Diabetes is an illness that can affect people of all ages, including infants and children. There are two primary forms: Type I, which is the autoimmune form, and Type II, which is linked to body weight. Pediatric endocrinologists, Thomas A. Wilson, MD, Professor of Pediatrics, Division of Pediatric Endocrinology, and Jennifer Osipoff, MD, Assistant Professor of Pediatrics, Division of Pediatric Endocrinology, discuss diabetes in children and the treatments available at Stony Brook Children's Service.
Isn't diabetes rare in children?
Recent studies have shown that Type I diabetes is increasing in the pediatric population. Right now, approximately one out of every 400 children is diagnosed with Type I diabetes, which makes it a fairly common disease.
The other main form of diabetes, Type II, is also becoming more common in children, and is likely related to increased body weight.
What are the symptoms?
As with adults, the symptoms are increased thirst and increased urination. With Type I diabetes, there may be weight loss despite adequate food intake.
Unfortunately, both parents and pediatricians can easily overlook diabetes symptoms in babies and children. If diabetes develops and is left untreated, a dangerous dehydration state called diabetic ketoacidosis can occur.
What happens with diabetes ketoacidosis?
When the body is not able to produce insulin it can't process sugar, so it looks for other sources of energy. It starts to break down fat, which produces ketones, a form of acid. Symptoms of diabetic ketoacidosis can include nausea, vomiting, respiratory distress, abdominal pain, dehydration and altered mental status. Diabetes ketoacidosis is a life-threatening condition that requires immediate emergency care.
What's the treatment for children with diabetes?
The most important goal is to get and keep the blood sugar under control. For type 1 diabetes, insulin is essential. For Type II diabetes, diet and exercise along with oral medications can be tried first, but insulin may eventually need to be added.
What makes Stony Brook's approach to diabetes care different?
At Stony Brook Children's, our pediatric endocrinology division is proactive about starting patients who need insulin on an insulin pump, if they qualify.
What are the advantages of pumps?
Insulin pumps most closely mimic the way the body naturally produces and delivers insulin. The pump is worn outside the body and programmed with a formula unique to each child.
An insulin pump also eliminates the need for multiple daily injections. Instead, the insulin is delivered through a small plastic tube inserted through the skin.
Does Stony Brook offer any other advantages to children with diabetes?
It takes a team to take care of children with diabetes. In addition to our four pediatric endocrinologists, we have a dedicated diabetes educator and a dietitian.
In all of our offices we can also monitor the Hemoglobin A1C, which keeps children from having to pay a visit to the laboratory. And we keep pace with new technologies as soon as they're available.
Can you give some example of these new technologies?
Our offices in Patchogue and East Moriches recently acquired a professional continuous glucose monitor called the IPRO2. The device, which is used for a few days twice a year, records the child's blood glucose 24 hours a day. With the IPRO2 we can get a much more accurate picture of the child's glucose levels during his or her daily activities, even when asleep.
also offer personal continuous glucose monitors, which children can wear at home. This device is an important addition to their insulin therapy.
What is the main message you want to leave us with about diabetes in children
That diabetes is more common in children than people may realize. It's important for all parents, as well as teachers and caregivers, to be aware of the symptoms of diabetes and to know what to do if a child with diabetes is having a medical emergency.
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