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How are children with type 1 diabetes cared for differently than adults?

Diabetes, Children And The Elderly

Anne Peters, MD, FACP, CDE (Professor and Director of Clinical Diabetes Programs, USC Keck School of Medicine) gives expert video advice on: How are children with type 1 diabetes cared for differently than adults? and more...

How are children with type 1 diabetes cared for differently than adults?

Children with diabetes- if they get type 1 diabetes when they're young- are treated a little bit differently than adults because we're afraid that too many low blood sugar reactions will hurt the developing brain. And in adults, we expect most adults with type 1 diabetes to have two to three mild low blood sugar reactions a week. So we know that using insulin to keep blood sugar levels normal means sometimes people will be a little high and sometimes a little low. With kids, we don't want them to be a little low most of the time, so these standards- the hemoglobin A1c, that average blood sugar test- is kept a bit higher in kids. And early on, obviously, the parents give the insulin. But by the age of four or so, lots of kids can give their own insulin, and they wear pumps, and they do all sorts of things just like adults. So I'm more impressed by kids than I thought I'd be because they do pretty darn well and I think the hardest thing about being a kid with diabetes is being an adolescent with diabetes. And that's a really tough age, and anyone who happens to have an adolescent child knows what that's like. And really most kids rebel and their blood sugars go higher and they get through adolescence and they settle down once they get a bit older, so it's always a tough age.

How are children with diabetes type 2 cared for differently than adults?

When children get type 2 diabetes, they are treated similarly to adults with certain differences. First like with adults, they are treated with changes in lifestyle and with improvements in their exercise and hopefully encouraging them to develop patterns that would be healthy for the rest of their lives. But many, many of the drugs that might work in children with type 2 diabetes have not yet been studied in children with diabetes. So a lot of the pills for adults haven't been tested in kids. So kids are actually treated more with drugs like insulin sooner than adults with type 2 might be treated because we just haven't studied those drugs in children. There are big research studies that are ongoing that are looking at how to treat children with type 2 diabetes but it is actually a pretty new phenomena because up until the last 10 years or so we haven't had lots of children with type 2 diabetes buy we are learning. If a kid has type 2 diabetes as well as type 1 I would really recommend sending that individual to someone that is used to treating kids with diabetes. Even though rates are increasing there is still not lots of those children and I think they need specialized care.