Diabetes in children may be scary, but it is controllable

Mikaela Carrillo, who was diagnosed with diabetes at age 11,

Four years ago, everyone in Mikaela Carrillo’s family came down
with the flu, but she couldn’t seem to recover. As the days passed,
her vision began to blur. She was thirsty all the time, but she had
to visit the bathroom constantly.
Four years ago, everyone in Mikaela Carrillo’s family came down with the flu, but she couldn’t seem to recover. As the days passed, her vision began to blur. She was thirsty all the time, but she had to visit the bathroom constantly.

When her parents took her to the family pediatrician, Carrillo, now 15, found out why. She had developed a condition known as Type I diabetes, which would require her to keep an eye on her blood sugar levels and inject insulin to control them for the rest of her life.

Fortunately, medical science is on her side. Today, the Gilroy High student uses an insulin pump, which delivers insulin to her blood throughout the day in a drip form rather than requiring her to inject the chemical as many as six times a day.

While the sudden onset of Carrillo’s illness may have been disconcerting, in some ways it is easier to come to terms with than Type II diabetes, said Gilroy Pediatrician Dr. K.K. Bhatia. Type II is more common in the overall population. In some cases, Type II can be much more damaging because symptoms are not as acute, and thereby not as noticeable, as those of Type I.

Nationwide, an increasing number of children are being diagnosed with Type II diabetes, which makes up more than 90 percent of all diabetes cases in the overall population. Type I only accounts for five percent, while other patients fall somewhere in between.

The key difference between Type I and Type II diabetes is the production of insulin, a chemical that transports sugar into cells. In the case of Type I, which usually appears in juvenile sufferers after an extended or very acute viral infection, the cells in the pancreas that are responsible for producing insulin – cease to function, said Sister Rachela Silvestri, a registered nurse at Saint Louise Regional Hospital. She is currently developing a comprehensive diabetes program for the medical center.

“The reasons why Type I diabetes occurs aren’t really known,” said Silvestri. “It’s usually classified as ‘immune mediated,’ which means having something to do with the immune system, or ‘idiopathic,’ which just means they don’t know how something happens.”

Conversely, Type II diabetes, sometimes refered to as adult-onset despite the fact that an increasing number of patients are children, is a relatively well-understood phenomenon.

In a normal person’s body, foods that are consumed are broken down into glucose, a simple sugar that cells convert into energy. In the case of a diabetic reaction, the pancreas cannot make enough insulin or efficiently use the insulin it has, to move glucose into the cells, and excess glucose builds up in the blood stream, according to the National Diabetes Information Clearing House, a division of the National Institutes of Health.

Silvestri compared it to losing a key.

“Type two is usually classified as insulin resistance,” said Silvestri. “For some reason the key is not there, so when the glucose goes to enter the cell, it can’t get in.”

In both cases, serious complications can occur over time, from numbness and fatigue to kidney, cardiac or vision failure, said Mickey Johnson a registered nurse and certified diabetic educator at Hazel Hawkins Memorial Hospital in Hollister, but with today’s technology, almost all cases of diabetes can be controlled.

“With the availability of insulin, insulin pumps (pager-like devices that release insulin throughout the day) and insulin pens (pre-loaded insulin needles that work at the touch of a button), I think children are doing much better than they were 20 years ago,” said Johnson, who teaches the hospital’s diabetes education program with staff dietitian Lynn Kjelson. “Their prognosis should be just as good as yours or mine with proper care and monitoring.”

Parents who suspect their child may be sick will encounter clear warning signs if Type I diabetes is involved, said Bhatia. The child will have extreme thirst, frequent urination and drowsiness or lethargy, she said. They may also have an increased appetite accompanied by sudden, rapid weight loss or sudden vision changes.

“Type II can be missed for a long time, but Type I usually progresses very fast,” said Bhatia, who noted that many parents initially think their children’s symptoms are the flu. “If you don’t seek treatment, they can progress to stupor or coma, but Type II doesn’t get bad as fast.”

The disease is diagnosed with a fasting blood test, which should show sugar levels between 80 and 110 or 120 milligrams of sugar per deciliter of blood in a normal child. Some diabetic children are diagnosed with levels as high as 400 mg/dL, said Bhatia.

In cases of Type I diabetes, children are routinely put on insulin shots, and their best chances for successful treatment lie in eating balanced meals three times a day at regular times.

“Since it’s children who are usually diagnosed with type one, the parents generally step in and take over,” said Bhatia. “The key to success is really patient education because there’s a lot to learn.”

Teenagers are among the most likely to resist treatment, said Johnson, mostly because they do not want to appear different from their peers.

“They want to know why they can’t they have regular soda instead of diet,” said Johnson. “They don’t want anyone to know they take shots, and one of the other problems is they discover not taking insulin is a great way to lose weight fast. Your body will try to use fat cells to make insulin and it will just wash them out, so the teenage girls will skip doses, but it’s not healthy. Add to that that some start drinking alcohol, and it could be dangerous.”

As Carrillo passes into her teens and 20s, these are all issues she’ll have to confront, but having watched a grandmother and grandfather grapple with the complications of untreated diabetes, she’s determined to live as healthy a life as possible. From daily workouts to careful diet monitoring, she’s paving the way for a healthy life, one choice at a time.

For more information on diabetes information classes in the area, call the Saint Louise Regional Medical Center at (408) 848-4939 or Hazel Hawkins Memorial Hospital at (831) 637-5711. Online, you can also check out more information at the American Diabetes Association’s Web site, www.diabetes.org, or you can call them at (800) DIABETES.

Things you can do to help keep your blood sugar stable

Educate yourself. The more you know about diabetes, the more you’ll be able to control it simply by making educated choices about routines, diet and exercise.

Avoid foods that contain simple sugars. Processed sugar, corn syrup, cane syrup and honey are no-nos. These items, often a part of syrups, cookies, gelatins, ice creams and alcoholic beverages, can be consumed occasionally, but only in low quantities.

Avoid high fat foods. Stick to leaner options like chicken, fish and fresh vegetables.

Obtain and maintain a healthy weight. This is especially important for growing children. Parents should consult their doctor regularly to make sure their child is at a safe and healthy weight.

Include high fiber foods in your diet.

Get regular. Keeping a consistent routine, including taking meals and insulin shots at the same time each day, helps to keep blood sugars at a constant level throughout the day, which new studies say could lead to fewer complications for diabetic patients.

Keep in touch with your doctor. If blood sugar levels are elevated for two or three days, it could indicate that you need a new type of insulin or an adjustment to your dosage level.

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