1. Diabetes in Children Rachael Jackson Shelbi Montanaro Rebecca Laper

2. Diabetes Characterized by high blood glucose levels from inadequate production of insulin by the pancreas or an inability of insulin to facilitate the transport of glucose into the cells Type 1, Type 2, Gestational, Prediabetes

3. Terminology and Classification Type 1- Juvenile-onset diabetes, caused by the inability of the pancreas to produce sufficient insulin as a result of the failure of B-cells production. ◦Insulin Dependent Diabetes Mellitus (5-10%) Type 2- Adult-onset diabetes, result of the ineffectiveness of insulin to facilitate the transport of glucose into the cells and is the result of insulin resistance. ◦Non-insulin-Dependent Diabetes Mellitus (90-95%) Gestational Diabetes- form of diabetes that develops in women during pregnancy. Hormones from the placenta block insulin, causing sugar spikes. Prediabetes- condition in those who have impaired fasting glucose, impaired glucose tolerance

4. Type 1 Diabetes Symptoms ◦Frequent urination ◦Excessive thirst ◦Unusual weight loss ◦Extreme hunger ◦Extreme fatigue and irritability

5. Type 2 Diabetes Symptoms ◦Any of type 1 symptoms ◦Frequent infections ◦Blurred vision or sudden vision changes ◦Tingling or numbness in hands and feet ◦Cuts, bruises, or sores that are slow to heal ◦Reoccurring skin, gum, or bladder infections

6. Prevalence of Diabetes 17.9 million Americans diagnosed 43% in 2005 1990-1998- 76% increase of 30-39 year olds, and 23% of 60 year olds and older 6.6%- Caucasion 7.5%- Asian-American 11.8%- African Americans 10.4%- Hispanics 10-19 year olds= 33%-49% of type 2 diabetes Racial differences in diabetes rates are parallel to obesity rates

7. Health Problems Linked with Diabetes Heart Disease Stroke Hypertension Peripheral Vascular Disease Kidney Disease Nervous System Disease Eye Disorders Dental Disorders Amputations Complications during Pregnancy

8. General Treatment of Diabetes Type 1: Insulin administration, diet, exercise ◦Administration is adjusted to carb, protein, and fat metabolism ◦Short acting or intermediate acting ◦Administered throughout the day to control glycemic intake Type 2: Weight loss, diet, exercise, drugs(pill-form) ◦Sulfonylureas-lowers blood sugar levels ◦Biguandides- reduce hepatic (liver) glucose production ◦Well balanced diet- no low carb, because body will rely on fat which can have a negative effects on blood sugar

9. Role of Physical Activity Type 1 : Exercise has NOT be clearly defined and is controversial Con: Prone to hypoglycemia (low blood sugar) and during exercise liver fails to release glucose at a rate that can keep up with glucose utilization Can lead to excessive swings in plasma glucose levels Pro: Can benefit those who have greater risk for coronary artery disease, cerebrovascular and peripheral vascular disease Athletes with Type 1 diabetes train and compete successfully Special attention to feet and weight bearing exercise places

10. Role of Physical Activity (con’t) Type 2 : Plays a major role in glycemic control Cells become resistant to insulin, the hormone cannot perform its function of facilitating glucose transport across the cell membrane, resulting in decreased insulin sensitivity Membrane permeability to glucose increases with muscular contraction Exercise decreases insulin resistance and increases insulin sensitivity* Reduces the cell’s requirement for insulin, which means that people taking insulin reduce their dosages*

11. Type 2 in Children: Research Increasing in Europe, Asian, South America Children in Asia are 13 more times to have type 2 diabetes Mostly found in girls and those with family history Many indicators: ◦Acanthosis Nigricans-skin condition  Dark, velvety discoloration in body folds and creases ◦Polycystic Ovarian Syndrome  Numerous cysts along the outer edge of the ovary ◦Hypertension dyslipidemia  Disorder of lipid metabolism ◦Body Mass Index  Greater than 30%=obese and at risk Tests- Oral Glucose and Plasma Glucose Plasma of 7.8-11.1 mmol/L=type 2 diabetes

12. Type 1 in Children: Research Has been increasing dramatically Services do not provide support and information to maintain blood glucose levels. Overall lifespan reduces by 15 years Lack of Education about treatment Reasons for uneducated children ◦Lack of appropriate services ◦Limited availability of trained personnel ◦High Costs ◦Parents are educated, not the children with disease

13. Gestational Diabetes: Research Provide education to those looking to have a child ◦Proper diet ◦Exercise ◦Reduces the child’s risk of developing type 2 diabetes later in life. 1000 Days Campaign ◦Created by the First Lady ◦Promotes proper nutrition for mothers during pregnancies and child’s first 2 years of life

14. Future Research Children have excess weight and sedentary lifestyles. Well balanced diet and physical activity are keys to prevent disease ◦Limit sugary drinks in schools and home, including, iced tea, juices, and soda. ◦Encourage WATER! ◦Reduce playing videogames ◦Promote going outside and involvement in organized sports

15. Future Research Support Groups ◦Network ◦Can learn about other ways people control the disease. ◦Understand the Insulin pump- a direct way to inject the hormone. ◦ Attached to different locations-abdomen, hip, arms, legs ◦ Monitors sugars when too high or too low. ◦ Alerts patients if one needs to consume sugar. ◦ Convenient

16. Future Research Skyping with Doctor ◦Provides direct communication with doctor and patient ◦Patient can ask questions that they have at a moments notice ◦Due to the complicated nature of the disease, its convenient for patients  Prevents them from having to always go to the office  Saves money

17. Conclusion Can be prevented and controlled Proper diet, exercise, and medicine assist in managing the disease Increased in children over the many years, and as educators one must help limit the cases that are diagnosed each year.

18. References