetes need to take insulin to help their bodies use glucose forenergy. As with type 1, frequently checking blood glucose levels with a monitor is a necessity.

“Type 2 diabetes is extremely complex,” says Memphis, Tennessee pediatric endocrinologist A. Jay Cohen, M.D. “The rapid rise in obesity, physical inactivity and the consumption of excessive calories appear to have led to the epidemic of children with type 2 diabetes.”

The National Institutes of Health are presently conducting two clinical trials to identify children at risk for type 2 diabetes, and to demonstrate the effectiveness of lifestyle intervention among youth. The first trial follows a group of about 6,400 children from sixth through eighth grade to determine whether modifications in exercise programs and nutrition at school can reduce their risk. Researchers are tracking the youths’ body mass indices (BMIs), fasting-glucose levels and fasting insulin levels toshow the health benefits of lifestyle adjustments. The second trial is exploring the best treatment options for children with this disease.

Inspiration for Kids

While parents listen to doctors and struggle to find the right care for their children with diabetes, kids may be most influenced by 17-year-old Nick Jonas of the Jonas Brothers, who was diagnosed with type 1 diabetes five years ago.

Jonas says when he was first diagnosed with type 1, he didn’t know anything about it and had never met anybody with diabetes. That’s all changed now. Young people with diabetes are among his most passionate fans, and he has even written a song, “A Little Bit Longer,” to share his experience with the disease. “So many fans with diabetes from all over the world share their stories and thank me for inspiring them,” Jonas said in a recent statement. “It’s important for them to know that they motivate and inspire me as well.” He has also created “Nick Jonas’ Dog Tag Program” (kids skip the traditional medical-ID bracelet in favor of these celebrity endorsed dog tags.) The program has raised more than $75,000 for the Jonas Brothers’ Change for Children Foundation to fight diabetes. To learn more, visit www.nickssimplewins.com and click on “Nick’s Dog Tags.”

For more information on diabetes, visit Juvenile Diabetes Foundation and American Diabetes Association