Don’t Let a Diagnosis of Type 1 Diabetes Catch You Off Guard

The following was submitted by Dr. Debra Etelson, Pediatrics at White Plains Hospital
When my then-nine-year-old son suddenly discovered that he was diabetic, he certainly surprised himself – and his pediatrician mother as well!

We were in the car with one of my older son’s friends, along with my then-3-year-old, who had been diagnosed at 13 months with Type 1 (formerly known as juvenile diabetes) about four months earlier. My older son dutifully demonstrated to his friend how easy it was to check the baby’s blood sugar level, then did the same to himself. The American Diabetes Association (ADA) recommends anyone with a level of 240 or above seek medical attention; his was several hundred above that, so our outing became very serious very quickly.

I’m happy to report that both of my sons – now 17 and 22 – are doing fine. But being aware of how diabetes works, and of what to watch out for, is something every parent should know.

According to the ADA’s latest estimates, about 283,000 Americans under age 20 have been diagnosed with diabetes. That’s roughly 0.35% of that population. Type 1 diabetes occurs when a person’s pancreas produces little or no insulin, which the body uses to convert sugar into energy. Treatment involves using insulin and refining one’s diet and lifestyle to prevent complications; the disease requires continuous insulin, blood sugar monitoring, and carbohydrate counting throughout one’s lifetime.

(For the record, Type 2 diabetes occurs when the body produces insulin, but the cells don’t respond appropriately due to what is called insulin resistance. While there is no cure for either type, diet and other lifestyle changes can help a person reverse – but not eliminate – the disease.)

Type 1 is an autoimmune condition whose exact cause is still unknown, but leading theories attribute it to genetics, environmental factors, and viruses; the latter would certainly seem to be true given what we saw during the height of COVID-19. The incidence rate, or number of new cases, of Type 1 diabetes was rising by 3-4% per year before COVID, increased by 14% during the first year of the pandemic and was 27% higher than the pre-pandemic period in the second year.

Type 1 diabetes can be diagnosed in a child as an infant, roughly 6 months after birth; it usually appears after age 5, though some people don’t get it until they are in their late 30s. Note that, despite the potential genetic component, a mother who is diabetic does not necessarily give birth to a child with diabetes.

What to Watch For

Babies obviously cannot verbalize how they’re feeling, but parents can tell if there’s a chance of diabetes (or other possible healthcare concerns) by observing the following:

• Increased urination (resulting in unusually frequent diaper changes for babies)
• A seemingly insatiable thirst/hunger
• Reports of blurred vision
• Unexplained weight loss
• Lethargy in a previously active child

Lethargy was what brought us in with our youngest child – whose level was at a frightening 900 – and, along with mood swings, had led us to suspect our older child might have developed it as well. Keep in mind that it may take months, if not years, for the above symptoms to manifest themselves, but a blood test during a child’s routine physical can indicate elevated blood sugar levels, both for Type 1 and Type 2.

If a child is diagnosed with diabetes, the rest of the immediate family is typically tested as well. While genetics are believed to play a part in contracting the disease, one family member having it does not mean they all (or any of them) will as well.

When at school or otherwise outside of the house, kids five and up with diabetes can usually self-administer insulin with an insulin pump, which involves installing a soft catheter in the upper arm, belly, hip, buttock, or thigh. Thin tubing connects the catheter to the pump, which can be worn in a pocket, on a belt, or in a pouch.

School nurses are an amazing resource, and they can administer insulin to a child if necessary or preferred.
A diabetes diagnosis can be scary for child and parent alike. But by being aware of warning signs, and of the treatments and support that are available, a happy and healthy life can be possible.

Dr. Debra Etelson is a board-certified pediatrician at White Plains Hospital Physician Associates in Somers. To make an appointment, call 914-849-7075.

Health Matters
The original version of this article was published in Health Matters, a White Plains Hospital publication.