Diabetes in Children and Teens

What you need to know about diabetes in children and teenagers.

Diabetes is becoming more common among children and teenagers. Therefore, early detection of diabetes is critical for young people and can improve wellness throughout their lives.

The National Diabetes Statistic Report of 2020 found that in the United States, 210,000 children and teenagers under the age of 20 have been diagnosed with diabetes.

Type 1 diabetes is more common among children and teenagers than type 2 diabetes. However, rates of both types of diabetes are rising. Type 1 diabetes was known as “juvenile diabetes” for many years. However, the term juvenile diabetes is no longer used because it implies that only children can acquire the disease. Until recently, type 2 diabetes was almost unheard of in children.

The National Institutes of Health (NIH) reports that the rate of type 1 diabetes diagnosis in children is rising annually by 1.8%, and type 2 diabetes diagnosis in children is rising by 4.8% annually.

Children diagnosed with diabetes will have a higher risk of health complications and side effects throughout their lives due to the disease’s longevity.

This article will help you learn about the symptoms of diabetes to watch for in children, the causes and risk factors, treatment options, and where to turn for support.

Types of Diabetes Affecting Children

Two types of diabetes can affect children: type 1 diabetes and type 2 diabetes. Type 1 diabetes is more common among children; however, the rates of type 2 diabetes are rising annually.

Type 1 Diabetes

Close up of child and adult holding hands, child wearing a type 1 diabetes braceletType 1 diabetes is an autoimmune disease. With this type of diabetes, your immune system creates antibodies that attack the beta cells in your pancreas. Beta cells are responsible for producing insulin. As beta cells are attacked and destroyed, your body makes less and less insulin. As the disease progresses, insulin production continues to decrease. Most people with type 1 diabetes produce no insulin or a minimal amount.

Without insulin, your cells are not able to use sugar for energy. This results in high levels of sugar in your blood (blood sugar). Because your body doesn’t make insulin, you will require injected insulin multiple times a day; otherwise, your blood sugar will rise to dangerous, even fatal, levels.

Type 1 diabetes is permanent; there is currently no cure. However, there have been significant improvements in diabetes technology over recent years, making managing type 1 diabetes in children less challenging.

Many children can wear continuous glucose monitors (CGM), which gives a more or less real-time reading of blood sugar levels. In addition, many parents find insulin pumps especially helpful for managing insulin dosing without constantly sticking the child with a needle.

Although people can be diagnosed with type 1 diabetes at any age, it is most commonly diagnosed before the age of 20. An estimated 85% of all people diagnosed with type 1 diabetes were diagnosed before 20.

Many people with type 1 diabetes find that eating healthy, being active, getting enough sleep, and managing stress help keep blood sugar levels more stable and predictable. In addition, some people find they need less insulin when all of these areas are managed. It is important to note that with type 1 diabetes, you will always require injected insulin. However, you may need less insulin and avoid blood sugar swings by making lifestyle changes.

Type 2 Diabetes

Type 2 diabetes is a metabolic disease that most commonly results from insulin resistance. With this type of diabetes, your body usually produces plenty of insulin; however, the insulin cannot function properly. Insulin acts as a key that opens your cells and allows your cells to use the sugar in your blood for energy. When you become insulin resistant, insulin can no longer open your cells to allow sugar to enter. This results in high levels of blood sugar.

Type 2 diabetes is more commonly diagnosed in adults over the age of 20. However, it is becoming more common for children and teenagers to acquire type 2 diabetes.

The exact cause of type 2 diabetes is not known. There is a strong link between obesity and type 2 diabetes. However, this does not mean that being obese causes type 2 diabetes. Researchers are now speculating that type 2 diabetes is more complicated than just being overweight, as was previously thought. A diet high in sugar and simple carbohydrates can lead to both weight gain and insulin resistance.

There is a genetic component to type 2 diabetes. According to the CDC, “More than 75% of children with type 2 diabetes have a close relative who has it, too.

Like type 1 diabetes, there is currently no cure for type 2 diabetes. However, many people with type 2 diabetes can reverse the disease through lifestyle changes. This is done by addressing the root cause of type 2 diabetes, insulin resistance. Choosing a diet that eliminates sugar and simple carbohydrates helps improve insulin sensitivity. In addition, making other lifestyle changes, such as exercise, sleep, and stress help improve insulin sensitivity.

Risk Factors for Diabetes in Children

Type 1 Diabetes

A child or teenager is at higher risk for type 1 diabetes if they have any of these risk factors:

  • Family History – Immediate family member with type 1 diabetes (parent or sibling).
  • Race – Type 1 diabetes is more common among white children than any other race.
  • Age – Children age 4 to 6, or 10 to 14 

Genetics – The presence or absence of certain genes pose an increased risk of type 1 diabetes

Type 2 Diabetes

Risk factors on a chalkboard sign along with a stethoscope A child or teenager is at increased risk for type 2 diabetes if they have one or more of the following risk factors:

  • Family History – Immediate family member with type 2 diabetes (parent or sibling).
  • Race and Ethnicity – Some races have a higher risk of type 2 diabetes, including Black, Hispanic, American Indian, and Asian Americans.
  • Weight – A child or teen who is overweight is at increased risk for type 2 diabetes. Excess weight can lead to insulin resistance, particularly excess weight around the abdomen.
  • Age and Gender – For children, type 2 diabetes is diagnosed more often in the early teen years. Girls are more likely to develop type 2 diabetes than boys.
  • Physical Activity – Inactive children have an increased risk for type 2 diabetes.
  • Birth Weight and Gestational Diabetes – Children with low birth weight and children whose birth mother had gestational diabetes are both at higher risk of developing type 2 diabetes.
  • Preterm Birth – Children born prematurely, before 38 weeks, have a greater risk of type 2 diabetes.

Symptoms of Diabetes

The symptoms of diabetes are often very similar between the different types of diabetes, regardless of age. The main difference between type 1 diabetes and type 2 diabetes is that type 1 diabetes progresses quickly, often over days or weeks. By contrast, type 2 diabetes can develop over months or even years.

Diabetes, especially type 1 diabetes, can be fatal if it is not caught in time. Therefore, it is vital to contact your child’s doctor immediately if you feel your child has any of the symptoms of diabetes. 

  • Increased thirst
  • Frequent urination
  • Bed-wetting in children who typically don’t
  • Dry bowel movements in diapers of young children
  • Headaches
  • Blurred vision
  • Extreme hunger
  • Fruity smell on their breath
  • Fatigue or feeling weak
  • Unintentional weight loss
  • Yeast infections
  • Irritability or changes in mood

Some people experience diabetic ketoacidosis at the time of diagnosis, which is very serious and can be fatal. Diabetic ketoacidosis occurs when the body starts burning fat for energy because there is no insulin.

Treatment for Children and Teens with Diabetes

Type 1 Diabetes

Children and teens with type 1 diabetes will require injected insulin for the rest of their lives. This can be very daunting for both children and parents when first diagnosed. Fortunately, technology has made significant advances in continuous glucose monitors (CGM) and insulin pumps, making managing diabetes significantly easier. 

If your doctor hasn’t recommended a CGM for your child, Total Diabetes Wellness strongly urges you to advocate that your child receives one of these devices. Most insurance plans should cover this cost as durable medical equipment. They are expensive, so check to see if your particular plan covers this cost for you.

Close up view of child with insulin pumpYour doctor will help you with a plan specific to your child to manage their type 1 diabetes. Doctors often recommend eating healthy, whole foods and counting carbohydrates to calculate insulin needs. Daily exercise or activity will also help stabilize blood sugar levels. Your doctor will likely also recommend regular blood and urine tests.

While there is no cure for type 1 diabetes, children and adults benefit from eating healthy, being active every day, getting enough sleep, and managing stress.

Type 2 Diabetes

Children and teenagers with type 2 diabetes may be able to reverse diabetes by making lifestyle changes. However, please be aware that reverse DOES NOT mean cure. There is no cure for type 2 diabetes. Reversing diabetes refers to making lifestyle changes that allow your child’s blood sugar to be in normal ranges without needing medications or insulin. If, after successfully reversing diabetes, lifestyle changes are not maintained, blood sugar will rise again, and diabetes symptoms will reappear.

Cutting back on sugar and simple carbohydrates in your children’s diet is one of the most significant changes you can make that will significantly improve blood sugar levels.

The CDC has outlined some lifestyle changes to help children with diabetes. Specifically, they recommend making changes as a family unit rather than just having your child with diabetes make changes. “Set a new normal as a family—healthy changes become habits more easily when everyone does them together.” This change will also help other family members lower their risk of developing type 2 diabetes as well.

“Mealtime Makeover”

Family in the kitchen cooking a healthy meal together

  • Drink more water, eliminate sugary drinks.
  • Eat more fruits and vegetables.
  • Involve kids in making and shopping for healthy meals.
  • Eat slowly – it takes your body at least 20 minutes to start feeling full.
  • Eat at the dinner table (not in front of a television or computer).
  • Shop for groceries on a full stomach so unhealthy foods will be less tempting.
  • Teach your kids how to read food labels and to understand what they mean.
  • Eat together as often as possible.
  • Don’t require your child to clean their plate.
  • Don’t put serving dishes on the table.
  • Serve smaller portions and let children ask for seconds.
  • Don’t use food as rewards.

“Getting Physical”

  • Set a goal of 60 minutes of physical activity every day, either at once or in several smaller sessions.
  • Be positive; focus on progress rather than what your child can or can’t do.
  • Take a class with your child.
  • Try new things, make physical activity more fun.
  • Ask your child what they like the best.
  • Encourage your child to join a sports team or try a new sport (parks and rec programs are a great place to try something new with low cost and low commitment).
  • Limit screen time to 2 hours a day.
  • Plan active outings such as a hike or bike ride.
  • Take family walks together.
  • Focus on moving more generally, both inside and outside (vacuuming, raking leaves, sweeping the garage, gardening, etc.)
  • Make chores into games, such as a race to see how fast you can pick up the house.

Unless specifically recommended and supervised by your child’s doctor, it is not recommended to put your child on any “weight loss” diet. Most children and teens are still growing, so if they are overweight, the goal is to slow down weight gain through lifestyle changes to allow proper growth and development. Caloric restriction and other weight loss measures should generally be avoided for children.

Rear view of family walking outside on a trail for exerciseSome doctors will have your child start with making lifestyle changes first. Other doctors may offer prescription medications to help control blood sugar. If your doctor is recommending prescription medication, it’s worth discussing the option of trying lifestyle changes first. Your child’s doctor will be able to advise if this is a reasonable course of action or not.

Always consult with your child’s doctor before making diet or activity changes, especially if your child is on any medications.

504 Plans and IEPs for Children with Diabetes

Diabetes Medical Management Plan (DMMP)

The American Diabetes Association (ADA) recommends that all school-age children have a Diabetes Medical Management Plan (DMMP). The ADA has a sample DMMP template on their website. We highly recommend you bring this paperwork to your child’s doctor and fill it out together. Since a DMMP is essentially “doctors orders” for your child’s diabetes management, it does require your child’s doctor’s signature on the last page. Your child’s DMMP will tell their school nurse and staff exactly how to manage their diabetes (when to test, where to test, when and how much insulin to give, whether the child needs help with any or all of these things, etc.)

Section 504 Plan

Book on desk with 504 plan for diabetesOnce you have a Diabetes Medical Management Plan in place, you should consider creating a 504 Plan to help your child be medically safe while at school. A 504 Plan is a legally binding document tailored specifically to your child to ensure they are treated fairly and all school staff are on the same page. The ADA has provided a template for a 504 Plan for children with diabetes on their website. Some schools may prefer to use their own forms. If they do, just make sure the plan appropriately meets all of the child’s diabetes care needs while at school and after school activities, sports, and clubs.

Here are some additional 504 Plan templates specific by child’s grade that you may want to consider using.

Individualized Education Program (IEP)

An IEP is also a legally binding document and is more focused and specific than a 504 Plan. An IEP “creates an opportunity for teachers, parents, school administrators, related services personnel, and students (when appropriate) to work together to improve educational results for children with disabilities.” 

Most schools use their own forms for IEPs because they are so specific for each child. Your child likely won’t need a 504 Plan if they have an IEP because the IEP should include all of your child’s diabetes provisions. Understood.org outlines the differences between a 504 and IEP plan in greater detail.

Tips To Help Cope: For Parents and Children

Finding out your child has diabetes can be quite overwhelming. Many parents of children with diabetes report that having people to talk with helps them cope and makes navigating diabetes significantly easier. Often children with diabetes find getting to know other children with diabetes and having people in their lives that they can talk to makes a big difference.

For support helping your child with their diabetes, parents can reach out to:

Adult support group, adults sitting in a circle discussing feelings

  1. Diabetes Educators – Diabetes educators are health professionals who specialize in educating and supporting people with diabetes. A diabetes educator can help you collaborate and problem-solve challenges that may arise. They look at your child’s unique situation and can help with diet, activity, medications, blood sugar testing, and anything else you may need help with related to diabetes. You can find a certified diabetes educator here. 
  2. Mental Health Professionals – Counselors and mental health professionals can be a healthy outlet for stress, anxiety, worry, anger, and other emotions associated with having a child with diabetes. 
  3. Social Workers – Your child’s doctor can connect you with a social worker who can provide you with additional resources to help manage your child’s diabetes.
  4. Support Groups – There are support groups, both in-person and online, that can connect you with other parents of kids with diabetes. Having another adult who has some experience or is also going through the same struggles can be very helpful.

For extra support, children with diabetes can reach out to:

  1. Support Groups – There are support groups, both in-person and online, that can connect your child with other children who have diabetes. A diabetes educator or social worker can help you find an age-appropriate group for your child. 
  2. School Counselors – For school-age children, school counselors can offer support for your child. Some schools provide group counseling; if this is an option at your child’s school, they may find it beneficial to connect with other children with similar medical conditions.
  3. Early Intervention – For toddlers and young children, you may qualify for early intervention programs depending on where you live and the type of diabetes your child has. Your diabetes educator or social worker should be able to help you with additional details.

What To Do if You Suspect Your Child Has Diabetes

Male doctor sitting next to young boy patient holding a tablet.If your child is experiencing any symptoms of diabetes, you must get them to either their doctor or a hospital and have their blood sugar tested.

If, for some reason, your doctor does not check your child’s blood sugar and they have one or more symptoms of diabetes, we strongly suggest that you get a second opinion. You can also purchase a blood sugar testing kit without a prescription at any pharmacy, drug store, or discount store.

If diagnosed with type 2 diabetes, the best response is to work on reversing the disease. Use our free Diabetes Wellness Plan to help get started.

If diagnosed with type 1 diabetes, it is important to create a plan, educate everyone involved in the care of your child about the disease, and share your health plan in case of an emergency. It is also important to implement a plan for your child in school and help establish daily routines to ensure your child’s safety.