Diabetes in Children Overview, Types of Diabetes

Diabetes in Children Overview

Diabetes, also known as diabetes mellitus, is a condition that affects the body's ability to produce a hormone called insulin, to use it properly, or both. Diabetes results in high levels of blood sugar (glucose). High blood sugar (hyperglycemia) can cause a number of serious complications in children, adolescents, and adults.

Glucose is a simple sugar that is made by the body from the foods we eat. The cells of the body use glucose for energy and growth. During digestion, glucose and other nutrients are released into the bloodstream, causing blood sugar levels to rise. High blood sugar levels then prompt special cells in the pancreas (called beta cells) to produce the hormone insulin. Insulin helps glucose enter the body's cells. Glucose cannot get into cells without insulin.

In some children with diabetes, the pancreas cannot make insulin. In others, not enough insulin is produced to allow glucose into the cells of the body. High blood sugar levels are dangerous, so it is important for children who have diabetes to carefully monitor and manage their blood sugar levels daily.

Types of Diabetes

There are many different types of diabetes. Type 1 diabetes (previously called insulin-dependent or juvenile diabetes) usually affects children and adolescents, but can develop at any age. Approximately 5–10% of all diabetes diagnoses are type 1 and about 75% of new diagnoses are in children younger than 18.

Type 1 diabetes is an autoimmune disease, which means that the patient's own immune system produces antibodies that attack and destroy cells in the body, including cells in the pancreas that produce insulin. Because the pancreas can no longer make insulin, children with type 1 diabetes need insulin injections for the rest of their lives, or until a new method for delivering insulin is developed and approved.

Type 2 diabetes often is linked to obesity. In the past, this type was called non-insulin dependent or adult-onset diabetes. However, obesity rates are rising rapidly in children and adolescents and type 2 diabetes is becoming more common in these age groups.

Type 2 diabetes results from insulin resistance. This occurs when the body's cells cannot respond properly to insulin and do not accept glucose. The pancreas makes more and more insulin, but the cells still do not respond. Eventually, the pancreas wears out and cannot make enough insulin to control the rising level of blood glucose and diabetes develops.

Children with type 2 diabetes sometimes can manage their blood sugar through exercise, diet, and medication and do not need to have insulin injections.

"Hybrid" or "mixed" diabetes occurs when symptoms of both type 1 and type 2 are present. Children who have this type often are obese and have insulin resistance in addition to antibodies that attack and destroy beta cells.

Maturity-onset diabetes of the young (MODY) is a rare form of diabetes, caused by a genetic defect that interferes with insulin secretion. This type usually occurs before the age of 25. MODY represents about 2–5% of all diabetes cases.

Secondary diabetes can develop in children who have cystic fibrosis or who need glucocorticoid medications (e.g., children who have certain inflammatory, autoimmune diseases, or who have had an organ transplant). This type represents approximately 1–5% of diabetes cases.

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Incidence and Prevalence of Diabetes

In the United States, approximately 177,000 children and adolescents have some form of diabetes, with types 1 and 2 being by far the most common. One in 400–600 children has type 1 diabetes and more than 13,000 children are diagnosed with this type each year.

Incidence of type 1 diabetes in children increases with age. Each year in the United States, 7 in 100,000 children age 4 and younger are diagnosed; 15 in 100,000 children between the ages of 5 and 9 are diagnosed; and 22 in 100,000 children between the ages of 10 and 14 are diagnosed.

Prior to 1994, fewer than 5% of children diagnosed with diabetes had type 2. Since then, this number has risen to 30–50%.

Diabetes affects all ethnic groups, but rates of diabetes are higher in Native American, African American, Latino, and Pacific Islander populations.

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