Special Issues for Children with Diabetes

When a child has diabetes, there are special issues to be considered that don’t affect adult diabetics. Whatever a persistent disease is present, the challenges of raising a child become so much greater. However, new technology and education make it easier than ever for children living with diabetes to stay healthy and safe.

Children and Diabetes

When a child is diagnosed with diabetes, it is normally type 1 diabetes. On average, 35 children are diagnosed with type 1 diabetes each day in America.[1] You may have heard this type of diabetes called juvenile diabetes because of the prevalence of children diagnosed with the diseases.

With juvenile diabetes, a child cannot produce insulin within their body. (Insulin is a hormone we all need to keep our bodies active and alive). In order to compensate for this inability to produce insulin, children with type 1 diabetes inject insulin on a daily basis.

Type 1 diabetes is a chronic diseases for children. It does not go away as they age or with medical care. In fact, it requires the child and their parents and other caregivers to constantly monitor their blood sugar levels. They must make sure the child always takes his or her injections.

Insulin and Juvenile Diabetes

In a normal child, insulin is secreted by the pancreas throughout the day. When a child eats, glucose from the food – sugars – excite the pancreas and cause it to release insulin.

The insulin takes the glucose – or the sugar – and helps the body it in to the cells. This gives fuel to the cells and energy to the body. In the normal juvenile the sugar amount decreases as it comes into the cells. When this happens, the pancreas automatically lessens the insulin being secreted and the blood levels even out.

In a child with type 1 diabetes the process does not function normally. Glucose – or sugar – never makes it to the cells. Insulin is not created by the pancreas to help move the sugar to the cells.

Instead of moving to the cells and acting as fuel, the sugar builds up in the blood of the child with type 1 diabetes. The cells do not get the nutrition or fuel they need and begin to starve. This affects all of the systems in the body.

As the cells starve for fuel, the juvenile develops high blood sugar. This can result in several problems:[2]

  • Lack of fluids: High levels of sugar in the blood can cause dehydration in a juvenile with type1 diabetes. When sugar builds up it makes urination more frequent as the body tries to get the sugar from the body. Unfortunately, when the kidneys eject the sugar they also lose a lot of water that can cause dehydration.
  • Loss of Weight: Along with dehydration comes weight loss in many juveniles with type1 diabetes. As the sugars are lost in the urine they are not able to provide the body with any calories.
  • DKA: Juveniles with Type 1 diabetes are subject to diabetic ketoacidosis, or DKA. Since the body does not have the needed insulin, and the cells do not have any fuel, the body begins to break down upon itself. This begins with the fat cells. Ketones, chemicals found in the fat cells that are highly acidic, break down and start to become plentiful in the blood. This increases the acidity of the blood.

At the same time, the liver releases sugar which only adds to the problem. With no insulin, the juvenile’s body cannot use these sugars either. The blood becomes a combination of high acidity and high blood sugars. This condition is known as Ketoacidosis and can threaten the life of the child.

  • Damage to other organs: The high glucose levels in the body can damage many other body organs. The juvenile’s eyes, kidneys, heart, and arteries can all be damaged by the disease.

What Causes Type 1 Diabetes in Children?

While the ultimate cause of type 1 diabetes or juvenile diabetes is difficult to discover, the basics are understood. For some reason, the body’s own immune system attacks the cells in the pancreas that are designed to produce insulin. As thie process progresses, eventually, enough of the insulin producing cells are destroyed that the few that remain are unable to keep up with the body’s demand. The result is an imbalance between glucose and insulin that leads to the disease of diabetes. One of the main issues under investigation is genetics – the fact that the disease may be inherited.[3]

Parents and caregivers should be alert to the special issues that signal type 1 diabetes in children:

  • An increase in thirst, an unquenchable thirst
  • An increased hunger
  • Dryness of the mouth, even after drinking
  • Nausea, with or without eating
  • Vomiting
  • Abdominal pain, normally of no known consequence
  • Increased urination
  • Weight loss that cannot be explained by other reasons
  • Tired and weak, and intense sense of fatigue
  • Vision problems, including blurry vision
  • High rate of infections, urinary tract, skin, vagina

Parents and caregivers must also be aware of special issues that indicate signs of an emergency. Children and juveniles with type 1 diabetes will likely demonstrate one or more of the following symptoms when a diabetic emergency arises:

  • Quick breathing
  • Mental confusion
  • Shaking of body extremities
  • Abdominal pain
  • Odd smell of breath, sometimes described as fruity
  • Unconsciousness

Juvenile Diabetes at School

Many parents are afraid to send children with diabetes to school. Schools are trained to care children with this disease. Personnel know how it is managed and how to get children the help they need.[4] Children with diabetes have a medical management plan in place and emergency procedures are also defined and will be followed if necessary.[5]

Many problems that arise for children are psychosocial. Schools, counselors, and others are also working to help make changes in this arena.[6] Special camps and support groups help juveniles adapt to their disease and living in the ‘real’ world.


[1]  The Facts about Diabetes. (n.d.). Retrieved from National Diabetes Education Program: http://ndep.nih.gov/diabetes-facts/index.aspx#type

[2]  Overview of Diabetes in Children and Adolescents. (n.d.). Retrieved from National Diabetes Education Program: http://ndep.nih.gov/media/diabetes/youth/youth_FS.htm#Diabetes

[3]  Ibid

[4]  Ibid

[5]  Schools. (n.d.). Retrieved from National Diabetes Education Program: http://ndep.nih.gov/hcp-businesses-and-schools/Schools.aspx

[6]  Johnson, S. B. (1980, 2004). Psychosocial Factors in Juvenile Diabetes. Journal of Behavioral Medicine , 95-116.

[7] This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.