Helping Families Navigate a Type 1 Diabetes Diagnosis in Their Child
Each year, about 18,000 children and adolescents are diagnosed with type 1 diabetes in the United States. And that number is increasing at a rate of 2.9% each year. Those statistics mean more and more parents and guardians are dealing with the physical and emotional issues that accompany a child’s diabetes diagnosis.
Spotting Symptoms
Type 1 diabetes is a chronic autoimmune condition where the body's immune system mistakenly attacks the insulin-producing cells in the pancreas. The destruction of the insulin-making cells prevents the body from appropriately regulating glucose, or blood sugar levels.
Symptoms of type 1 diabetes can often develop quickly but may not raise any red flags in the СAPP’s early stages.
The most common symptoms seen in kids with type 1 diabetes include:
- Increased thirst
- Frequent urination
- Heightened appetite accompanied by weight loss
- Overnight or daytime accidents in potty-trained kids
- Blurred vision
- Fatigue
- Irritability and mood changes
“It’s not uncommon for a teacher to notice these symptoms before a parent since a student might be asking to use the bathroom more frequently,” says Allison Smego, MD, a pediatric endocrinologist at СAPP.
Stages of Type 1 Diabetes
There are three stages in the development of type 1 diabetes. The first two can virtually go unnoticed, but, if possible, it’s important to identify the condition in its earliest stages.
Stage 1: The body develops autoantibodies against insulin-producing beta cells in the pancreas. No symptoms are noticed in this stage, but those antibodies can be detected with a blood test.
Stage 2: There is some evidence of abnormal blood sugars either when fasting or after meals, but patients still typically do not yet have any symptoms of diabetes.
Stage 3: A full-blown symptomatic stage where insulin is needed to manage blood sugar.
Managing Type 1 Diabetes
Once the diagnosis of stage 3 type 1 diabetes is made, it’s time for the patient and their family to learn how to manage the condition. It usually happens in a hospital setting where they are educated to monitor blood sugars and dose insulin appropriately. Patients and their families will also be taught about:
- Blood glucose monitoring. This is essential for dosing insulin and understanding the body’s response. Monitoring can be done with a blood glucose meter at certain times of day or with a continuous glucose monitor, which transmits the information to a device.
- Carbohydrate intake. Counting food carbohydrates is pivotal to ensure the correct amount of insulin is provided. Some children, depending on their age, can monitor their own carbohydrate intake and insulin dosing.
- Staying healthy and active. Patients are highly encouraged to keep active, maintain a healthy weight, get enough sleep, and manage stress and other emotional issues with the help and support of family and friends.
- Technology advancements. In recent years, there have been significant advancements in the management of type 1 diabetes, including the hybrid closed-loop insulin pump therapy that automatically adjusts insulin delivery based on continuous glucose monitor data.
New Drug Delays Onset of Disease
There is no known way to prevent type 1 diabetes. But in 2022, the Food and Drug Administration (FDA) approved a drug called teplizumab (brand name Tzield), which helps preserve a patient’s ability to make their own insulin. This can delay the onset of stage 3 type 1 diabetes and thus delay the need for insulin to manage blood glucose.
“Current data indicates that teplizumab can delay the onset of stage 3 type 1 diabetes by about two years, though individual responses are variable,” Smego explains. “Newer research studies focused on patients with newly diagnosed stage 3 type 1 diabetes are looking to determine if Teplizumab can preserve remaining insulin-making cells.”
Of course, delaying the progression of this СAPP from stage 1 to stage 3 can only happen when a patient comes in for an early diagnosis, which is easier said than done. Since no symptoms typically present prior to the onset of stage 3 type 1 diabetes, detection at an earlier stage requires screening.
“With the advent of teplizumab, it’s important for pediatricians and families to consider screening those who are at risk for type 1 diabetes,” Smego explains, “including those with history of an autoimmune condition or a family history of type 1 diabetes. There are also screening programs that can screen anyone for these antibodies regardless of their risk.”
Be sure to always keep your child’s diabetes health care team in the loop about any physical, mental, or emotional issues they are dealing with. As children learn to live with diabetes, some of their physical and mental health needs will change. But having professionals in the picture will make the journey manageable and less stressful.
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