DIABETES
is a chronic metabolic disorder,
resulting in the body's
inability to utilize glucose normally, resulting in high levels of blood glucose.Type 1
Diabetes, previously called juvenile, or insulin dependent diabetes, is a condition that
prevents the body from utilizing food (glucose) for energy. This form of diabetes occurs
when the insulin producing cells of the pancreas, the islet cells, are destroyed, and the
body no longer produces insulin.Insulin, a hormone, is normally released in response to an
increase in blood glucose (or "blood sugar") levels within a relatively narrow
range
(80-120mg/dl). In the absence of insulin, the blood glucose continues to rise.
Common symptoms of high blood glucose, or hyperglycemia, include: excessive thirst and
urination, hunger, weight loss, fatigue, and blurred vision. When insulin is deficient,
serum and urine
ketones increase, causing abdominal pain, nausea, and
vomiting. Children who have Type1, or
insulin dependent diabetes, must receive daily injections of insulin to replace the
missing
hormone which is essential for life. Insulin is necessary for blood glucose to be
maintained within a relatively narrow range.
Type 2
Diabetes, previously called adult onset, or non-insulin dependent diabetes, rarely occurs
in children, though in recent years it appears to be coming more common, primarily in
adolescents. A resistance to insulin (which may actually be present in very large
amounts), rather than a deficiency of insulin, characterizes Type 2 diabetes.
Cause
The exact cause of diabetes is unknown; however, there is a strong hereditary component.
Type 1 diabetes appears to be an autoimmune disease that may be triggered by certain viral
infections or environmental factors.
Diabetes is not contagious. Type 2 diabetes tends to occur in individuals who are
overweight and who have a positive family history for diabetes.
Treatment
The primary goal of treatment for diabetes is to maintain optimal blood glucose levels,
while avoiding the extremes of low blood glucose (hypoglycemia) and high blood glucose
(hyperglycemia) or
ketoacidosis (high blood sugar levels with ketones).
When the diabetes is managed with a
balance of diet, oral hyperglycemic agent or insulin, and exercise, functional lifestyles
are
the norm. Strict adherence to the medical regimen is essential for health maintenance and
prevention of secondary complications. Normal development stresses (adolescent growth), as
well as physiologic assaults (viral episodes, injuries) complicate the diabetes and create
the need to closely monitor and alter the diet, insulin, and exercise balance. Students
with diabetes can attend school regularly, fully participate in all activities, including
competitive sports. Students can do quite well if sufficient supports exist for them. It is
essential that the faculty closest to the student be thoroughly in-serviced about the
disease, normal maintenance requirements, and emergency
interventions. Treatment involves
the daily administration of medication, appropriate food consumption, and exercise. Most
children are able to inject insulin and monitor blood glucose levels independently as they
mature.
These procedures are ideally performed by a mature, knowledgeable, responsible person who
may be a supervising adult. If there is concern as to the accuracy of the insulin
administration or monitoring values, these procedures should be performed by an adult.
Prognosis
Insulin- dependent diabetes is currently irreversible, but can be fairly well
controlled through a balance of insulin, diet, and exercise. Type 2 diabetes may be
reversed through diet and exercise, if caught early in the course, although oral
medications taken religiously can help people be functional, productive adults. Management
of diabetes is lifelong.
Uncontrolled diabetes can lead to blindness, kidney disease, amputations, heart disease, and death. Medications and/or insulin may ultimately be necessary.