Diabetes: Child’s Diagnosis Often a Surprise to Parents 6/17/04

WICHITA, Kan. – As a young mother, Jan McMahon thought her nearly four-year old daughter might have a urinary tract infection. The diagnosis was type 1 diabetes.

McMahon, who is a K-State Research and Extension family and consumer sciences agent in Sedgwick County, is knowledgeable about nutrition and health. She was aware of an aunt and a cousin who had type 1 diabetes, yet hoped that her daughter would be spared the disease.

Tips for Parents of Children with Diabetes

WICHITA, Kan. – “Parents of children who are newly diagnosed with diabetes can feel anxious and a little scared. For many, it’s a first experience with managing a chronic illness,” said Susan Sanders, mother of two children with diabetes and former area manager of programs with the American Diabetes Association in Wichita.

“Diabetes can be managed successfully,” said Sanders, who along with parents of children with diabetes Jan McMahon, Sedgwick County, Kan., and Mary Siderewicz, from Westmoreland, Kan., share tips to help parents and families manage their child’s diabetes successfully:

* Be aware of your family’s health history.

* Watch for early warning signs, such as excessive thirst; frequent urination; unusual hunger; unexplained weight loss; fatigue; weakness; irritability or blurred vision. In children, early warning signs also may mimic the flu.

* Ask to be referred to a physician who specializes in diabetes or pediatric diabetes. Once diagnosed, children usually are hospitalized to stabilize blood sugar. Educational sessions for patients and families are typically offered during the hospitalization.

“After the sessions, I could feel my anxiety giving way to ‘we can do this,’” Siderewicz said.

* Ask about a diabetic support group and ongoing educational opportunities.

“Talking with others who are experiencing similar concerns can be helpful,” said Jan McMahon, who is a K-State Research and Extension family and consumer sciences agent. She said that she usually leaves the meetings with a tip or two.

* Re-define normal. A basic diabetic diet includes a variety of foods balanced with physical activity that likely will benefit the whole family. (See companion news release, “Diabetic Diet Beneficial to Most.”)

* Try not to dwell on the illness or single out a person with diabetes.

Siderewicz said that she has learned not to call attention to the illness. When her daughter’s friends recently complimented her on snack she served them, they were surprised to learn that it was made with sugar-free gelatin.

“If I had told them it was sugar-free, I suspect they might not have been so enthusiastic,” said Siderewicz, who has added diabetes education to nutrition and health classes she teaches as a family and consumer sciences teacher.

* Keep the people who need to know in the know.

McMahon provides periodic updates on her daughter’s diabetes and care first to her daycare provider and now to the school nurse. She monitors school lunch menus, provides a snack kit for use as needed to help regulate her daughter’s blood sugar, and a checklist so school officials can let her know when snacks or other supplies need replenishing.

“Birthday parties and sleepovers have caused some anxiety,” said McMahon, who has found that talking with the host’s parents can ease concerns on both sides.

The Siderewicz’ older daughter, Niki, who does not have diabetes, asked that she be allowed to learn how to give her sister an insulin injection.

“Family involvement and support make managing the disease easier,” Siderewicz said.

More information on managing diabetes is available from local K-State Research and Extension offices, on Extension’s Web Site: www.oznet.ksu.edu , from the American Diabetes Association: www.diabetes.org and Centers for Disease Control and Prevention: www.cdc.gov .

Type 1 diabetes typically strikes children and young adults, and early warning signs, such as thirst, fatigue or irritability, can be easy for parents to miss. The disease is thought to have a genetic link, yet can strike without warning.

A call from a school nurse alerted Mary Siderewicz, of Westmoreland, Kan., that her daughter Kallie, 11, wasn’t feeling well. The seemingly healthy 6th grader had experienced something like a momentary electric shock while putting up a school poster. The next day, she was diagnosed with type 1 diabetes.

Siderewicz, who is a family and consumer sciences teacher in USD 323 (Rock Creek), said that her experience with the disease was limited to cousins who had type 2 diabetes.

“The diagnosis can surprise parents,” said Susan Sanders, mother of two children with type 1 diabetes. Sanders, who also has worked as the area manager of programs with the American Diabetes Association in Wichita, said that she often has been asked: “Isn’t there some kind of a pill that will cure this?”

“At this point in time, the answer is ‘no,’” she said. “Diabetes is a chronic illness that a child will have to live with.”

“The disease can be managed successfully,” Sanders said. “Our daughter was diagnosed at age five, and has grown in her ability to manage her diabetes. She now is a typical teenager doing the same kinds of things other kids do.”

“The onset of the disease could have been triggered by a viral infection like the flu or a childhood illness like the chicken pox,” Sanders said.

Early warning signs of diabetes typically include excessive thirst; frequent urination; unusual hunger or unexplained weight loss; fatigue; weakness; irritability or blurred vision.

Type 1 diabetes has typically been described as “juvenile-onset diabetes,” but the National Center for Disease Control and Prevention (CDC) and American Diabetes Association both report that type 2 (“adult-onset”) diabetes is becoming more common among children and adolescents. Data on the number of children diagnosed with the disease are not yet available.

Diabetes is a chronic illness and people who have it are at greater risk of heart disease and stroke, high blood pressure, blindness (from diabetic retinopathy), kidney failure, damage to the nervous system that can result in amputation of the feet and lower legs, and periodontal – or gum – disease. Such complications can develop 15 or 20 years after the diagnosis.

“Complications from the disease can be devastating for anyone, yet particularly so for children, who may begin to experience one or more of the complications by the time they reach the age of 30,” Sanders said. “The good news is that families can learn to manage the disease successfully and reduce risks from complications.”

Melissa Patton, Wichita, Kan., was four years old when diagnosed with type 1 diabetes.

“It seems like living with the disease has always been part of my life,” said Patton,

Now 24 and having earned a degree in public health, she is employed as a program assistant with the Family Nutrition Program, a United States Department of Agriculture nutrition education program delivered locally by the Sedgwick County Kansas State University Research and Extension office and elsewhere in the state by other county Extension offices.

“Melissa is particularly effective in working with younger diabetics,” said Jan McMahon, Extension family and consumer sciences agent who works with Patton in delivering nutrition education programs.

“In teaching, she can speak from experience and lead by example,” McMahon said. “She lives what she teaches, eating a variety of health-promoting foods; choosing a standard serving sizes; balancing meals and snacks, and adding physical activity to each day.”

Diabetes is an increasingly common, but often misunderstood disease. The National Center for Chronic Disease Prevention and Health Promotion reports that between 1980 and 2002, the number of Americans with diabetes more than doubled, rising from 5.8 million to 13.3 million. The American Diabetes Association estimates that still more – 5.2 million – may have the disease and not know it. That often is true of parents who may not recognize symptoms of the disease.

Type 1 diabetes, in which the pancreas does not produce insulin, a hormone that regulates the metabolism of carbohydrates and fats, typically affects children and young adults. Children may be genetically predisposed to the disease.

Type 2 diabetes, in which some insulin may be produced, may have a genetic link. It often is associated with lifestyle, including a high-calorie or -fat diet, sedentary lifestyle and obesity. It has typically been described as “adult onset diabetes,” yet is now occurring in children.

A third type of diabetes – gestational diabetes – occurs during pregnancy and, if uncontrolled, poses a risk for the mother and child.

More information on managing diabetes is available from local K-State Research and Extension offices, on Extension’s Web Site: www.oznet.ksu.edu, from the American Diabetes Association: www.diabetes.org and Centers for Disease Control and Prevention: www.cdc.gov .

K-State Research and Extension is a short name for the Kansas State University Agricultural Experiment Station and Cooperative Extension Service, a program designed to generate and distribute useful knowledge for the well-being of Kansans. Supported by county, state, federal and private funds, the program has county Extension offices, experiment fields, area Extension offices and regional research centers statewide. Its headquarters is on the K-State campus, Manhattan.