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Pediatric Endocrinology - Diabetes

​​​​​​​​Diabetes is a condition that happens when the pancreas can no longer make insulin (a hormone). 

The body needs insulin to turn the glucose (sugar) from food into energy. If the body doesn't have insulin, the level of sugar in the blood can get too high. Over time, high amounts of sugar in the blood can harm the body. Diabetes is a lifelong disease, so there is no cure.

Diabetes is broken down into two categories:

  • Type 1 - In children with type 1 diabetes, the pancreas stops making insulin. Food is still broken down into glucose. And glucose still travels to the cells. But without insulin, glucose can't enter the cells. Instead, it builds up in the blood. Too much glucose in the blood is called hyperglycemia (high blood sugar). Without glucose, a child's cells don't get the energy they need and over time, high blood sugar can cause other health problems.

  • Type 2 - With type 2 diabetes, food is still broken down into glucose. And glucose still travels to the cells. But the pancreas may not make enough insulin for the amount of glucose in the blood. The liver may release too much glucose at once. And the body's cells may not respond the right way to insulin. This is called insulin resistance. Because of this, the cells receive less glucose than they need. At first, the pancreas makes more insulin to try to keep up. But as time passes, the pancreas can't make enough insulin to overcome resistance. When this happens, glucose builds up in the bloodstream.

Treatments

Type 1 Diabetes
There is no cure for type 1 diabetes, but the condition can be managed by monitoring blood sugar level, replacing insulin, eating a proper diet, and being active.

  • Insulin: There are two basic types of insulin. Fast-acting insulin is given before meals to cover mealtime blood sugar. Long-acting insulin provides a small amount in the bloodstream at all times. A child will probably use both types of insulin. Insulin delivery methods include:​
    • A needle and syringe is the most common, least expensive option. It is covered by most insurance plans. This method allows mixing two kinds of insulin in the same syringe.
    • ​ An insulin pen is a device that includes a needle and a cartridge of insulin. Pens make it easy to measure the insulin and prepare the shot. In public places, a pen may attract less attention and be more convenient than a traditional needle.
    • ​ ​An insulin infusion pump can deliver insulin continuously in very tiny amounts. About the size of a pager, the pump is attached to the child's body by a long, thin tube and is worn all the time. Pumps are expensive, but some insurance companies cover them.

  • Monitoring: Your healthcare team will work with you to set a blood sugar target range for your child. You will also learn how to check blood sugar level. This helps you monitor whether your child's blood sugar is in a healthy range.

  • ​ ​Eating: A dietitian will help you develop a meal plan. You will learn which foods are best for your child, how much your child should eat, and how often your child should eat. ​

Type 2 Diabetes
There is no cure for type 2 diabetes. In most cases, oral medication or insulin are necessary to treat it. A healthy lifestyle is an important part of the treatment plan.​

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Diabetes: Test Your Knowledge

If you have diabetes, taking steps right away to control it will help you avoid complications that may come up later. This multiple-choice quiz will help you with important answers now. It is based on information from the American Diabetes Association, the National Institute of Diabetes and Digestive and Kidney Diseases, and the CDC.

1. Diabetes happens because of which of these?
2. Two of the main types of diabetes are type 1 and type 2. How many people with diabetes have type 2?
3. A certain gland or organ doesn't work right in a person who has type 1 diabetes. Which gland or organ is it?
4. Why is insulin important for your body to use blood sugar?
5. Keeping your diabetes under control early on will help you prevent complications that may come up later. People with diabetes are at increased risk of developing which of these?
6. Why are a healthy diet and regular exercise so important if you have diabetes?
7. Type 1 diabetes happens when your insulin-producing cells called beta cells in the pancreas are destroyed. What destroys them?
8. A diabetic condition can develop as a side effect of some medicines. Which of these can raise blood sugar?
9. Which ethnic groups are most likely to develop type 2 diabetes?