By: Melissa Brady & Megan Sell
November is National Diabetes Awareness Month at Better Health. Diabetes is non-prejudice and non-discriminatory of anyone, young or old. By raising awareness and offering services to assist and educate Cumberland County residents, we hope to help reduce the rates of diabetes and help all clients lead healthier lives. The reality is that diabetes can be well managed and each diabetic’s journey can be unique and inspiring. There are key differences between Type 1 and Type 2 diabetes, but resources are available for everyone.
Type 1 Diabetes Mellitus (T1DM) is a disease affecting over 1.25 million Americans including about 200,000 children according to the Juvenile Diabetes Research Foundation. Each year approximately 40,000 children are diagnosed with T1DM and by year 2050 it’s estimated nearly 600,000 children will be living with T1DM.
“When I was told I had Type 1 Diabetes at the age of six I thought it was the end of the world. Now, almost 10 years later, I’ve grown accustomed to the daily fingerpicks, counting carbohydrates and receiving insulin using an insulin pump. There are still days, however, that I wake up and think, ‘why me?’ Here’s my answer. Without diabetes I wouldn’t have been able to pass Chapter 8 in Biology (a chapter dedicated to diseases). Without it, I wouldn’t have turned unfamiliar faces into friends nor discovered my love for art. Diabetes doesn’t define who I am, instead it has helped to shape who I’ve become,” said Isabelle Miller
T1DM is a disease in which the pancreas does not produce insulin. After a meal, starches and sugars are broken down by the body into a simple sugar called glucose. Glucose is the body’s preferred source of energy. Insulin is vital to life in that it helps the cells of the body use glucose for energy. When cells do not have the help of insulin, they are unable to use glucose for energy. Instead fat and muscle become energy sources which can lead to unwanted results for diabetics. High blood glucose levels can lead to severe complications. Children diagnosed with T1DM can use insulin therapy to help their cells use glucose. Insulin therapy along with diet and exercise allows children with T1DM to live long, healthy lives.
“Living with diabetes has been a blessing in disguise. For as many hard times as there’s been since being diagnosed at age two, there's been even more good. The summer before third grade, I got to go to diabetes camp and I’ve gone every summer since then. Also, I was able to join JDRF Children’s Congress where I served as an advocate to help create a world without Type 1. Living with type one diabetes has made me realize just how important it is to stay healthy and maintain stable blood sugars through making smart food choices and working out,” said Rachel Horne.
What signs and symptoms should parents look out for in their child? The onset of T1DM most commonly occurs between the ages of 4 to 6 and 10 to 14. Classic symptoms include increased thirst, increased urination and weight loss. Increased thirst occurs because high blood glucose levels pull water from the body signaling the increased need for water to avoid dehydration. Children previously potty-trained begin having “accidents” where they wet themselves during the day or wet the bed at night. In children who were not previously potty-trained, parents may begin to notice an increased frequency of wet diapers or an increased volume of urine. Weight loss happens as a result of the body using fat and muscle for energy. The breakdown of fat can lead to nausea, decreased appetite and ketones, contributing to even more weight loss.
Is T1DM manageable and can my child lead a normal life? There is currently no cure but with proper insulin therapy, blood glucose monitoring, nutrition and exercise, T1DM is manageable. It affects the whole family, not just the child, and parents are crucial in the management of their child’s T1DM. But, it should not limit your child from going on vacation, staying the night at a friend’s house, going to camp or studying abroad. It is important to know that a T1DM diagnosis will change the life of your child and your family, but it doesn’t have to stop your child from living out his/her dreams.
“Living with diabetes has legitimized my voice through which I can speak for impoverished people in our country. The costs of diabetes are plentiful: the embarrassment of being ‘different’ as a child, the extra layer of having just one more thing to worry about on top of other adult life worries. The biggest cost is financial. It’s morally unfair that some can afford the cost of good management while uninsured are left acutely sick with horrible long term complications. Through my experiences with diabetes, having a platform to close that gap with Better Health of Cumberland County makes me happy,” said Caroline Gregory, J.D.
Although T1DM is typically a childhood disease, another unsettling trend is on the rise in the U.S.: Youth Onset Type 2 Diabetes. Children are being diagnosed with an adult disease at alarming and steady rates, without any foreseeable decline. According to the American Diabetes Association 208,000 children under age 20 are estimated to have been diagnosed with diabetes, approximately 0.25 percent of that population. In 2008 and 2009, the annual incidence of youth diagnosed with diabetes was 18,436: 5,089 with Type 2. This trend was virtually unheard of ten years ago. Unless this disturbing trend changes, T2DM children will likely face diabetic complications as young adults instead of later in their adulthood years.
Carla Caccia, RD, CDE at The Regional Diabetes and Endocrine Center said, “A major challenge in managing diabetes regardless of Type 1 or Type 2 is the constant management. Day and night blood sugar checks, daily insulin injections, having to count carbs in food and beverages, trouble shooting high blood sugars, growth spurts and exercise, fatigue, care burnout, physical and mental side effects from blood sugar swings, the financial costs of medications, supplies, insurance changes & coverage… It’s a full time job on top of daily responsibilities.”
Reversing the trend is easy: eat healthy and move more! Set the household standards. Provide snack options like fruit and water at soccer practice. Limit family screen time. Get a good night’s sleep. Reward good behavior with a book or movie. Meet at a park instead of a restaurant. Walk. Rake leaves. Visit your local Parks and Rec Fitness Center.
Know the T2DM symptoms. Increased thirst, frequent hunger, even bedwetting could point to a diabetes issue in your child. Age-specific risk-assessment tools are being developed but screening is paramount.
In addition to our existing adult diabetes education programs, expansion into the childhood arena is planned. But we need your help. Complete a survey at https://www.surveymonkey.com/r/2GB6ZLV and enter your child to be featured in our next newsletter publication. Together we can fight diabetes and lead healthier lives!
Megan Sell is a PharmD candidate and Melissa Brady, BSD is a Diabetes Educator at Better Health