Supreme Court nominee Sonia Sotomayor was diagnosed with type 1 diabetes when she was 8, and patient advocates have seized on her nomination as proof that diabetes is no longer a life-limiting disability. That’s the good news.
The bad news is that the number of children with type 1 diabetes continues to rise, and doctors don’t know why. A new study out in today’s Lancet projects that the number of new cases of type 1 diabetes in children under 5 will double by 2020. Yikes. That is just a projection, based on data from 17 countries in Europe, but it still has distressing implications for families in the United States, particularly since our environment and cultures are so similar. About 3 million Americans have type 1 diabetes now, and 30,000 are diagnosed each year, about half of them children.
Doctors still don’t know what causes type 1 diabetes, an autoimmune disorder in which insulin-producing beta cells in the pancreas are destroyed by the body’s own immune system, causing a lack of the hormone that makes it possible for the body’s cells to absorb glucose from food. The disease usually surfaces in childhood, as it did with Sotomayor, or early adulthood. There’s speculation that the lack of early-childhood infections somehow makes the immune system attack beta cells, or that environmental and lifestyle changes, such as the fact that children in developed countries are taller and heavier than in decades past, may play a role.
[Read about progress in the search for a type 1 diabetes cure.]
By contrast, type 2 diabetes usually develops later (although it’s becoming increasingly common in children), and occurs when the pancreas fails to make enough insulin. Eating right, exercising, and maintaining a proper weight can prevent or delay type 2 diabetes, but that’s not the case with type 1. (There have been some uninformed media comments that Sotomayor might not have diabetes if she shed a few pounds! That’s so not true.)
Untreated type 1 diabetes can be fatal, so we parents need to be hip to the symptoms, which may come on suddenly and mimic flu and other childhood illnesses. Here, from the Juvenile Diabetes Research Foundation International, are type 1 diabetes warning signs:
- Extreme thirst
- Frequent urination
- Sudden vision changes
- Sugar in urine
- Fruity, sweet, or winelike odor on breath
- Increased appetite
- Sudden weight loss
- Drowsiness, lethargy
- Heavy, labored breathing
- Stupor, unconsciousness
People with type 1 diabetes have to monitor their blood sugar levels several times a day by pricking a finger and testing their blood. They then must inject insulin based on the test results. That can be a big challenge for kids, needless to say, but diabetes education programs have gotten much better at giving children age-appropriate information that lets them take charge.
For kids who have been diagnosed with type 1 diabetes, Sotomayor’s nomination provides a great teachable moment: Take good care of yourself, and you too could someday be named to the highest position in your chosen field. That’s the point made forcefully by Diabetes Mine blogger Amy Tenderich, who praised President Obama’s focus on Sotomayor’s legal qualifications rather than her medical file.
Researchers are hard at work trying to figure out how to keep type 1 diabetes from destroying a person’s beta cells, and they’re also looking at using stem cells to create new beta cells. But that doesn’t offer help to people who have already been diagnosed. For them, for now, good management is key. The American Diabetes Association has a family-friendly diabetes website, Planet D, and parents also can sign up for a weekly E-mail diabetes newsletter. When it comes to managing type 1 diabetes, knowledge is most definitely power.