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SALEM COMMUNITY HOSPITAL...Examining Type 1 diabetes in children

October 3, 2010
Salem News

Every day, 35 children in America are diagnosed as having type 1 diabetes

"This type of diabetes, which has also been called juvenile diabetes, occurs when the body stops producing insulin, a hormone which is essential for life," explained Pediatric Endocrinologist Humberto Latorre, M.D.

"Insulin helps the body use the food that is eaten and regulates the amount of glucose in the blood, which is sometimes called blood sugar. If a child's blood glucose levels are too high, serious damage may be done to various organs in the body, such as the nerves, kidneys and heart. Today, children with diabetes have more options for blood glucose testing and insulin administration than ever before, and new developments are occurring regularly. With proper daily care and treatment, children with diabetes today lead healthy, active, fun-filled lives."

Monitoring Blood Glucose Levels

"Blood glucose control is the single most important factor in assuring your child's health and in preventing complications," Dr. Latorre added. "Blood glucose monitoring requires a monitor and a drop of blood, which is obtained through a fingerstick with a special device called a lancet. Very young children often cannot recognize the symptoms of low blood sugar, which is why frequent blood glucose monitoring is especially important for them."

Your doctor will work with you and your child to develop a treatment plan that includes:

- A meal plan which helps your child learn to eat in ways that control blood sugar

- A target range for your child's blood glucose level

- A schedule for checking blood glucose levels

- Directions for adjusting insulin doses as needed, depending on blood glucose levels and activities

- Regular exercise

"As your child gets older, he or she will gradually take more responsibility for following the treatment plan," Dr. Latorre continued. "However, parents must continue to be involved and supportive to make sure that your children are keeping their blood glucose levels within the target range."

Your child will also have to have insulin shots every day usually several times a day. "Improvements in insulin and its administration are occurring quite regularly," he said. "New forms of insulin have greatly increased the flexibility in eating patterns and insulin dosage regimens. Efforts to improve comfort have created more choices in devices to administer insulin such as pen-type injectors. External insulin pumps are popular among adolescents and young adults, and implantable insulin pumps are being tested as well. There are also blood glucose monitors that will give continuous glucose readings for three or seven day periods, using one small needle sensor placed under the skin."

Eating and Exercise

"Eating at the same time every day helps to keep blood glucose levels steady," Dr. Latorre advised. "Depending on the insulin regimen, snacks between meals may be important. Children with diabetes can have sweet foods occasionally, so long as they are accounted for in the meal plan and insulin doses adjusted if needed.

"Exercise helps to lower blood sugar, so regular activity is also an important part of treatment for children with diabetes. A child doesn't have to sit on the sidelines during gym class or avoid joining in sports. But, it's a good idea for your child to have snack foods on hand to help maintain their food - insulin balance. Children should also always carry glucose tablets, sugar cubes, or hard candy to treat low blood sugar."


Keeping blood sugar levels in the target range requires balancing insulin, food and exercise. If this balance is not maintained, two short-term complications can occur.

"Hypoglycemia, or low blood sugar, occurs when the body has too little food or too much insulin and can also be caused by increased activity or exercise," Dr. Latorre stated. "It is the most common problem in children with diabetes and is easily treated by giving the child glucose tablets or glucose-containing foods or beverages.

"Hyperglycemia, or high blood sugar, occurs when the body has too little insulin or too much food. It may also be caused by stress or illness. It needs to be treated promptly. Without treatment, it may cause ketoacidosis, which is a very serious complication that can lead to a diabetic coma."

Tips for Parents of Children with Diabetes

The staff at your child's preschool or school should be advised about your child's diabetes. The school must have a written plan for your child that identifies:

-?When to check blood sugar and take insulin

-?Meal and snack times; avoiding delays and permitting extra snacks if needed, especially in relation to exercise or sports activities

-?The symptoms and treatment for high and low blood sugar

-?Phone numbers for parents and other emergency contacts

In addition, parents can help support their child to:

-?Develop healthy eating habits.

-?Maintain a regular schedule for meals and snacks.

-?Test blood glucose levels four times daily.

-?Make sure your child has a source of sugar on hand at all times to treat low blood sugar.

-?Make exercise a normal part of every day's activities.

-?Meet with your child's school staff to make sure they understand the special needs of a child with diabetes.

-?Encourage full participation in academic, social, and sports activities.

-?Teach babysitters and other caregivers how to use the blood glucose monitor, administer insulin, and treat hypoglycemia.

-?Reassure your child - especially when they're younger - that diabetes is not their fault, and that they didn't do anything to cause it.

Humberto Latorre, M.D., is a pediatric endocrinologist affiliated with Salem Community Hospital's medical staff. His office is located at 2020 East State Street, Suite F in Salem, 330-337-2839.



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