T1DM can occur at any age but peaks at ages 2, 4-6, and 10-14 years of children. 70% of T1DM are diagnosed by age of 30. T1DM accounts for 5-10% of all diabetes, affects 1.4 million in USA and Caucasians are more susceptible.
How does T1DM present? The classic symptoms are extreme thirst and urination. Urination comes first then thirst, these children are awake all night. Other symptoms are weight loss, fatigue which may progress over months, and symptoms progress with acute illnesses; flu, appendicitis, extreme stress that increases cortisol levels which increases the blood glucose levels. In children, insulin is needed for proper growth and insulin needs increase during times of physiological stress (illness or puberty).
The history of insulin can be traced back to 1916 to now. More commonly used insulin for T1DM are Humalog, Regular, Lantus, and Levemir. Modern dosing is based on schedule of meals and bedtimes and dose is related to blood glucose for younger children and as they grow older, calculate insulin for blood glucose and their carbohydrates. Children ages 1-4 years, doses are lower for
safety and their unpredictable level of activity. School age child factors in carbs as their activity level is usually consistent in the school day. Young adolescents may begin managing insulin pump but their bodies are changing with puberty, may sneak extra snacks and activity level changes with after school programs/sports.
Hypoglycemia is a special situation that requires immediate intervention. This occurs when individual has low blood glucose level <80 and continuous to drop. It can happen when individual has taken too much insulin, has not eaten enough food or excessive exercising. The treatment is following the 15-15 rule. Look at the individual, are they confused, sweating, feeling shaky, pale, and
drowsy, verbalizing feels low, and hungry. Give 4 oz of juice (15gms) and recheck blood glucose in 15 minutes. Always send an adult with young child to be cared for. Repeat if blood glucose remains less than 80.
Technology is increasing with new meters that are web based; bionic
pancreas pumps and CGM (continuous glucose monitoring meter) that help the individual and families better manage the T1DM condition. Dexacom is one of companies that develop the CGM. Having the continuous reading sent to close proximity of IPOD and cell phone of the school nurse-teacher allows school to keep tabs on students with Diabetes during the day. When low/high alarms settings
go off, the student must always check their blood glucose for accuracy.
There are summer camps for T1DM individuals that are offered through Joslin: Camp Joslin for boys/Camp Clara Barton for girls and in RN- Camp Surefire. Camp Surefire is held at Alton Jones during week of June 25-30, 2017. Students can meet other individuals with T1DM and gain confidence and knowledge with their diagnosis.
Posted by: Jennifer Romph