When I was 28 years old and a 3rd year resident in pediatrics at UAB, I was your typical doctor to be. I was running around the hospital on different rotations, being a dad of two young boys born 18 months apart, and trying to sleep whenever I could.
Over the course of two months, I started to notice some things about myself. I started to become incredibly thirsty all the time and I was waking up 6-7 times a night to go urinate. And it wasn’t just a small amount, it was a huge volume! I was hungry all the time too. At the time, I was working overnight shifts in the ER and moonlighting in the neonatal nursery. I blamed my crazy body symptoms on my hectic schedule with coffee at crazy hours in the night and not sleeping well. I also had occasional blurry vision, but just chalked that off to being tired. I didn’t really notice until a month or two later that I was losing weight. In fact, I lost almost 25 lbs! I’m not a big guy, so this was pretty drastic to say the least. I kept brushing it off and brushing it off. But finally, it hit me like a ton of bricks- I have Type 1 Diabetes! I was stunned. I went to our resident clinic and ran some tests. Sure enough, my blood glucose was through the roof and I was almost dehydrated. Within 24 hours, I had seen my internist at UAB and was plugged in with an endocrinologist (diabetes specialist). I was fine… but I was lucky.
I tell you this story because it documents a growing trend in our country. Diabetes is becoming more and more prevalent, although it’s not exactly clear why. Let’s talk about diabetes in general and then get to some specifics about kids.
There are two types of diabetes, Type 1 and Type 2. Type 1 often occurs in kids (although with me it occurred in my 20s) and has a strong genetic or family predisposition. Typically these kids are healthy and of average weight when symptoms start. In Type 1 diabetes, the body attacks its own pancreas and leads to an absence of insulin. Insulin is necessary to ensure that glucose floating around in the blood stream gets into the individual cells. Lack of insulin leads to an increase in blood sugar and all the above symptoms. If the symptoms are not caught and go too far, then the body can go into diabetic ketoacidosis or DKA. When this happens, the body is severely dehydrated and acidotic and unfortunately can lead to death if not treated. Treatment involves rehydration and supplemental insulin to get the blood sugar and symptoms under control. Type 1 Diabetes is not reversible, but there some amazing studies going on right now that are trying to find a cure or at least slow it down.
Type 2 diabetes is a disease of insulin resistance. The body makes insulin, but cannot use it properly. Oftentimes, this is found in overweight adults, but we are seeing it more and more in adolescents and teenagers. It is possible to reverse Type 2 Diabetes and treatment involves weight loss, exercise, diet changes and medication. If not treated and controlled, both types of diabetes can lead to an increased risk for heart attack, stroke, kidney disease, eye disease and poor wound healing.
In our community, there have been a lot of newly diagnosed children with Type 1 Diabetes. So, how would you know? You need to look for signs- is my child thirsty all the time? Or urinating all the time? Have they had an unexpected weight loss? Does their breath smell sweet? If you have noticed any of these symptoms, it never hurts to have your child checked out. Luckily, there are a lot of more common possible explanations for these symptoms. But, if you are worried, a simple urinalysis can usually reveal what is going on in just a few minutes. If need be, bloodwork can be drawn as well. When in doubt, check with your child’s doctor for answers and peace of mind.