Difference Between Diabetes in Children & Adults

Diabetes mellitus is a disease in which the body either has no insulin or not enough insulin to convert food into energy for the cells. This disease is both chronic and progressive, and affects children and adults. The effects of diabetes on children are not always the same as the disease's effects on adults, and it's important to understand the difference in order to effectively treat diabetes and promote good health.

Types

• When we eat something, the pancreas secretes a hormone called insulin. Insulin is the key that allows the converted energy (glucose) through the door of the cells, thereby giving us energy for the daily activities of life. When glucose cannot get into the cells, it circulates uselessly in the blood stream. Because the body needs energy and cannot get it from glucose, it breaks down stored fat and muscle. The breakdown of fat releases ketones, which are then used instead of glucose for energy.
  Diabetes mellitus is divided into two groups. Insulin Dependent Diabetes Mellitus (IDDM), or type 1 juvenile diabetes, is when the diabetic is dependent on daily injections of insulin to control glucose levels. The onset of IDDM is typically seen in late childhood or early adolescence. Non-Insulin Dependent Diabetes Mellitus (NIDDM), or type 2 adult onset diabetes, is when the diabetic can control glucose levels with diet, exercise and oral medications. Until recently, the onset of NIDDM was at about 40 years of age.

Causes

• With IDDM, a predisposing event such as a viral or bacterial infection, dietary event or chemical irritant may trigger an autoimmune response which destroys beta cells in the pancreas, and insulin cannot be produced without beta cells. Diabetics may also be genetically predisposed to IDDM.
  With NIDDM, constant high levels of carbohydrates, fats and proteins contribute to insensitivity to insulin. The level of insulin may also be normal but not high enough to handle high levels of carbohydrates, fats and proteins. Diabetics may be genetically predisposed to NIDDM as well.
  The incidence of NIDDM has increased proportionally to the increase in obesity. According to the American Diabetes Association, most patients with this form of diabetes are obese, and obesity itself causes some degree of insulin resistance. Patients who are not obese by traditional weight criteria may have an increased percentage of body fat distributed predominantly in the abdominal region.
  According to Jean-Claude DesMangles, M.D., type 2 diabetes in children and adolescents now accounts for one-third of all diabetes diagnosis. Because of this, diabetes mellitus is usually no longer classified as juvenile or adult onset diabetes, but as types I and II.

Symptoms

• Early symptoms include hunger (the body believes it is starving when glucose cannot get into the cells); weight loss (the body breaks down stored fat and muscle for energy); increased urination (caused by excess glucose and ketones from muscle breakdown spill into the urine); dehydration (caused by excessive urination); increased thirst (the body is compensating for dehydration); lethargy caused by lack of energy; and fruity breath (which is the smell of excess ketones).
  Late symptoms of diabetes include ketoacidosis (ketones in the blood and urine causes the body to become more acidic); Kussmal respirations (the body hyperventilates in an effort to rid itself of ketones); electrolyte imbalances; confusion; and coma.

Diagnosis

• In addition to the symptoms listed above, the American Diabetic Association's Diagnostic Criteria (2009) include random glucose level greater than 200, fasting glucose greater than 126, 2 hour post glucose of greater than 200 after ingesting 75 g of glucose, and a blood test (hemoglobin A1c greater than 6 percent).

Treatment

• Diabrtes treatment includes subcutaneous insulin shots or an insulin pump (definitely in type 1; possibly in type 2), oral medications, diet, exercise, stress control, infection control and diligent glucose monitoring.

Complications

• Complications of type 1 and type 2 diabetes are the same for children and adults. They include heart disease, eye disease, nerve damage, kidney damage, poor-healing injuries, hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar).

Differences Between Children and Adults

• The physical effect of diabetes on children versus adults are pretty much the same except in one major area. According to a study by S.C. Ferguson and colleagues, children who were diagnosed with diabetes prior to age seven performed more poorly on intellectual and cognitive tests than those who were diagnosed after seven years of age. It is thought that the complications of diabetes, such chronic hyperglycemia or hypoglycemia, affects brain development.
  The ability to cope with a diagnosis of diabetes is another major difference between children and adults. Teens and pre-teens already have the burden of dealing with their changing bodies, self-image and peer pressure. The addition of diabetes can be devastating to the self-esteem.