Juvenile Diabetes in Babies

What is Juvenile Diabetes?

Juvenile diabetes is also known as type 1 diabetes or insulin-dependent diabetes. It is an autoimmune disease in which the pancreas stops making its own insulin. The patient depends on injected or infused insulin to survive. Historically, most of those who developed diabetes in childhood developed type 1 diabetes, so it has been called juvenile diabetes. However, adults can also develop this disease. The most accurate description for the disease is type 1 diabetes.

Causes of Juvenile Diabetes

The cause of juvenile diabetes is still unknown, although there are many theories as to the triggers for this disease. Juvenile diabetes is thought to be a genetic disorder that is triggered by something that happens in the child’s environment, although most children who are diagnosed with diabetes do not have a parent or sibling with the disease. Enteroviruses, cesarean sections and early exposure to non-breastmilk proteins have been studied as possible triggers for diabetes, but the exact cause for each child is uncertain.

Can Babies Get Juvenile Diabetes?

Every day, more than 40 children and 40 adults in the United States are diagnosed with type 1 diabetes. Babies and toddlers are among them. Children who are diagnosed before the age of five may have different genetic characteristics and autoimmune triggers than those diagnosed in later childhood. Studies such as Trial Net are working to discover the genetic and environmental origins of type 1 diabetes.

If a baby is diagnosed before 6 months of age, it is possible that child has a different form of diabetes called neonatal diabetes (NDM). Babies with NDM can have similar symptoms to children with type 1 diabetes. This form of diabetes has been confused with type 1 diabetes in the past and it has also been controlled with insulin. However, it is actually a form of diabetes that results from the KCNJ11 or ABCC8 genes, unlike type 1 diabetes that results from multiple genes and environmental triggers. This form of diabetes occurs in 1 in 100,000 to 500,000 live births. Some forms of this disease are transient and disappear and reappear throughout a person’s life. Today, sulfonylurea drugs are used as therapy for this disease.

Causes of Juvenile Diabetes in Babies

The exact origins of type 1 diabetes are unknown. Some babies are genetically predisposed to get diabetes and an environmental factor triggers that gene very early. Breastfeeding or feeding a baby a hydrolyzed formula may help prevent type 1 diabetes. In a hydrolyzed formula, the proteins have been broken down. Delaying solids like wheat and dairy may help prevent type 1 diabetes.

Presentation of Juvenile Diabetes in Babies

Babies who have type 1 diabetes will often lose weight, since their body is unable to change carbohydrates into energy. The body also tries to remove extra glucose through the urine, and this leads to many very full diapers and to potty training regression in toddlers.

Diabetic ketoacidosis (DKA) is a dangerous condition that results from very high blood sugar. The symptoms of DKA include intense thirst and hunger, drowsiness, vomiting and an odd smell to the breath, often likened to that of nail polish remover. All symptoms are not always present. If your baby has some of the symptoms above, visit a doctor or the emergency room. DKA is a potentially life-threatening condition.

Treatment of Juvenile Diabetes in Babies

Treatment of type 1 diabetes is through injections or infusions of insulin. Historically, people with type 1 have been given injections of slow-acting basal insulin and faster-acting insulin for meals. It can be very difficult to measure the carbohydrate intake of a baby. Babies also have a small body size, making it more challenging to give small, precise amounts of insulin. While placing an insulin pump infusion set and keeping one on a baby can also be difficult, insulin pumps also offer more flexibility for babies and toddlers who eat at irregular times and require smaller basal rates of insulin.

Diagnosing and treating diabetes in babies can be complex, since babies are unable to describe their symptoms. It takes an alert medical team and a lot of family assistance to diagnose a baby, determine insulin dosages, and monitor a baby’s blood glucose levels. Children under the age of 6 months should also be tested for Neonatal Diabetes to determine whether drug treatment could be an option.

References

Blackstock, Jennifer. 2010. Breastfeeding and Diabetes. Diabetes Health. https://www.diabeteshealth.com/browse/pregnancy/breastfeeding/

Eba H. Hathout, MD, Noelle Hartwick, MPH, Omar R. Fagoaga, PhD, Anna Rita Colacino, Jeannine Sharkey, CPNP, CDE, Michael Racine, MD, Sandra Nelsen-Cannarella, PhD, John W. Mace, MD. Clinical, Autoimmune, and HLA Characteristics of Children Diagnosed With Type 1 Diabetes Before 5 Years of Age. PEDIATRICS Vol. 111 No. 4 April 2003, pp. 860-863 Diabetes UK. 2008.

Babies born by Caesarean more likely to have Type 1 diabetes. https://www.diabetes.org.uk/About_us/News_Landing_Page/2008/Babies-born-by-Caesarean/ Harrison LC, Honeyman MC. Cow’s milk and type 1 diabetes: the real debate is about mucosal immune function. Diabetes. 1999 Aug;48(8):1501-7.

JDRF: Diabetes Facts. https://www.jdrf.org/index.cfm?page_id=102585

National Diabetes Information Clearinghouse. Monogenic forms of Diabetes. https://diabetes.niddk.nih.gov/dm/pubs/mody/

Roivainen, M and K Klingel. Role of enteroviruses in the pathogenesis of type 1 diabetes. Diabetologia Volume 52, Number 6, 995-996. https://www.springerlink.com/content/7558700v33991771/