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Diabetes in Children and Teens

Until recently, the common type of diabetes in children and teens was type 1. It was called juvenile diabetes. With Type 1 diabetes, the pancreas does not make insulin. Insulin is a hormone that helps glucose,or sugar, get into your cells to give them energy. Without insulin, too much sugar stays in the blood.

Now younger people are also getting type 2 diabetes. Type 2 diabetes used to be called adult-onset diabetes. But now it is becoming more common in children and teens, due to more obesity. With Type 2 diabetes, the body does not make or use insulin well.

Children have a higher risk of type 2 diabetes if they are overweight or have obesity, have a family history of diabetes, or are not active. Children who are African American, Hispanic, Native American/Alaska Native, Asian American, or Pacific Islander also have a higher risk. To lower the risk of type 2 diabetes in children:

  • Have them maintain a healthy weight
  • Be sure they are physically active
  • Have them eat smaller portions of healthy foods
  • Limit time with the TV, computer, and video

Children and teens with type 1 diabetes may need to take insulin. Type 2 diabetes may be controlled with diet and exercise. If not, patients will need to take oral diabetes medicines or insulin. A blood test called the A1C can check on how you are managing your diabetes.

Diabetes Medicines

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

type 1 diabetestype 2 diabetes

What are the treatments for diabetes?

Treatments for diabetes can depend on the type. Common treatments include a diabetic meal plan, regular physical activity, and medicines. Some less common treatments are weight loss surgery for either type and an artificial pancreas or pancreatic islet transplantation for some people with type 1 diabetes.

Who needs diabetes medicines?

People with type 1 diabetes need to take a diabetes medicine called insulin to control their blood sugar.

Some people with type 2 diabetes can control their blood sugar with healthy food choices and physical activity. But for others, a diabetic meal plan and physical activity are not enough. They need to take diabetes medicines.

The kind of medicine you take depends on your type of diabetes, daily schedule, medicine costs, and any other health conditions that you have. Over time, you may need to take more than one diabetes medicine.

What are the types of medicines for type 1 diabetes?

If you have type 1 diabetes, you must take insulin because your body no longer makes it. There are different types of insulin that start to work at different speeds, and the effects of each last a different length of time. Your health care provider will measure your blood glucose to decide on the type of insulin. You may need to use more than one type.

You will also need to check your blood sugar at home. Your provider will tell you how often. The results of your blood sugar testing can help you make decisions about food, physical activity, and medicines.

You can take insulin several different ways. The most common are with a needle and syringe, an insulin pen, or an insulin pump. If you use a needle and syringe or a pen, you have to take insulin several times during the day, including with meals. An insulin pump gives you small, steady doses throughout the day. Less common ways to take insulin include inhalers, injection ports, and jet injectors.

In rare cases, taking insulin alone might not be enough to manage your blood sugar. Then you would need to take another diabetes medicine.

What are the types of medicines for type 2 diabetes?

There are several different medicines for type 2 diabetes. Each works in a different way. Many of them are pills. There are also medicines that you inject under your skin, such as insulin.

Over time, you may need more than one diabetes medicine to manage your blood sugar. You might add another diabetes medicine or switch to a combination medicine. A combination medicine contains more than one type of diabetes medicine in the same pill. Some people with type 2 diabetes take both pills and injections.

Even if you don't usually take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

What else should I know about taking medicines for diabetes?

Even if you take medicines for diabetes, you still need to eat a healthy diet, stop smoking, take your other medicines, and get regular physical activity. These will help you manage your diabetes.

It is important to make sure that you understand your diabetes treatment plan. Talk to your provider about:

  • What your target blood sugar level is
  • What to do if your blood sugar gets too low or too high
  • Whether your diabetes medicines will affect other medicines you take
  • If you will have any side effects from the diabetes medicines

You should not change or stop your diabetes medicines on your own. Talk to your provider first.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Diet

What is diabetes?

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood glucose levels.

Prediabetes means that your blood glucose levels are higher than normal but not high enough to be called diabetes. If you have prediabetes, you are more likely to develop type 2 diabetes.

How do the foods I eat affect my blood glucose levels?

The glucose in your blood comes from certain foods called carbohydrates, or "carbs." Foods that are high in carbs include candy and sweets, sodas, breads, tortillas, and white rice. The more carbs you eat, the higher your blood glucose level will be.

Whether you have type 1 or type 2 diabetes, making the right food choices is an important way to keep your blood glucose at a level that is healthy for you. When you control your blood glucose, you lower your chance of having serious health problems from diabetes, such as vision loss and heart problems.

And if you have prediabetes or are at risk for diabetes, eating foods that keep your blood glucose levels healthy may help prevent type 2 diabetes later on.

What's the best diet for diabetes?

There isn't a specific diet or meal plan that works for everybody. Your health care provider may have you see a registered dietician (RD) or a diabetes educator who can help design the best eating plan for you. The plan will consider:

  • Any medicines that you take
  • Your weight
  • Any other health conditions you have
  • Your lifestyle and tastes
  • Your goals

All eating plans for diabetes have a few things in common, including eating the right foods in the right amounts at the right times.

What foods should I eat if I have diabetes?

Eating the right foods for diabetes means eating a variety of healthy foods from all the food groups:

  • Fruits and vegetables
  • Whole grains, such as whole wheat, brown rice, barley, quinoa, and oats
  • Proteins, such as lean meats, chicken, turkey, fish, eggs, nuts, beans, lentils, and tofu
  • Nonfat or low-fat dairy, such as milk, yogurt, and cheese
What foods should I limit to control my blood glucose?

To keep your blood glucose under control, you may need to cut back on certain foods and drinks. This doesn't mean that you can never enjoy them. But you will need to have them less often or in smaller amounts.

  • High-carb foods and drinks, such as:
    • Sugary foods, such as candy, cookies, cake, ice cream, sweetened cereals, and canned fruits with added sugar
    • Drinks with added sugars, such as juice, regular soda, and regular sports or energy drinks
    • White rice, tortillas, breads and pasta - especially those made with white flour
    • Starchy vegetables, such as white potatoes, corn, and peas
  • Fried foods and other foods high in saturated trans fats.
  • Foods high in sodium (salt).
  • Alcohol. If you do drink, you should drink moderately. This means no more than one standard drink a day if you're a woman or two standard drinks a day if you're a man.
What else do I need to know about diabetic diets?

If you have diabetes, it's important to eat the right amount of food every day. Your eating plan will include how much to eat, so that you get the right amount of carbs in each meal or snack. You'll learn how to count carbs and measure your food.

Eating at the right times is also important. You will want to plan for regular, balanced meals to avoid blood glucose levels that are too high or too low for you. Eating about the same amount of carbs at each meal can be helpful.

Your eating plan will also teach you how to stick with your plan at home and when you eat out.

Eating healthy to control your blood glucose does take some effort. But the reward is a chance to live your healthiest life with diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Nerve Problems

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage the covering on your nerves or the blood vessels that bring oxygen to your nerves. Damaged nerves may stop sending messages, or may send messages slowly or at the wrong times.

This damage is called diabetic neuropathy. Over half of people with diabetes get it. Symptoms may include:

  • Numbness in your hands, legs, or feet
  • Shooting pains, burning, or tingling
  • Nausea, vomiting, constipation, or diarrhea
  • Problems with sexual function
  • Urinary problems
  • Dizziness when you change positions quickly

Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. Controlling your blood sugar can help prevent nerve problems, or keep them from getting worse. Treatment may include pain relief and other medicines.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Medical Ethics

The field of ethics studies principles of right and wrong. There is hardly an area in medicine that doesn't have an ethical aspect. For example, there are ethical issues relating to :

  • End of life care: Should a patient receive nutrition? What about advance directives and resuscitation orders?
  • Abortion: When does life begin? Is it ethical to terminate a pregnancy with a birth defect?
  • Genetic and prenatal testing: What happens if you are a carrier of a defect? What if testing shows that your unborn baby has a defect?
  • Birth control: Should it be available to minors?
  • Is it ethical to harvest embryonic stem cells to treat diseases?
  • Organ donation: Must a relative donate an organ to a sick relative?
  • Your personal health information: who has access to your records?
  • Patient rights: Do you have the right to refuse treatment?
  • When you talk with your doctor, is it ethical for her to withhold information from you or your family?