Model Chrissy Teigen, who is married to Grammy-winning singer John Legend, has revealed that her six-year-old son Miles was diagnosed with type 1 diabetes, which mostly occurs in children. The boy was hospitalised with another illness when the mother-of-four found out Miles had diabetes. Does this mean it is difficult to detect type 1 diabetes in children? Let us tell you all about type 1 diabetes, what causes it, its common symptoms and more.

Chrissy Teigen on her son’s type 1 diabetes diagnosis

The 38-year-old model took to Instagram to thank her 42.3 million followers for reaching out after they noticed her son was wearing a continuous glucose monitor or CGM, which is worn by people with type 1 diabetes, in a photo.

“You noticed his type 1 diabetes monitor and extended so much love and encouragement in every way possible. I was, and am, so blown away by the kindness of this community, already,” she wrote.

Check out her post here!

She went on to share that she found out about her son’s diagnosis after he was taken to the hospital for a “terrible case of shigella” (bacteria that cause diarrhea). Teigen noted that the doctors knew “something else was off about his blood tests.” Since then she learnt that this is “how so many young children end up being diagnosed with type 1—going to the hospital for something completely different.”

What is type 1 diabetes?

Insulin is an essential hormone produced by beta cells in the pancreas, which is an organ situated behind the stomach. It is meant to convert sugar or glucose from food into energy. Type 1 diabetes is a lifelong condition where the pancreas fails to produce sufficient insulin, leading to high blood sugar levels, says endocrinologist Dr Pranav Ghody. Approximately, 5 to 10 percent of people with diabetes have type 1 diabetes, according to the US Centers for Disease Control and Prevention. Type 1 diabetes can appear at any age, but it usually occurs in children and youngsters, as per National Institute of Diabetes and Digestive and Kidney Diseases.

What are the symptoms of type 1 diabetes in children?

The symptoms of type 1 diabetes can develop rapidly in children and may include –

• Increased thirst
• Frequent urination, including bed-wetting in case of children
• Extreme hunger
• Unintentional weight loss
• Fatigue and weakness
• Blurred vision
• Irritability or mood changes

What are the causes of type 1 diabetes in children?

In most of the cases, the cause of this type of diabetes is believed to be an autoimmune disorder. In such situations, the body’s immune system mistakenly attacks and destroys the cells that produce insulin in the pancreas, says Dr Ghody.

Here are some of the factors that may contribute to it –

• Family members of patients with type 1 diabetes have an increased lifetime risk of developing type 1 diabetes.
• Viral infections and toxic chemical agents may trigger the immune response leading to diabetes.

How is type 1 diabetes diagnosed in children?

In most cases, it is diagnosed after the symptoms of diabetes become noticeable and they are tested for it. But routine blood tests are not usually suggested if a child is healthy. Diagnosis typically involves a thorough medical history, physical examination, and specific blood tests, says the expert.

Common diagnostic tests include –

• Fasting blood sugar test: The test is done to measure blood sugar following an overnight fast. If the number is more than 126 mg/dL, it is considered abnormal.
• Two-hour oral glucose tolerance test: It measures blood sugar two hours after giving a standardised solution of sugar. If the sugar is more than 200 mg/dL, it is considered abnormal.
• A1C test: It provides an average blood sugar level over the past two to three months. An A1C level of 6.5 percent or higher is abnormal.

Generally in children without symptoms, two or more tests need to be abnormal to confirm the diagnosis, says the expert. Occasionally children may present directly with symptoms of diabetes or with Ketoacidosis, which is a serious complication of diabetes. In these cases, a Random Blood sugar (drawn at any time) may be done. If it is more than 200 mg/dL, it suggests diabetes.

How is type 1 diabetes treated in children?

There is currently no cure for type 1 diabetes, but it can be effectively managed –

1. Insulin therapy

Since children with type 1 diabetes do not produce sufficient insulin, the main treatment involves lifelong insulin therapy. This can be done through multiple daily injections or an insulin pump, which provides a continuous supply of insulin, says the expert.

2. Blood sugar monitoring

Regular monitoring of blood sugar levels is essential for children with diabetes. This is typically done using a glucose meter or a continuous glucose monitor (CGM), which has three parts –

• A tiny disposable sensor needs to be inserted under the skin of the child with a sticky patch. There is also an implantable sensor, which may be placed inside your body. These sensors help in estimating the glucose level in the fluid between the cells of the child.
• The CGM’s second part is a transmitter, which sends the information to the third part, which is a software programme stored on a phone, or on an insulin pump.

3. Diet

A balanced diet that includes carbohydrates, proteins, and fats is crucial. Children or parents need to learn how to count carbohydrates to match their insulin doses with food intake. For example, if your child plans to eat 45 grams of carbohydrate in a day and their insulin-to-carb ratio is one unit of insulin for every 15 grams of carbohydrate consumed. Then divide 45 by 15 to find out how much insulin you need to give to your child.

4. Physical activity

Young or old, regular exercise is important for overall health. It can also help manage blood sugar levels, says the expert. Some people may experience a drop in blood glucose while exercising or after a workout session. So, before your child goes out to play, check their blood glucose, and be prepared to treat hypoglycemia or low blood glucose. If their blood glucose level is less than 100 mg/dl before starting exercising, give them a carbohydrate snack of approximately 15 grams to increase their blood glucose.

5. Transplant

It is often done as part of simultaneous pancreas-kidney transplant for children with advanced kidney disease due to diabetes, says Dr Ghody. New diabetes treatment options being explored are islet cell transplantation which involves transplanting insulin-producing cells from a donor pancreas into a person with type 1 diabetes.

Children are usually more affected by type 1 diabetes. If children are healthy, it may be relatively diagnose type 1 diabetes. But if they start showing symptoms of diabetes, tests will help to diagnose it.