By Vanessa Orr
Type 1 diabetes is on the rise in the United States and around the world, increasing by roughly 2-3 percent each year. The disease is quite prevalent in Florida, including among pediatric patients, which is why parents should know the early warning signs.
“Some of the biggest warning signs that parents should take their children to a doctor include fatigue, low energy, excessive thirst, and frequent urination. They may also develop belly pain, nausea, and vomiting,” said KIDZ Medical Services endocrinologist Dr. Jennifer Navarro. “Unfortunately, many children aren’t diagnosed until they come into the ER with full-blown diabetic ketoacidosis.”
KIDZ Medical Services is a private, physician‑owned multispecialty healthcare organization whose team of more than 400 clinicians and team members care for patients and families across dozens of hospital partner sites and medical practice locations throughout South Florida.
With Type 1 diabetes, an autoimmune condition that can also have a genetic component, the body begins to develop antibodies against the pancreas that attack and damage the organ.
“It can be a long process—years can go by without a person developing symptoms until the damage is done, and that is far too late,” said Dr. Navarro. “When the pancreas cannot make insulin, blood sugars rise to dangerous levels. The body’s cells are starving for glucose, but without insulin, it can’t unlock the cells to let the sugar in.
“Eventually, these starving cells produce a protein called ketones, which makes the blood very acidic,” she adds. “When that happens, symptoms can be severe, ranging from belly pain to vomiting to problems breathing and confusion if the disease is not caught in time. It can be deadly.”
Type 1 diabetes is a permanent condition that requires lifelong treatment with insulin. Type 2 diabetes, in which the pancreas can make insulin but the body is resistant to the hormone, is more easily treatable, and patients may eventually no longer need treatment. Type 1 diabetes affects a range of ages from infants to teens, and Type 2 is usually seen in late adolescence.
While insulin is always required for Type 1 diabetes, education is also important. “Families may not necessarily need to change their children’s diets, but they do need to learn how to count carbohydrates efficiently and learn how to give the proper amount of insulin to keep blood sugars as stable as possible,” said Dr. Navarro.
The good news is that with evolving technology, it’s easier than ever to track blood sugar levels. “Smart” pumps like the Omnipod and Tandem t:slim remain in constant communication with a sensor on the patient to detect blood sugar levels at all times.
“While these pumps can predict to a certain degree when to administer insulin if blood sugars are rising, they still need input from the patient or parents,” said Dr. Navarro. “If you tell it that you are going to eat a certain number of carbs, it can determine the amount of insulin you need; it does the math for you.”
Though pumps can make care easier, Dr. Navarro said that it is still important to know how to use finger sticks for diabetes management. “While pumps do minimize the number of finger sticks a patient has to do, they can fail, and there may be a lag time between the reading and a patient’s condition,” she said. “If a person is showing symptoms of low sugar, like jitteriness, sweating, and palpitations, even if the sensor says they are fine, they should test with a finger stick.”
Advancements in certain immunotherapy medications like Tzield® can also make it easier to treat kids who are at risk of Type 1 diabetes, but who haven’t developed full-blown diabetes yet. These immunotherapies help slow down the autoimmune destruction of the pancreas and preserve function longer, which can delay the onset of symptomatic diabetes.
“Children with Type 1 diabetes can live normal, fulfilling lives and still be active—they don’t need to restrict certain dietary habits or stop playing sports,” said Dr. Navarro. “But they do need to learn what happens to blood sugars in these situations and treat those things accordingly.
“Being prepared is important; we tell our patients always to keep a box of juice or glucose tabs available so they have something with them if they go low,” she added.
Dr. Navarro also suggests that families join diabetes community groups, which are especially helpful to the newly diagnosed. “Reach out to others so that you don’t feel so alone,” she said. “For example, the group Breakthrough T1D provides resources for parents and children as well as community opportunities to meet other families and talk things through.”
