Author: Meera Palaniappan
Given the fact that diabetes has become increasingly common within the world, you most likely know or have encountered someone with diabetes. Now, in America, 1 in 10 individuals are diagnosed with diabetes while many others may have it and not even know. It is estimated that 283,000 children and adolescents have diabetes as well. Though the amount of people who are diagnosed continues to rise, there seems to be an ongoing stigma surrounding diabetes. People tend to look down and judge those with diabetes based on incorrect information. The most common stigmas include ideas such as: those with diabetes are older, most often overweight, and brought this upon themselves. However, it is important to be aware of the circumstances surrounding one’s diagnosis of diabetes as it can even be life threatening. Certain stigmas can cause individuals to feel ashamed and internalize certain negative ideas and comments which can cause them to hide their diabetes, affecting the way they treat and manage their diabetes as well. Many also get confused between the terms type 1 and type 2 diabetes.
So what is the difference between type 1 and type 2 diabetes? Each type has a different root cause. For type 1, it is due to the fact that the pancreas is unable to make insulin as the body attacks the islet cells on the pancreas. The immune system mistakenly identifies healthy cells as foreign invaders and attacks. Essentially, it is caused by an autoimmune reaction and develops earlier life in children and adolescents. However, for type 2, the pancreas stops making the same amount of insulin that it used to and the body becomes resistant to insulin. For type 2, it often occurs later in life. Several outside factors are large contributors to an individual developing type 2 diabetes. This may consist of being physically inactive, being overweight, genetic family history of diabetes, and more. Symptoms for type 1 and type 2 diabetes are very similar. The most commonly noticed symptoms are urinating frequently, drinking lots of water, feeling tired easily, feeling hungry, blurry vision, having very dry skin, being exposed to more infection, mood swings, and experiencing unexplainable weight loss. Type 2 diabetes is much more manageable compared to type 1 as it can be prevented and managed by maintaining a healthy lifestyle which includes eating a balanced diet and staying active. Type 1, on the other hand, is unable to be prevented.
There is currently no cure for those who are diagnosed with type 1. Majority of those who experience type 1 diabetes are also children. This is where the term “juvenile diabetes” comes from. It can last for years or can even be a lifelong condition. Once a child or the child’s parents notice certain symptoms correlated with type 1 diabetes, it is critical to get a blood test. A small sample of blood is taken by the doctor after fasting overnight to get a close look at blood-sugar levels. Though it may be scary for the child to get their blood drawn, it is necessary to do so in order to manage symptoms. Even though I may not have diabetes, I have gotten tested due to a family history of diabetes. I have even watched my dad manage his diabetes for a long time as well. As a child, I would watch as my dad would poke his finger everyday to check his blood sugar levels. This is common within type 1 diabetes as well where blood sugar is monitored often in order to keep these levels between 80 to 130 mg/dL or less than 180 mg/dL after eating. On top of that, other forms of treatment include taking insulin, eating a balanced diet, and keeping active. Insulin can be taken through injections under the skin or an insulin pump that can be worn outside of the body. Those with type 1 diabetes will often visit their doctor often in order to keep their diabetes managed.
This can obviously be a lot for a child to handle and rather than having others judge them for their condition, they need the utmost support they can get in order to thrive in any environment. As a parent, it is important to educate your child about their condition and allow them to embrace themselves as they are. They will need lots of care and will need to be prepared when you aren’t there, especially younger children. This can be in school or any area where they may be by themselves. In school, teachers and staff will need to understand how to support and accommodate for your child’s diabetes. Usually the school nurse will be provided with all the information to take care of your child. Have your child go places with certain supplies such as blood sugar testing kits, insulin syringes/pumps, water, and extra snacks in case blood sugar levels drop while they are out. Easy snacks to pack would include juice boxes, fruits, or crackers. Signs of low blood sugar may include but are not limited to: shakiness, chills, sweating, dizziness, hunger, nausea, and mood changes.
Children can often be forgetful of how to care for themselves or may hide their diabetes when they are outside due to fear of getting judged and life with diabetes can be difficult. From the Children’s Hospital of Pennsylvania, many patients share their journey with type 1 diabetes. Jordan explains how, “Having juvenile diabetes forces you to grow up and deal with life and death decisions many times before you are fully mature. I would often wonder, ‘Why do I have to have this disease?’ Add in the stress from school, and balancing activities plus a social life, and it’s easy to get off track.” Having and dealing with diabetes can be mentally taxing for anyone’s especially children. They have so much going on in their life with the added responsibility of managing diabetes, making it easy to get off track as Jordan says. It can be extremely overwhelming to deal with a diagnosis that requires constant care and attention in order to thrive. Another patient, a 2 year-old named Emily, was also diagnosed with type 1 diabetes. Her mom experiences how, “Instead of seeing her baby sleeping as usual, Melissa was shocked to find Emily covered in vomit. ‘It was the worst day of my life...Emily’s hands and lips were purple, and she was having a hard time breathing. I couldn’t believe what was happening.’” After the EMTs arrived and took her to the hospital, they ran tests and confirmed her diagnosis of diabetes. If she weren’t rushed to the hospital, her type 1 diabetes could have been fatal. This only further reinforces the severity of dealing with type 1 diabetes and how scary it can be when presented in children.
When does type 1 diabetes result in hospitalization? There are two main reasons why those with type 1 diabetes are hospitalized: diabetic ketoacidosis (DKA) and severe hypoglycemia. Diabetic ketoacidosis occurs when the body doesn’t have enough insulin to allow blood sugar into your cells to use as energy. This occurs when blood sugar levels aren’t monitored and medicines aren’t taken as prescribed. The early common signs of DKA are becoming very thirsty, urinating more, rapid breathing, stomach pain, nausea/vomiting, headache, and muscle stiffness. When treating DKA, you will be taken to the emergency room and admitted to the hospital where fluids and electrolytes will be replaced, and receive insulin and other medicines as well. Another cause for hospitalization would be hypoglycemia. This would occur when an individual doesn’t have enough glucose in their blood, resulting in a lack of energy and function. Hypoglycemia can lead to seizures or unconsciousness in severe cases which is when you would have to be hospitalized. Taking your child to the hospital for their diabetes can be extremely terrifying for parents just as much as it is for the child. From the Telethon Kids Institute, Heath’s mom describes her first time taking her son to the hospital. She says, “The first needle I had to do in the hospital was horrific. I did it...I then left the room and cried. Because it's not pleasant. The idea of, you know, deliberately hurting your child because you need to keep them alive is a hard thing to process and it's a hard thing to come to terms with.”
Not only is it hard for the parents, but the child feels scared throughout the process as well. Being hospitalized for type 1 diabetes and going through these different procedures can feel very isolating. A child experiencing diabetes needs all the support they can get from others to make them feel more at ease with their diagnosis. How can we as a community help these children and individuals? I have a personal connection with diabetes as the majority of my family is diagnosed and I have watched my dad deal with his symptoms firsthand. Because of this, I try to help in any way I can. This could look like taking the time out of your schedule to go volunteer at a hospital, write cards to children, or volunteer through organizations like Crafting Smiles! This can truly have a huge impact on the lives of children who are hospitalized with life threatening conditions like type 1 diabetes.
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