Chapter One: What is Diabetes :: Nationwide Children's Hospital

What is Diabetes?

When you have diabetes, your body does not make enough insulin or does not use insulin well. The body is made up of many cells. Each cell needs sugar (glucose) for energy. Glucose comes from the foods you eat. Insulin is the key that allows glucose to get into the cells to make energy. Insulin is made in your pancreas.
Glucose going into cell

What kind of diabetes do I have?

There are different kinds of diabetes that children can have. The most common are:
  • Type 1 diabetes
  • Type 2 diabetes
You can also have both types of diabetes. Sometimes your doctor will know right away what type of diabetes you have. Sometimes your doctor will need to see the results of lab tests before they know which type of diabetes you have. This can take many weeks.

Type 1 Diabetes

  • The most common type of diabetes in children, teens, and young adults.
  • An autoimmune disorder. This means that the body gets rid of the cells that make insulin.
  • The body has little or no insulin.
  • You will always need to take insulin.
There is nothing you did to cause your diabetes. There is nothing you could have done to prevent your diabetes. Nobody can catch diabetes from you.
Insulin deficiency

Type 2 Diabetes

  • It is more common in adults.
  • Some children and teens can develop Type 2 diabetes.
  • Insulin is in the body, but the body cannot use it well. This is called ‘insulin resistance.’
  • It may be controlled by eating healthy foods, exercising every day, and being at a healthy weight.
  • Sometimes you will need pills to help your body use insulin better or get rid of extra glucose in the body.
  • You may need insulin.

What happens when I have diabetes?

When there is not enough insulin or insulin does not work well:
  • The glucose stays in the blood.
  • When the blood glucose gets too high, some glucose leaves the body through the urine.
  • Water leaves the body with the glucose.

When your blood glucose is high you may:

  • Feel thirsty
  • Go to the bathroom a lot
  • Have a dry mouth
  • Wet the bed

When glucose cannot get into the cells:

  • The body starts to use fat for energy. 
  • When fat is used for energy, your body makes ketones. 
  • Ketones are in the blood and in the urine. 
  • Ketones cause the blood to have more acid. 
  • Acid in the blood leads to diabetic ketoacidosis (DKA). This can make you very sick. 

When you cannot use glucose for energy you:

  • Feel tired
  • Lose weight

When you have ketones in your blood you:

  • May have a stomach ache
  • May throw up (vomit)

When you have diabetic ketoacidosis (DKA) you:

  • Feel Sick
  • Start to breathe fast
  • Have a fruity smell to your breath
  • Can be hard to wake up

Honeymoon

When you find out you have diabetes and start to take insulin, your body does not have to work as hard to make insulin. Some of the cells that were not making insulin may begin to make some insulin again. This is called a honeymoon phase. This does not happen for everyone. If it does, then it happens soon after you find out you have diabetes.
 
The honeymoon phase lasts for a few weeks or longer. There is no way to know how long it will last. Taking insulin is the best way to stay in the honeymoon phase.

What do I need to do if I have diabetes?

Keep your blood glucose as close to normal as you can. A normal blood
glucose is 70 to 120 mg/dl.

How do I keep my blood glucose in a normal range?

You can learn to manage your diabetes by learning to think like a pancreas.
When your pancreas is working well it gives your body the amount of
insulin you need for the food you eat and your activity level at that time.
 
This keeps your blood glucose in a normal range.

Think and act like a pancreas by:

  • Checking your blood glucose at least 4 times each day
  • Taking insulin at least 4 times each day
  • Counting carbohydrates in the foods you eat
  • Learning what makes your blood glucose change and making changes to keep your blood glucose in target range

 

 

Food Activity

 

Why do I need to take care of diabetes?

There are health problems that can happen when your blood glucose is too low or too high. We will teach you what to do when this happens.
 
Having diabetes does not cause permanent problems, but high blood glucose over many years can cause permanent problems.

Will diabetes stop me from doing things I want to do?

You will still be able to do all of the things you did before you had diabetes.
  • You will need to plan so you have time to check your blood glucose, count carbohydrates, and take insulin.
  • You will need to be ready for times when your blood glucose is too low or too high.
Your family, your healthcare team, and this book will help you learn what you need to know to take care of your diabetes.
 
Image Credits: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

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