Health Concerns

Children with type 1 or type 2 diabetes can be more likely to develop health problems earlier in their lives than children who do not have diabetes. Some children with diabetes may never have serious complications.

  • Problems take a long time to show up, so they usually do not affect young people.
  • The risk goes up after puberty.

The treatment goals depend on the child and his type of diabetes.

The best way to prevent complications of diabetes is to keep the blood glucose levels near the normal range. Children who are able to keep their blood glucose near normal most of the time are said to be in “good control.”  Children who do not have well controlled diabetes for many years run the highest risk of developing problems. That is why it is important to have a team of diabetes professionals to help manage diabetes properly. Teaching your child good health habits early can help prevent many health problems down the road.

There are three main reasons why it is important to keep your child’s blood glucose levels within a certain target range:

1. To feel well. Blood glucose levels that are below or well above the normal range can make a child feel uncomfortable. Low blood glucose levels prevent the brain from getting enough fuel to function properly. Very high blood glucose levels can cause symptoms of untreated diabetes (frequent urination and excessive thirst). A child may also complain of headaches, mood changes and difficulty concentrating.

2. To grow and mature appropriately. When blood glucose remains high over a prolonged period, weight gain and growth may be too slow. A child’s grades in school can be affected by blood glucose levels that are frequently outside the normal target range.

  • Diabetes professionals teach kids and their families to adjust treatments so that diabetes does not prevent a child from doing activities that are important to him. This includes sleep-overs, overnight camps, sports and school field trips.
  • Children with diabetes have extra pressures on them that can sometimes be too much to handle. Problems like depression and eating disorders are much more common in kids with diabetes compared to those with no chronic disease. Support and understanding from parents about how diabetes makes their child’s life harder is the most important part of recognizing and treating these problems. Psychologists can often teach kids and their families to better manage the day-to-day stresses that come with diabetes.

3. To prevent complications of diabetes.

Short term complications of diabetes include low blood glucose levels that usually cause uncomfortable episodes (feeling sweaty and shaky), but can sometimes be more serious and cause a child to pass out.

    • Children with well-controlled diabetes who take insulin usually have to accept that these episodes will happen and they need to be prepared to manage them by checking their blood glucose level and then having a drink or a snack.
    • Diabetic ketoacidosis (DKA) is a severe short-term complication that occurs when someone with diabetes does not get enough insulin. Children with DKA usually have vomiting and pain in their stomach. They can have trouble catching their breath and usually look sick. Their eyes may be sunken and the inside of their mouth can be dry. Unlike low blood glucose episodes, DKA cannot be treated easily. Help from a pediatric diabetes specialist is needed.

Long term complications of diabetes usually occur after having diabetes for decades, and can be limited by good treatment. Research has shown that blood glucose control is the best predictor of problems with eyes (retinopathy), nerves (neuropathy) and kidneys (nephropathy).  

  • Eye Disease (Retinopathy)
    After many years of having diabetes, people can get an eye disease called retinopathy. This starts with extra growth of blood vessels in the back of the eye, the retina. As it progresses, the new blood vessels bleed. If it progresses further, the retina can become detached, resulting in partial or complete blindness.
    • Blindness can be prevented by laser treatments if retinopathy is discovered early.
    • It is very important that patients with diabetes follow their doctor’s recommendation to have routine eye examinations.
    • Even if early retinopathy is present, good blood glucose control can prevent its progression.
    • Cataracts are also more common in people with diabetes. Cataracts can damage the lens and cloud vision.
  • Nerve Disease (Neuropathy)
    Long-term exposure to high blood glucose may cause neuropathy, a disease of the nerves that causes abnormal sensations such as burning, tingling or numbness. The toes and feet are the areas that are most often affected. Neuropathy may also slow stomach movement after eating. This can cause bloating and feeling of being full after eating only a small amount of food. The nerves affecting the heart or the penis also may be affected.
  • Kidney Disease (Nephropathy)
    Diabetes is the most frequent cause of adult-onset chronic kidney failure in the U.S. The first sign of damage to the kidney (nephropathy) is the presence of protein (albumin) in the urine. Keeping blood sugar in the target range and treating high blood pressure are very important in limiting kidney disease
  • Heart Attack and Stroke
    Diabetes increases the risk of a person having a blockage in their arteries when they are middle-aged. If the blockage is in the heart, it can cause a heart attack. If it is in the brain, it can cause a stroke. Other risk factors for blocked arteries are high blood pressure, high cholesterol, smoking and being inactive.

    • It is important that all children with diabetes develop healthy eating and exercise habits.
    • Smoking cigarettes is forbidden.
    • People with diabetes should take even small increases in their blood pressure or cholesterol levels seriously.