November is National Diabetes Awareness Month! This is a great opportunity to recognize the hard work diabetics and their families do every day to manage their disease. It is also an important time for the rest of us learn more about diabetes.
Before we talk about diabetes, it’s important to understand a few key terms.
There are two different types of diabetes: Type 1 Diabetes and Type 2 Diabetes. Type 1 occurs when a person’s pancreas stops making insulin. Type 2 is when insulin stops working properly. Insulin is a hormone that allows glucose into our cells to use for energy. Without functional insulin, we cannot move glucose from our digestive systems into our body’s cells. Instead, it moves into the bloodstream and stays there until it is urinated out. If diabetes is not treated, this excess of glucose can lead to serious complications for the body including blindness, kidney failure, brain and nerve damage, and death.
Type 1 diabetes most commonly starts in childhood. It is a genetic disease that is triggered by unknown factors. When triggered, the immune system destroys cells in the pancreas that produce insulin. Without insulin, the body quickly starts collecting glucose in the blood stream. Without glucose, the cells feel like they are starving. When this happens to a person, they suddenly become very thirsty, hungry and tired. Kids will wake up during the middle of the night to eat and drink. They also urinate a lot and start losing weight quickly.
If you notice these symptoms in your child, it is very important to seek medical attention. A urine test will show if there is glucose in the urine or not. If there is, your child will need to go to the Seattle Children’s Hospital (SCH) Emergency Department to start treatment with insulin which must be injected into the skin or given through an IV. At the hospital, you and your child will stay for 1-2 days learning about how to manage diabetes by counting the carbohydrates they eat and using the appropriate amount of insulin to get those carbs into their cells. This does not mean Type 1 diabetics can no longer eat sugar; it means they must be aware of everything they eat so they can get enough insulin for their body to use the glucose properly. There is no cure for Type 1 diabetes. It must be treated with insulin for the rest of one’s life. Luckily, there are various devices (insulin pens and pumps) that make this much easier than it used to be with syringes.
Type 2 diabetes is more commonly diagnosed in adults but can happen in children too. It has a genetic component but is primarily caused by lifestyle choices like not getting regular exercise and consuming too much processed food. This gives the body too much glucose to deal with. Over time, your natural insulin becomes less effective at moving glucose into cells. The symptoms are the same as Type 1, but they come on much more slowly. This can be prevented, and often treated, by changing your lifestyle. Many Type 2 diabetics can take oral medication to help their insulin work better. Some need injectable insulin. Treatment for both types of diabetes is usually managed by the endocrinology team at SCH. They work very closely with families to make sure all the diabetic’s medical needs are being met.
All diabetics have to check their blood glucose levels throughout the day to make sure they are not getting too high or too low. This can be done by placing a drop of blood from the finger into a handheld device called a glucometer. It can be also done by using a continuous glucose monitor which is attached to the skin. If you see people using these devices, please understand that they are managing their disease. Most diabetics would prefer that you ask them about what they are doing if you are curious instead of staring, which can feel judgmental.
If glucose levels do get too high or low it can lead to major problems. Too low can cause fainting and seizures. Too high can cause confusion, blurry vision, urinary wetting accidents, and ultimately Diabetic Ketoacidosis (a very serious condition that requires hospitalization). If you have a diabetic in your life, it is important to be watchful for these symptoms and educate yourself on what to do to help them if need be.
Diabetes is a serious disease that requires constant vigilance to treat properly. This is no easy task. We can all try to keep our insulin working as best it can by living healthfully. Everyone should be getting at least 1 hour of vigorous exercise per day, eating “real” (not processed, especially those with added sugar) foods, avoiding juice and soda, getting adequate sleep and taking care of our mental health. Staying healthy and reducing stress goes a long way to potentially keep the triggers for diabetes at bay and helps diabetics take control of their disease.
Dr. Brandi Irwin is a pediatrician in the Allegro Pediatrics Redmond location.