Juvenile Onset Diabetes
What is Type I diabetes?
Type I diabetes is also known as insulin-dependent or juvenile onset
diabetes mellitus. Although type I diabetes can appear at any age, it
most often appears prior to the age of 30, as opposed to type II diabetes
that is most frequently adult-onset. The onset of symptoms is usually
rapid and severe. Control of type I diabetes is achieved by the use of
insulin injections for the rest of the person’s life. The exact cause
of type I diabetes is not known, and there is not a cure for diabetes.
This type of diabetes is a chronic illness that occurs when the pancreas
does not produce enough insulin to regulate blood sugar levels appropriately. With inadequate
insulin, glucose is not used by the cells, and instead builds up in the bloodstream.
Despite the high levels of glucose, the
body is unable to use the glucose for energy, thus leading to increased
hunger. These high glucose levels also result in increased thirst and
subsequent increased urine production. Within about 5 years of the onset
of diabetes, the insulin-producing beta cells are completely destroyed,
resulting in no production of insulin at all.
Incidence and prevalence
Overall incidence is approximately 15 cases per 100,000 individuals annually
and probably increasing. An estimated 3 children out of 1000 develop IDDM
by age 20 years. Caucasians seem to be affected more often than African-Americans, who have the lowest overall incidence of type 1 diabetes. Male-to-female
ratio is approximately 1:1. Long called juvenile-onset diabetes, type
1 diabetes typically is diagnosed in childhood, adolescence, or early adulthood, with the peak incidence in adolescence. Type 1 diabetes also may develop in older adults and increasingly
is being recognized through the measurement of islet-cell antibodies.
Type II diabetes is generally associated with increased weight and more sedentary
lifestyles.
There is growing concern among healthcare providers about an increase
in type 2 diabetes among children and adolescents.
“If you go back 20 years, about 2% of all cases of new onset diabetes
(type 2) were in people between 9 and 19 years old. Now, it's about 30%
to 50%,” noted Dr. Gerald Bernstein, a past president of the American
Diabetes Association (ADA) and an endocrinologist with Beth Israel Medical
Center in New York City.
Health experts blame the trend on burgeoning
rates of obesity among children and adolescents during the past three
decades. Indeed, the emerging epidemic of type 2 diabetes among children
reflects a trend in the population at large. In August 2000, the Centers
for Disease Control and Prevention (CDC) issued a report chronicling a
70% rise in the number of 30- to 39-year-old adults with the disorder
between 1990-1998. Over the same period, rates of the disease rose by
40% among those aged 40 to 49, and by 31% among those aged 50 to 59, according
to the report. As the incidence of obesity and limited exercise increases
among children, it is anticipated that the rate of type 2 diabetes will
increase in this population as well.
For more information about the difference between type 1 and type 2 diabetes
in children, visit:
http://www.childrenwithdiabetes.com/d_0n_d00.htm
Symptoms of type 1 diabetes
The sudden onset and severity of symptoms of juvenile onset diabetes
usually result in prompt medical attention. Symptoms may include:
- Increase thirst
- Increased urination
- Weight loss, despite increased appetite
- Nausea
- Vomiting
- Abdominal pain
- Fatigue
- Absence of menstruation
- Double vision
Complications
Besides the symptoms listed above, there may be other, more serious symptoms
if diabetes is not kept under control. The following complications are
very serious and require immediate medical attention.
Diabetic ketoacidosis
This occurs when the body uses fat as a fuel if insulin is not present.
Fat produces a byproduct called ketones which build up in the blood and
spill over into the urine. Ketoacidosis is a condition that develops when
ketones build up in the blood, making it acidic.
Hypoglycemia
Proper management of diabetes requires a careful balancing of activity, diet, and
insulin injections. Hypoglycemia, or low blood sugar, is the condition that occurs when the
balance between insulin, food intake, and exercise is lost.
In
the mild forms of hypoglycemia, the person may experience hunger, nervousness,
and an increased heart rate. Confusion and loss of consciousness may occur
when hypoglycemia becomes more serious. If not treated quickly, loss of
consciousness due to hypoglycemia may lead to a hypoglycemic coma.
Long-term complications are likely to develop in people who have had
diabetes for several years. Good management of diabetes through insulin,
proper diet and exercise can keep blood sugars more stable and minimize these
long-term complications.
- Vascular disease
- Microvascular disease
- Eye complications
- Diabetic nephropathy (kidney disease)
- Diabetic neuropathy (nerve disease)
- Foot problems
- Skin and mucus membrane problems
The morbidity and mortality associated with diabetes are related to the
short- and long-term complications. These complications include hypoglycemia
and hyperglycemia, increased risk of infections, microvascular complications
(ie, retinopathy, nephropathy), neuropathic complications, and macrovascular
disease. Diabetes is the major cause of blindness in adults aged 20-74
years, as well as the leading cause of nontraumatic lower-extremity amputation
and end-stage renal disease (ESRD).
Part 1 — Introduction, Incidence, Symptoms, and Complications