Diabetes is a condition in which too much sugar, or glucose, remains in the blood because the body doesn't properly convert it to energy. This happens when there's a lack of insulin — a hormone that allows sugar to enter cells to be converted into energy — or when insulin isn't working well.
During the normal digestion process, the pancreas senses the amount of sugar in the bloodstream and releases insulin to keep blood sugar in a normal range. With diabetes, the pancreas doesn't produce the right amount of insulin. Sugar accumulates in the blood and spills over into the urine, causing frequent urination, a symptom of diabetes.
Diabetes is the fifth deadliest condition in the United States, affecting children, teenagers and adults. If diabetes isn't managed properly, high blood sugar levels over many years can lead to complications, including blindness, kidney failure and loss of sensation in the extremities that could result in amputation. Maintaining near-normal blood sugar levels can delay or prevent these complications.
Types of Diabetes
There are several types of diabetes, which have different causes and symptoms. They include:
- Type 1 Diabetes — Type 1 diabetes most often affects children and adults under the age of 35, but older adults also can have the disease. In type 1 diabetes, the insulin-producing beta cells in the pancreas stop making insulin. Although the cause of the condition is unknown, research has shown that type 1 diabetes results from an underlying genetic risk coupled with one or more environmental exposures. In type 1 diabetes, the immune system attacks and destroys the insulin-producing cells, which is why the condition is referred to as an autoimmune disease. Although signs and symptoms seem to develop rapidly over weeks to months, the destruction of beta cells often occurs slowly over years.
- Type 2 Diabetes — This form of diabetes differs from type 1 in that the initial problem is thought to be the body's increased resistance to insulin. The body's fat, muscle and liver cells don't respond to insulin properly, making it difficult for sugar to enter the cells. Initially, the insulin-producing cells in the pancreas try to compensate by making more insulin, but may not be able to sustain this increased production over time. At that point, blood sugars start to rise and diabetes develops.
Type 2 diabetes usually occurs in people over age 45, but can affect children and teenagers, especially those with family members who have type 2 diabetes. It is the most common form of diabetes, and is becoming even more common. The condition affects an estimated one in 20 people in the United States and occurs 10 times more often than type 1. Type 2 tends to run in families and in some cases appears to be inherited as a dominant trait.
Being overweight and inactive increases the chances of developing type 2 diabetes. African Americans, Hispanic or Latino Americans, American Indians, Asian Americans and Native Hawaiians or other Pacific Islanders tend to be at a higher risk than Caucasians.
- Gestational Diabetes — Gestational diabetes refers to diabetes that is diagnosed during pregnancy. It occurs in about seven percent of all pregnancies. The condition usually develops in the second half of pregnancy due to insulin resistance. If gestational diabetes is not treated, the mother and fetus may experience complications. Gestational diabetes typically resolves after delivery, but women who experience gestational diabetes are at risk of developing type 2 diabetes later in life.
- Maturity Onset Diabetes of the Young (MODY) — The main characteristic of maturity onset diabetes of the young (MODY) is a diagnosis before the age of 35 in at least three generations of family members. Accounting for two to five percent of all cases of diabetes, this condition is due to a single gene that's passed down from generation to generation as a dominant trait. Several genetic defects affecting the beta cell and insulin production and secretion have been noted in relation to this condition. Some people with MODY are treated with insulin. Others can be treated with oral diabetes medications.
Some of the common symptoms of all forms of diabetes include:
- Bedwetting in children who have been toilet trained
- Blurred vision
- Dry, itchy skin
- Extreme hunger
- Fatigue or low energy level
- Poorly healing wounds
- Tingling in the feet
- Urinating often, especially at night
- Weight loss
- Yeast infections
Diabetes often goes undiagnosed because these symptoms seem harmless or people aren't aware of them.
In diagnosing diabetes, your child's doctor will conduct a thorough medical history and physical examination, making note of any symptoms that may be related to diabetes. If your child's doctor suspects diabetes, a series of tests will be recommended to make a definite diagnosis. These may include:
- Blood Sugar Test — Also known as a glucose test, this is the standard test for diagnosing type 1 and type 2 diabetes. In the test, blood is drawn to check blood sugar levels. For a fasting blood sugar test, your child must not eat or drink anything for at least eight hours prior to the test. A diagnosis of diabetes will be made if your child has a fasting blood sugar level of 126 milligrams per deciliter (mg/dl) or higher on two separate days. A normal fasting blood sugar level is between 70 to 100 mg/dl.
The doctor may order a random blood sugar test. A diagnosis of diabetes will be made if your child has symptoms of diabetes and a random blood sugar level higher than 200 mg/dl, regardless of when your child last ate, on two occasions.
Managing your child's diabetes is a group effort involving the whole family. At UCSF Benioff Children's Hospital, our team — including doctors, dietitians, nurses, educators and social workers — work closely with your family to provide treatment, information, support, guidance and help. Your doctor will help you and your child develop a daily diabetes treatment plan.
Diabetes management is designed to keep your child's blood sugar levels in a near-normal range and prevent erratic swings. The treatment plan will also promote your child's normal physical and emotional development.
Treatment typically involves following a healthy meal plan, getting regular exercise, checking blood sugar levels, participating in regular screenings for long-term complications of diabetes and taking insulin or oral medication as prescribed. The treatment plan is reviewed and revised as necessary. It's generally recommended that patients visit the Pediatric Diabetes Program every three months.
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Reviewed by health care specialists at UCSF Benioff Children's Hospital.