Children and Diabetes: Types, Symptoms, Diet & Treatment - UK (2023)

Children and young people are a demographic that has seen a significant rise in the number of diabetes cases in the UK as of late. Apart from the jump in type 1 diabetes, an autoimmune disease, the significant increase in type 2 diabetes in children is an alarming phenomenon linked to increasing levels of childhood obesity and poverty.

UK parents and caregivers should strive to keep the condition under control to prevent serious long-term complications. Here's all you need to know about the types, symptoms, and care required for cases of diabetes in children.

The most common type of diabetes in children and young people is type 1 diabetes, previously known as juvenile diabetes. This type occurs due to an autoimmune response that destroys the pancreatic islet cells responsible for insulin secretion. 

Since the body doesn't produce enough insulin or none at all, blood sugar immediately skyrockets after the onset of the disease.

Type 1 diabetes in children isn't linked to dietary choices, exercise, or body weight. It's also not often linked to family history since around 85% of the cases have no family members with the condition.

Children show the following symptoms of type 1 diabetes shortly before being diagnosed:

Children with type 1 diabetes often show significant unintentional weight loss. That's because insulin is the hormone responsible for signalling body cells to accept and utilize glucose as fuel. Without glucose, the body uses stored fat as the only fuel source.

Since the body cells can't use glucose without insulin, it remains in the bloodstream. High blood sugar levels increase the osmotic pressure of the blood vessels, pulling water away from the cells, which causes increased thirst.

You may notice your child looking constantly parched, asking for water more than usual and drinking it faster than usual.

The severe and often sudden weight loss after the onset of type 1 diabetes causes the depletion of the body's fat stores. 

Body fat is responsible for regulating satiety and hunger cues through hormone production. 

That means that low body fat can increase the production of the hunger hormone, ghrelin, which influences how hungry the child gets.

Excess blood glucose levels and increased thirst lead to frequent urination, which is very common and one of the early signs of diabetes. 

Your child may need more bathroom breaks, struggle with urinary incontinence even if potty trained, or wet the bed at night.

Due to the absence of available energy for the body in the form of glucose, children with diabetes often exhibit signs of lethargy after small amounts of physical activity. They tire quickly after playing or prefer to sit instead of running with their peers.

Caregivers and teachers often misinterpret this sign as difficult or uncooperative. So, if your child complains about getting tired easily, it's crucial to check their blood sugar levels.

Type 2 diabetes used to be labelled as adult-onset diabetes because most people suffering from it were above the age of 21. 

However, due to the quick increase in the number of obese or overweight children who suffer from the condition, this naming is rejected in scientific circuits.

The number of children and young people under 19 years old in the UK who have type 2 diabetes is estimated to be about 10% of all cases of diabetes in children.

Unlike type 1 diabetes, type 2 diabetes has strong ties to obesity, family history, the lack of a healthy diet, a sedentary lifestyle, and other environmental factors, like poverty. It's also more common in children of South Asian, Afro-Caribbean, and Black African descent.

Limited access to fresh fruits and vegetables, insufficient physical activity, and other health inequalities associated with growing up in deprivation increase the chances of these children developing type 2 diabetes.

The symptoms of type 2 diabetes in children are similar to those of type 1 cases. However, there are a few other signs that you should also watch for.

A common tell-tale sign of type 2 diabetes in children is having darker skin around the back of the neck and the groin. This is often mistakenly attributed to poor hygiene, especially in overweight young people, although dark skin doesn't respond to scrubbing or exfoliation.

The high blood sugar levels common in type 2 diabetes patients can cause the eye lens to swell up with fluid, changing its shape and flexibility. This can cause transient blurry vision that usually corrects itself once blood glucose drops.

Bacteria and yeast cells find high blood sugar a comfortable breeding ground. The lack of control over blood glucose is also one of the risk factors for a lower immune response in the case of an infection.

Unfortunately, untreated infections, especially in the extremities, can cause severe complications in the short and long term that might lead to gangrene and amputation.

Not all cases of diabetes in children are diagnosed early. In fact, many children with type 1 diabetes first come to the hospital with symptoms of diabetic ketoacidosis (DKA). 

This condition happens when the body fails to metabolize glucose and uses fat instead. It causes a build-up of ketone bodies, the chemical byproduct of burning fat for energy.

The symptoms of DKA include:

• Extreme thirst

• Blurred vision

• Confusion, sleepiness, and fatigue

• Diarrhoea

• Nausea

• Vomiting

• A fruity smell that resembles apples or pears or a chemical smell that resembles acetone (nail polish remover).

Diabetic ketoacidosis is a serious condition that, if left untreated, can lead to severe long-term risks, like brain or organ damage or even death.

Treatment for diabetes in young people differs depending on the type.

Type 1 diabetes means the body produces little to no natural insulin, so the only way to control the condition is with regular insulin injections.

The most common method for children to self-administer their insulin is through pre-loaded pens, although many parents may choose an insulin pump to avoid the injections.

A needle-free solution for insulin injections exists in the form of a jet injector, like InsuJet. It uses the finest technology to deliver insulin under the skin without a needle. This is ideal for children and young people who might be uncomfortable or afraid to self-administer their insulin.

The treatment for type 2 diabetes in children usually involves using oral medication instead of, or alongside, insulin injections. Drugs like metformin improve the body's sensitivity to naturally secreted or artificial insulin.

The role of lifestyle changes in younger patients with type 2 diabetes is also essential in controlling the condition and preventing long-term complications.

Patients with diabetes are mistakenly thought to avoid certain carbohydrate-rich foods, like sweets. This is an outdated idea that has little to do with current medical protocols for diabetes.

Taking insulin injections before eating with the right amount of insulin for each meal is the most critical consideration for diets in type 1 diabetes and insulin-dependent type 2 diabetes.

That said, eating a healthy diet with balanced protein, fat, and carbohydrates is essential for maintaining a healthy weight and active metabolism. This is a priority for children and young people with type 2 diabetes, who tend to have a higher body mass index.

Your child's diabetes care team should draw out a management plan based on their condition and according to the National Institute for Health and Care Excellency's (NICE) guidelines. This usually involves guidance on handling insulin at mealtime and accurately monitoring blood sugar levels.

Research has proven that physical activity positively affects heart health, reduces blood cholesterol, and even lowers blood glucose levels.

For children with type 2 diabetes, especially those who are obese or overweight, exercise can be a great addition to their daily routines. It can help them maintain a lower body weight and reduce long-term risks associated with high blood sugar, like blood vessel disease and heart disease.

For children with type 1 diabetes, exercise can be beneficial but has to be done under close supervision from adults, like a parent, a caregiver, or a teacher, with prior knowledge of their condition.

Children who take insulin to treat their diabetes can suffer from hypoglycemia (hypo for short). It's a dangerous condition that makes their blood sugar levels drop rapidly, leaving the brain needing glucose.

The signs and symptoms of a hypo include:

• Paleness

• Dizziness

• Profuse sweating

• Hunger

• Moodiness and irritability

• Fainting

In severe cases, the child might suffer a seizure. If left untreated, they might slip into a coma that, in rare cases, can lead to death.

To prevent the possibility of hypos, children and young people with diabetes should always exercise near an easy source of glucose, like non-diet fizzy drinks, hard candy, or glucose tablets. You should also discuss adjusting insulin doses with your child's doctor to fit their exercise schedule.

Families of children with diabetes should form a support network alongside their healthcare team to allow children to live their lives to the fullest while preventing future complications.

The central concern here is maintaining healthy blood glucose levels at most times by using fast-acting insulin at mealtimes and long-acting insulin at bedtime. It also reduces the chances of blood sugar spikes, as sustained high blood sugar can cause damage to the blood vessels, kidneys, and eyes.

Diabetes affects many children's mental health, as well. It's crucial to address their concerns and find out the exact cause of any negative emotions they might have around the condition. Cultivating a healthy relationship with food and medication should also allow them to live a relatively normal life and properly manage their condition.

Lastly, raising awareness among the child's school peers by providing helpful information about diabetes can allow them to spot hypo symptoms and report the condition to an adult. This can be life-saving, preventing the risk of severe brain damage.

While the vast majority of cases of diabetes in children and young people is type 1 diabetes, there's an alarming rise in type 2 diabetes in children under 19. This is mainly due to the increasing number of obese or overweight children.

The early diagnosis of diabetes prevents conditions like diabetic ketoacidosis, which results from the body burning fat stores for energy instead of glucose. The accumulation of ketone bodies in the blood can be hazardous, causing death in rare cases.

Management of diabetes involves treatment with insulin and/or oral medication, like metformin. However, a balanced diet and exercise are invaluable in controlling type 2 diabetes in children and young people, who can have the disease remission if they maintain a healthy weight and lifestyle.

Preventing long-term complications, like eye, kidney, blood vessel, and heart diseases, from arising is also a treatment goal. Continuous monitoring and working with the child's diabetes care team can help them keep healthy and live a normal life.