November is recognized as National Diabetes Month, a time dedicated to raising awareness about diabetes management and prevention. Type 1 diabetes, a chronic autoimmune condition, significantly impacts children and adolescents, affecting their ability to use food for energy. Unlike type 2 diabetes, type 1 diabetes has no known cure and requires lifelong management to maintain normal blood sugar levels.
Type 1 diabetes occurs when the body fails to produce adequate amounts of the hormone insulin. Insulin is essential for converting nutrients from food into glucose, which serves as a primary energy source for cells. The pancreas, which typically produces insulin in specialized beta cells, becomes compromised when the immune system mistakenly attacks these cells. This disruption leads to an accumulation of glucose in the bloodstream, resulting in high blood sugar levels, known as hyperglycemia. If untreated, the body resorts to breaking down stored fat for energy, producing ketones that, in excess, can be harmful.
Symptoms of type 1 diabetes in children can be severe and include extreme thirst, frequent urination, and increased hunger, often accompanied by weight loss. Other indicators may be irritability, headaches, and blurry vision when blood sugar levels are critically high. In serious cases, untreated type 1 diabetes can lead to a diabetic emergency characterized by nausea, vomiting, abdominal pain, rapid breathing, and even loss of consciousness. Parents should seek immediate medical attention if their child exhibits flu-like symptoms along with increased thirst and urination.
Diagnosis of type 1 diabetes generally involves evaluating classic symptoms alongside abnormal blood sugar levels. A common diagnostic test is the hemoglobin A1c (HbA1c), which reflects average blood sugar levels over the past three months. Alternatively, an oral glucose tolerance test (OGTT) may be performed, measuring blood sugar levels before and after consuming a sugary drink. Presence of islet autoantibodies in the bloodstream can also indicate an ongoing immune attack on beta cells, further confirming type 1 diabetes.
Treatment for type 1 diabetes focuses on regulating blood sugar levels, which is a complex process. Patients must frequently monitor their blood sugar using a blood glucose meter or a continuous glucose monitor (CGM). The latter provides real-time glucose levels and can communicate with insulin pumps for more effective management. Insulin is administered through multiple daily injections or via an insulin pump, which delivers insulin continuously through a small tube under the skin.
Diet plays a crucial role in managing type 1 diabetes. Insulin dosing must align with carbohydrate intake, and physical activity can influence insulin needs. Some insulin pumps are equipped with settings that adjust insulin delivery during exercise or sleep to prevent low blood sugar episodes.
Advancements in technology have led to the development of automated insulin delivery systems (AID), also known as “artificial pancreas” systems. These systems enhance blood sugar regulation by enabling communication between the insulin pump and the CGM, adjusting insulin levels based on real-time data.
While type 1 diabetes cannot be fully prevented, screening programs have been established for individuals at higher risk, particularly those with a family history of the disease. New medications approved by the FDA can delay the onset of type 1 diabetes in some high-risk individuals by targeting the immune cells responsible for beta cell destruction. This intervention can extend the period before full-blown diabetes develops by an average of two years.
As awareness grows, the conversation surrounding type 1 diabetes continues to evolve, highlighting the need for ongoing research and support for those affected by this challenging condition. The insights gained during National Diabetes Month underscore the importance of education, early diagnosis, and innovative treatment options to improve the quality of life for individuals living with type 1 diabetes.
