of Juvenile Diabetes
There are two types of diabetes that
are common in children. The first one is
type-one diabetes and the second one is type-two diabetes.
Type-one diabetes is referred to as juvenile
diabetes mellitus. It is one of the most
common chronic diseases that affects children.
About 150,000 children are affected by it nationwide
(Band & Weisz,
1990). It is a disorder of the endocrine
system and affects about 0.1 percent of children that are school age. Also, out of all the cases diagnosed,
type-one makes u p 5-10 percent of them.
There are major health problems associated with
troubles physically, psychologically, behaviorally, socially and
(Yousef, 1993). Type-one comes about when
the pancreas ceases to produce insulin the body needs to break down
the blood. These diabetics give
themselves injections of insulin to keep their glucose level in their
down (Cauchi, 2002).
Type-two diabetes is caused by children being
obese. Up until about a decade ago, this
type was rarely heard of in children.
This sudden increase of type-two diabetes in
children is caused by kids
eating too much junk food and their lack of physical exercise. Type-two occurs when the body has a glucose
level in the blood that is too high and it consumes the insulin
produced by the
pancreas. If the disease is left
untreated, children with diabetes may experience heart attacks,
blindness, or kidney
disease by time they are in their late 20s.
According to endocrinologist, a twenty fold increase
diabetes is predicted within the next decade among teenagers (Cauchi,
Type-one diabetes has equal incidence of males
females, but occurs more in Caucasians than non-Caucasians. Type-two used to be primarily found in people
who were older and overweight, and now the younger ages are starting to
predominant in type-two than the older people.
Also, type-two is more predominant in African
Americans, and Hispanic Americans.
In the United States, studies were
done on age, sex, and
season of onset of juvenile diabetes in four geographic regions. The four geographic regions were Pittsburgh, Gainesville,
Galveston, and Melbourne. The study concluded that the sex of the child
with type-one diabetes is equal in frequency for both males and females
(Fleegler, Rogers, Drash, Rosenbloom, & Travis, 1979).
Also, reports indicated that the highest
frequency of onset of diabetes was in the fall and winter and the
lowest was in
the summer, except for in Melbourne. Melbourne
had a reverse trend in that it had its highest onset in the summer. Similar results were received in Great Britain and in Australia
(Fleegler et. al, 1979).
In Hungary, another study was
incidence of type-one diabetes in Hungarian children.
In 1990, central/eastern Europe
reported an increase in the incidence of type-one diabetes in Hungarian
children aged 0-14 years over a 10-year period from 1978-1987. A second decade was studied from 1989 to
1998. During the second decade in Hungary,
was a change in the political system and it produced economic, social
environmental changes as well. The
results were that there were no differences between sex, both male and
had the same incidence of diabetes, but the incidence of getting
lowest in the youngest age group of children and the highest in the
group (Gyurus, Green, Patterson, & Soltesz, 2002).
In Australia, there was an
done on a 15-year-old girl named Sally Hoss (not her real name, as
the interview). Sally was diagnosed with
type-two diabetes. She was not obese,
but she was a medium height and 60 kilograms.
Although she was susceptible because she was
overweight, her ethnicity
was part of it as well. She is an
Aborigine as she as well as others on that side of the world are not
Western food from the United States.
When they eat junk food and things that they are not
used to, they are
vulnerable to the disease. It was
guessed that 5000 children in Australia
under the age of 18 had type-two diabetes, and 100,000 with type-one. It is also predicted that in 10 years there
will be more cases of type-two diabetes than there are of type-one
symptoms of having Type-one diabetes are being extremely thirsty,
urination, increase in appetite, drowsiness, dry and warm skin, sweet
odor on the breath, and deep breathing.
Type-one is a lifelong disease where your body
cannot metabolize glucose
because of a lack of insulin produced by the body.
In maintaining normal blood concentration,
the kidneys pull out sugar and mass amounts of water from the body. This results in frequent urination, which
results in dehydration and then causes the child to become very thirsty
drink large quantities of liquid. Because the sugar going into
is not used by the cells due to the lack of insulin, the child feels
eats mass amounts of food, loses weight, and becomes tired and weak. Diabetes is most often a hereditary
disease. Other factors that may cause a
person to get diabetes are obesity, viruses, lack of physical activity,
diet, and a high consumption of sugars and fats (Yousef, 1993).
Psychological problems are not
typically found in children with diabetes, but having diabetes may lead
psychological reactions to living with the disease.
Children may be in denial of their illness or
behave like they don’t know what the dangers of their illness are. Dependency for children with diabetes is
another difficulty. Having diabetes
requires lots of attention because of the involved medical treatments
restricts the child’s activities. Some
other reactions are blaming other people for them being sick, showing
and being rebellious, withdrawal from activities because of depression,
very emotional, exaggerating their responsibilities to the disease and
their childhood. Having diabetes as a
child can be very stressful. It causes
negative views of self-concept and just being aware that you are
be stressful for a child (Yousef, 1993).
Parental reactions and attitudes
also play a part in the characteristics of children having diabetes. The child being hospitalized, their diet and
medical regime, financial problems, and knowing that the disease is
can all cause distress on the family.
There are 6 criteria that can have an influence on
the family’s response
to the child having diabetes: 1) the severity of the illness, 2) the
age of the
child when they experience symptoms, 3) the nature of the illness, 4)
family’s psychological adjustment, 5) how the siblings are affected and
cost of treating the illness (Yousef, 1993).
If the parent accepts the child’s disease, then the
child will be on a
better mental status to learn to accept it themselves.
There are many types of coping behaviors that
can be done to help both the family and the child.
It is important that the child receives
support from both parents or both members of the couple.
Promoting communications with the child and
the family about coping strategies and reactions could improve the
dealing with the disease for the entire family (Goldbeck, 2001).
Children that are diabetic have
certain issues within a classroom setting.
They are normal students with normal minds that are
ready to learn and
have expectations of fitting in to a regular school.
If their disease is not controlled properly,
it may cause difficulties for successful academic performance. Being absent from school, being late for
school, missing classes and bad attitudes from parents and teachers
to poor educational performance. A child
may have poor attendance due to them not taking them medications and
symptoms of their attacks of low or high blood sugar, like convulsions
vomiting. When the child leaves classes
to give themselves injections or check their blood sugar, they are
classes which can affect their academic performance.
If the child doesn’t get the support they
need from the school, then the parents get involved and get bad
because it is a public school and the child should get the same
as the other children (Yousef, 1993).
On the teacher’s part though, they may not be
have the time to give a child with special needs all the attention they
succeed. Even though the child is normal
and can function in a regular school, the child may need special help
attention when it comes to dealing with their diabetes.
Along with the child presenting issues for
the school to deal with, the school also provides issues for the
deal with. Things like not having the
resources or trained staff to deal with emergencies when they arise,
providing the right diet for the child because some families don’t have
money and their child needs to eat on a meal plan from the school, so
child’s dietary needs be met ?
Also, another issue is ensuring that the staff
school is educated on the illness, because if they don’t know anything
it, how can they help the child to do things like remember to take
medicines. Also, because of the stress
the child experiences from having the disease, they may reject school
of their depression or denial and refuse to make friends or feel
to them. Issues like participating in
gym class should be regulated by a doctor.
The school staff should be trained in regulating the
activity, diet and injections. If the
child is hurt and receives a wound to the skin, the school staff should
trained in how to address it and they should monitor the progress how
healing. The school staff should also
know the symptoms of low blood sugar and high blood sugar so they can
action if necessary. If the blood sugar
is too low, then it may be because of too much insulin in the body, too
physical activity or irregular amounts of food.
When low blood sugar is demonstrated in the child he
or she usually
appears restless, has blurred vision, exhibits behavior changes, has
sweating, headaches, vomiting, cold hands and feet, and may experience
convulsions and eventually comas. If the
child is given concentrated sugar like orange juice or fruit flavored
this can stop the reactions. If the
child has blood sugar that is too high it could be caused by low
insulin or a
viral infection or disease. The symptoms
develop slowly and include dry and warm skin, sweet or fruity odor to
breath, deep breathing and coma.
Injecting the child with insulin can stop the
Children with diabetes monitor their
blood levels and inject themselves three to five times per day. An issue with this in the school is finding a
place that is safe and private to do all the procedures.
Doing it in the bathroom is unsafe and
embarrassing for a child. Some kids are
afraid to be around when that is going on because they are afraid that
will go wrong. Another issue is that
injections need to be timed in accordance with mealtime because after
injections the levels of insulin can go up and down (McNamara, 2000).
A new way to get insulin and not have to worry
the injections is to switch to an insulin pump, which is a needle under
skin in the stomach that releases insulin as you need it from a remote
sized device. This saves time so classes
are not missed, it helps to take it with meals better than injections,
does not require a safe private place.
An issue that comes along with treatment is having a
school staff that
knows how to deal with a child with diabetes, especially how to deal
emergency situations (McNamara, 2000).
With the physical needs addressed, the psychological
issues needs to be
assessed by the school as well. If the
child is going through the adjustment process with things like denial,
depression and lack of self -esteem, they may reject a classroom
setting. They would not make friends, not
academically or have any kind of experience a normal child would have. Implementing counseling sessions with the
guidance counselor can help. The
counselor needs to have knowledge and training with dealing with
diabetes or any other lifelong disease like diabetes.
They first need to establish a trusting
relationship with the child so the child will open up to them and talk
about how they are feeling inside.
Also, working with the family to set up an IEP will
help if the child is
absent frequently or has to miss class.
Also it can help if the child is just starting the
and is rejecting school. The IEP will
help to give more attention to the child and address their needs on an
emotional, educational and personal level.
The people on the child’s IEP team can be the
parents, teachers, school
nurse, school psychologist and the guidance counselor.
The child would also have to be evaluated for
their emotional status and social maturity.
Also the guidance counselor can help the parents
with their child’s home
life. If the parents are having
adjustment problems the counselor could recommend family counseling to
about Juvenile Diabetes
Juvenile diabetes is a disease that affects many
in the world and it is continually growing each day.
It is a disease that puts stress on everyone
that is affected by the child, like family, friends, school, and
doctors. If knowledge of the disease is
by people that deal with children like this on a regular basis, the
suffer severely for it.