ABOUT THE DISEASE
What are the different types of diabetes?
Type 1 (insulin-dependent or juvenile)
Type 1 diabetes (juvenile diabetes) can occur at any age, but most commonly is diagnosed from infancy to the late 30s. In this type of diabetes, a person's pancreas produces little or no insulin. Although the causes are not entirely known, scientists believe the body's own defense system (the immune system) attacks and destroys the insulin-producing cells in the pancreas. People with type 1 diabetes must inject insulin several times every day.
Type 2 (non-insulin-dependent or adult-onset)
Type 2 diabetes typically develops after age 40, but can appear earlier, and has more recently begun to appear with more frequency in children. In this form of diabetes the pancreas still produces insulin, but the body does not produce enough or is not able to use it effectively. Treatment includes diet control, exercise, self-monitoring of blood glucose and, in some cases, oral drugs or insulin.
Monogenic Diabetes
Type 1 and 2 diabetes are polygenic diseases, meaning the risk of developing these forms of diabetes is related to multiple genes. But some rare forms of diabetes result from mutations in a single gene and are called monogenic; they are sometimes mistaken for type 1.
Gestational Diabetes
About 2 to 5 percent of pregnant women develop high blood sugar during pregnancy. Although this type of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes are at high risk of developing type 2 diabetes later in life.
What are the symptoms of type 1 diabetes?
The symptoms may occur suddenly, and include one or more of the following:
•Extreme thirst
•Frequent urination
•Drowsiness, lethargy
•Sugar in urine
•Sudden vision changes
•Increased appetite
•Sudden weight loss
•Fruity, sweet, or wine-like odor on breath
•Heavy, labored breathing
•Stupor, unconsciousness
If you think you have diabetes, call a doctor immediately, and drink fluids WITHOUT SUGAR to prevent dehydration.
What is the "honeymoon phase"?
In a person who has type 1 diabetes, the insulin-producing beta cells in the pancreas are destroyed by immune cells. However, right after the time of diagnosis, some patients go through a "honeymoon phase" in which their existing beta cells still function. A number of research projects are currently taking place which hope to preserve the function of these existing beta cells after the honeymoon phase in people with type 1 diabetes.
Is type 1 diabetes hereditary?
Ninety percent of children who develop type 1 diabetes actually have no relative with the disease. Thanks to studies of families, researchers now can identify at birth when a baby carries some of the genes that indicate risk factors for type 1 diabetes. Certain genes called HLA markers are associated with diabetes risk. If a child is born with such markers, his or her risk of developing type 1 diabetes is about the same as if he or she had a sibling with type 1 diabetes, even though no other family member may have the disease. There are other genes that also create risk for juvenile diabetes that have not yet been identified.
How did my child get type 1 diabetes? We have no family history.
Although the causes of type 1 diabetes are not entirely known, scientists believe the body's own immune system attacks and destroys insulin-producingcells in the pancreas. It is not caused by obesity or by eating excessive sugar, which are two common myths about type 1. Both genetics and environmental "triggers" are being studied as potential causes of type 1 diabetes.
According to William Winter, M.D., a professor at the University of Florida College of Medicine in Gainesville, "At most, only 15 percent of people with type 1 diabetes have an affected first-degree relative - a sibling, parent, or offspring. Research suggests that genes account for less than half the risk of developing type 1 diabetes. These findings suggest that there are other factors besides genes that influence the development of diabetes."
How long will my child have type 1 diabetes? Can you outgrow it? What is the life expectancy?
At this point, type 1 diabetes is a chronic disease, meaning you never outgrow it. However, JDRF is doing everything in its power to find a cure in your child's lifetime. We were founded in 1970 by parents of children with type 1 diabetes.
Life expectancy is very difficult to predict -- just as each child is unique so will be their experiences with type 1 diabetes. On average, the current life expectancy of a child with type 1 diabetes is shortened by 7-10 years, but this number has been trending down in recent years with advances in technology and treatment options. The best thing you can do is listen and learn from the experiences of others while also responding to your child's individual needs -- avoid blaming yourself or your child when things don't go smoothly. The reality is that type 1 diabetes is a difficult disease to manage, but we have come a long way and the technology is getting better all the time. Take advantage of the people, products, and other resources available to you.
DAILY LIFE AND MANAGEMENT
What is the optimal blood sugar range?
You should check with your doctor to determine the range of blood sugar levels best for you. In general, optimal blood sugar goals are:
Before Meals: 70-110 mg/dl
At Bedtime: 100-140 mg/dl
If your before-meals blood sugar is consistently lower than 70 mg/dl or higher than 140 mg/dl, or your bedtime blood sugar is consistently lower than 100 mg/dl or higher than 160 mg/dl, you probably need a change in your treatment plan and should consult your doctor. Blood sugar goals may be modified for children and others who are at greater risk for hypoglycemia.
What foods should a person with type 1 diabetes eat/avoid?
You'll be pleased to learn how many different foods can be included in the diet of a person with type 1 diabetes. Once you get into the habit of eating less fat and smaller portions of a variety of nutritious foods, you and your entire family will benefit.
Fat restriction is very important for those with type 1 diabetes because high cholesterol and diabetes are two of the four risk factors for developing heart disease. Some tips:
•Don't fry foods - bake, broil, poach, or sauté in non-stick pans.
•Steam or microwave vegetables.
•Make ice cream, butter, and whole milk cheese an occasional treat.
•Eat less high-fat red meat and more low-fat turkey, fish, and chicken with the skin removed before cooking.
•Avoid refined sugar, or at least limit its use. Several kinds of artificial sweeteners are available, but talk to your doctor or dietitian about them.
•Restrict salt (sodium), which can raise blood pressure. This is particularly important for people with type 1 diabetes - as is anything that threatens the circulatory system.
•Replace diets high in animal protein with meals high in complex carbohydrates, which are starches found in breads, cereals, starchy vegetables, legumes, rice, and pastas.
•Choose whole-grain cereals, breads, and other products such as brown rice, kasha, bulgur, and barley. •Eat fresh vegetables and fruits, unpeeled. Avoid overcooking vegetables.
Are there support groups or other parents I can talk to about everyday issues?
Yes. JDRF has many compassionate, understanding, and dedicated volunteers who have been through many of the things you are experiencing and are more than happy to help you. Our Online Diabetes Support Team is made up of such volunteers. In addition, there may be support groups in your local community that meet on a regular basis. For information on specific topics like Type 1 Diabetes in School and latest products and technology, see our Resources page. Furthermore, many children with type 1 diabetes and their parents enjoy the Web site http://www.childrenwithdiabetes.com/, an online community with chat rooms and information on a variety of type 1 diabetes-related topics.
What other resources are available to me?
Although you are probably overwhelmed right now, JDRF can provide information and a support network to make this time easier for you and your family. We have a packet of information that is sent to the family of a child who has been recently diagnosed (e-mail ).
What do I need to know about type 1 diabetes in school?
School presents a host of challenging issues for children with juvenile diabetes, and it's important to know your rights. Information on laws protecting your child, as well as many articles with practical tips and advice from other parents is available on our Type 1 Diabetes in School page.
How do I know whether my child is getting the best medical care available?
Is there a list of recommended doctors and health care experts I can check?
Ultimately only you can determine whether or not your child is seeing the right doctor, but we will attempt to provide general guidelines to help you make that determination. On your next visit to your doctor, you may want to ask some or all of the following questions, in order to determine his/her level of expertise with type 1 diabetes management. If you don't feel comfortable with your doctor and have difficulty engaging in dialog with him/her, it is probably best for you to seek better care.
Questions for your doctor:
•How many patients with type 1 diabetes do you care for in your practice?
•Are you familiar with the Diabetes Control and Complications Trial?
•Do you work with a type 1 diabetes nurse educator?
•Do you work with a dietitian knowledgeable about type 1 diabetes?
•Do you work with an eye doctor knowledgeable about diagnosing and treating eye problems related to type 1 diabetes?
•Do you have any experience with insulin pumps?
•Is someone available 24 hours a day to help me manage problems with my type 1 diabetes? How do I contact that person?
You can also ask other parents of children with type 1 diabetes in your area who they recommend. In addition, the American Association of Clinical Endocrinologists (AACE) Web site is an excellent resource for type 1 diabetes care information, and allows you to search for an endocrinologist in your area. In May 2002, the AACE created the Intensive Diabetes Self-Management System, which includes an AACE Patient/Physician Contract - emphasizing that type 1 diabetes care is the responsibility of both the doctor and the patient.
Where can I get a medical ID for my child?
A number of companies make medical alert bracelets specifically marketed toward children with juvenile diabetes.
I need financial assistance for type 1 diabetes supplies and/or healthcare.
In North America there are pharmaceutical assistance programs offered directly by some drug companies for people with type 1 diabetes who have little or no insurance to help offset the cost of supplies or prescription medications. The Pharmaceutical Research and Manufacturers Association (800-762-4636) has information on such programs. The Partnership for Prescription Assistance (PPA) offers a point of access to hundreds of assistance programs that have joined together to provide savings to the uninsured. Phone: 1-888-477-2669. The Together Rx Access Card offers hardworking Americans and their families 25 to 40 percent off brand-name prescription medications at pharmacies nationwide. Phone: 1-800-444-4106.Additionally, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has a publication called "Financial Help for Diabetes Care." Order print copies from the National Diabetes Information Clearinghouse: 800-860-8747.
Where can I find health insurance for my child with type 1 diabetes? (north America only)
Every state in the nation has a health insurance program for infants, children, and teens who are not otherwise insured. To find out about programs in your state, search Insure Kids Now!, offered by the US Department of Health & Human Services (or call 877-KIDS-NOW). Another option to investigate is your state Children's Health Insurance Program (CHIP). Also, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has a publication entitled "Financial Help for Diabetes Care." Order print copies from the National Diabetes Information Clearinghouse: 800-860-8747.
Where can I find information about camps for kids with type 1 diabetes?
JDRF Kids Online has articles on diabetes camps. In addition, state-by-state listings of summer camps for children with type 1 diabetes can be found at Children with Diabetes and the Diabetes Education and Camping Association. You can also search for juvenile diabetes camps on the American Camp Association's website.
RESEARCH
What's the latest research information? Is there a cure in sight?
This is the question JDRF is actually best equipped to answer, as the only major type 1 diabetes organization focused exclusively on research. JDRF is the number one nonprofit, nongovernmental funder of type 1 diabetes research worldwide and our mission is constant: to find a cure for type 1 diabetes and its complications through the support of research. The brave kids org. is proud to say that more than 85% of our expenditures go directly to education, information and services . We have been instrumental in establishing a focus on the needs of all people with type 1 diabetes, which has helped set the world's juvenile diabetes research agenda to find a better control and manage for better life quality.and cure, and we are witnessing significant research progress. To find out the latest in type 1 diabetes research news, you can do several things: Join our org. in various ways, donate our org. for more services .
How can I help find a cure?
The best ways are by making a donation or volunteering with brave kids org. Canada Brave kids Canada's sole mission is to find a solution for families and kids with juvinile diabeties and cure for type 1 diabetes and its complications through the support of information, education and services , so you know that the money you donate or help raise will be used appropriately. More than 85% of our org. expenditures goes directly to research and education about research. our org. has many wonderful opportunities for volunteers. Events such as Walks, Galas, golf tournaments, and various other fundraisers are great ways to meet other families dealing with type 1 diabetes and forge bonds that will last a lifetime. In addition to fundraising, our volunteers also invest time in our grassroots advocacy initiatives, such as Brave Kids Club , Congress or Brave Kids and the Brave Kids Walk. While The Brave Kids Canada is the one of world's fast growing nonprofit / charity org., for type 1 diabetes services , education and research, we also advocate for federal support of type 1 diabetes research, in order to ensure that sufficient funds will be available to support the critical final phase of research to find a cure: human clinical trials by other supporting groups like JDRF.
