In people with Type 1 diabetes, the pancreas does not make insulin (a hormone that helps the body use sugar for energy). Type 1 diabetes was once called juvenile diabetes because most patients are in childhood or adolescence when they are diagnosed.
Type 1 diabetes develops from a combination of factors: First, a genetic predisposition must be present. Then, at some point in a person's life, an exposure to a common viral illness or other environmental cause will trigger the body’s immune system to attack its own beta cells (cells in the pancreas that make insulin), destroying their ability to make insulin. Nothing can be done to prevent this from happening.
Without insulin, the cells cannot use sugar for energy. As an alternative, the body will begin to break down fat for energy, flushing out sugar through the urine. For this reason, people with Type 1 diabetes often experience the following symptoms:
- Unintended weight loss
- Increased urination
- Urinating multiple times at night or wetting the bed
- Increased thirst
- Increased hunger
- Irritability and mood changes
- Blurred vision
Diagnosis of Type 1 Diabetes
If your child is showing symptoms of Type 1 diabetes, a doctor can use the following blood tests to make a diagnosis:
- Hemoglobin A1c. A hemoglobin A1c blood test provides your child's average blood sugar levels over a period of two to three months. High A1c values are a sign of poor blood sugar control and indicate the presence of diabetes.
- Random blood sugar test. A blood sugar test is performed at a random time. A normal result is based on when your child last ate.
- Fasting blood sugar test. A fasting blood sugar test measures your child's blood sugar levels after he or she has not had anything to eat or drink (except plain water) for at least eight hours.
The Type 1 Diabetes and Celiac Disease Connection
Research shows a link between Type 1 diabetes and celiac disease. Some studies suggest that children with Type 1 diabetes are more likely to be diagnosed with celiac disease. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 3 to 8 percent of people with Type 1 diabetes will have biopsy-confirmed celiac disease. Celiac disease associated with diabetes is usually silent, showing no symptoms, and may only be found upon screening. Like Type 1 diabetes, celiac disease is also an autoimmune disease. At Riley at IU Health, your child will be screened for celiac disease approximately every two years. If your child has an elevated antibody level for celiac disease, he or she will be referred to the Gastroenterology Department for further evaluation.
Treatment for Type 1 diabetes includes:
- Insulin injections. If your child is diagnosed with Type 1 diabetes, he or she will require insulin every day to help his or her body process sugar normally. Insulin is usually given before meals and snacks and at bedtime. Insulin can be given with syringes, insulin pens or an insulin pump. Parents or guardians should help young children with their insulin injections. As children get older, they can learn to give their own injections.
- Diabetes management. Diabetes management involves a lifestyle change. You or your child will test his or her blood sugar four or more times a day using a blood glucose meter and record the results in a logbook. Your child should also follow a meal plan, making sure to eat three meals and possibly a few snacks each day. It is important to count the number of carbohydrates eaten at meal and snack times so the appropriate amount of insulin can be given. In addition, getting enough exercise and reducing stress will help your child's body use insulin. As your child gets older, he or she will learn to manage the condition independently but will need continued supervision from you.
- Continued monitoring by your child's healthcare team. The diabetes specialists at Riley at IU Health recommend your child see his or her healthcare team every three to four months for continued health monitoring. The following health evaluations may be performed during these visits:
- Growth and weight gain. Your child's height and weight are plotted on a growth chart at each visit to monitor his or her growth. Children whose diabetes is in control should grow normally.
- Hemoglobin A1c test. The same blood test that is used to diagnose Type 1 diabetes is also used to keep track of your child's average blood sugar levels after diagnosis. This test will be done each time your child sees his or her doctor.
- Thyroid function test. Children with Type 1 diabetes are at an increased risk for developing thyroid conditions. A test to check if your child's thyroid is functioning normally will be performed every two years.
- Cholesterol test. High blood glucose levels can affect cholesterol levels. High cholesterol levels can contribute to heart disease. Your child's cholesterol levels will be checked every four years—more often if they are high.
- Urine microalbumin test. High blood sugar concentrations over a long period of time can result in the thickening of kidney membranes. When this happens, protein abnormally leaks into the urine. A urine microalbumin test is performed each year once your child turns 10 or has had diabetes for five years to monitor for signs of kidney problems.
- Dental exam. High blood sugar can predispose children to periodontal disease. Although all children should have their teeth examined every six months, this is especially important for children with Type 1 diabetes.
- Eye exam. Long periods of high blood sugar can damage the tiny vessels in the eyes leading to poor vision. Children over the age of 10 or who have had diabetes for more than five years should see an ophthalmologist at least once a year.
- Yearly influenza vaccine. Influenza can make diabetes management very difficult and can result in emergency room visits or hospitalization. The physicians at Riley at IU Health recommend that all patients with Type 1 diabetes and their family members receive a yearly seasonal influenza (flu) vaccine.
By carefully following your child's diabetes management plan—which includes balancing food, insulin, physical activity and stress—your child can keep his or her blood sugar levels within a target range and live a normal, healthy life.
Key Points to Remember
Key Points to Remember
- In people with Type 1 diabetes, the pancreas does not produce insulin.
- People with Type 1 diabetes require daily insulin injections, given through a syringe or an insulin pen or pump.
- Type 1 diabetes develops from a combination of factors, but the condition is not preventable.
- At first, a parent or guardian may need to give insulin injections to a child, but over time the child can learn to give his or her own injections.
- Children with Type 1 diabetes can live a normal, healthy life when proper attention is given to the balance of food, insulin, activity and stress to keep blood sugars within a target range.
Support Services & Resources
Support Services & Resources
Visit the links below to learn more about Type 1 diabetes and discover support groups and resources.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
The official website of the American Diabetes Association provides in-depth information about living with Type 1 diabetes and connects patients and families to local American Diabetes Association offices and events.
This federally funded program is working to improve treatment and outcomes for people with diabetes and provides comprehensive resources about the condition on its website.
The Diabetes Youth Foundation of Indiana supports, educates and encourages children and teens with Type 1 diabetes.
JDRF (formally known as the Juvenile Diabetes Research Foundation) is the leading global organization funding Type 1 diabetes research.
This site includes information about clinical trials available for children with Type 1 diabetes.
Type 1 Diabetes Research
Type 1 Diabetes Research
The Diabetes & Endocrinology Department at Riley at IU Health is involved in multiple research studies for Type 1 diabetes. Talk to your child's doctor to learn more about these studies and find out if your child is eligible to participate in a clinical trial.