Understanding the Diagnosis of Diabetes
The diagnosis of diabetes is surprisingly straightforward. It doesn’t require many tests to rule out other possibilities. The following signs establish the diagnosis of diabetes:
- a urine test showing a lot of sugar and the presence of ketones
- symptoms such as extreme thirst and frequent urinating
The following test confirms the diagnosis: a reliable laboratory blood sugar reading of more than 11.1 mmol/L (200 mg/dL) taken at any time of day. It doesn’t matter when the child last ate.
It is not usually difficult to tell whether a child has type 1 or type 2 diabetes. By far most children and teens have type 1. Symptoms of type 1 diabetes usually start dramatically because the pancreas stops making insulin. Ketones are much more likely to be present in the urine in type 1 diabetes than in type 2. However, if there are no ketones it doesn’t mean that it isn’t type 1. Rather, it suggests that the child was diagnosed early, before ketones had the chance to form. Unfortunately, early diagnosis doesn’t mean that the child has a less severe case of diabetes, or that treatment will be easier.
In rare cases, it can be difficult to determine whether the diagnosis is type 1 or type 2 diabetes. Other testing might include fasting insulin levels, genetic testing, or looking for immune markers of type 1 diabetes. In type 1 diabetes, there are certain antibodies in the body. They are created in response to the proteins on the pancreas cells that release insulin. If these markers are present, it suggests that the diabetes is more likely to be type 1. If no markers are present, it is more likely type 2 diabetes, but this is not a definite diagnosis.
What happens after your child is diagnosed with diabetes?
Once your child has been diagnosed with diabetes, you and your child will meet the members of your child’s diabetes care team and start learning how to manage the diabetes. This is called diabetes education. The team may include a doctor, nurse, dietitian, and social worker. They will set up a diabetes education program with you and explain the roles of each member of the team.
Starting out
The first step is to learn the skills needed to take care of the diabetes: how to draw up and inject insulin, how to measure blood glucose/sugar levels accurately, how to begin to plan meals and snacks.
The emotional impact
Your diabetes team will help deal with any of the doubts, questions, or worries you may have. Hearing the diagnosis can be stressful, and it can lead to many strong emotions, ranging from anger to denying that your child is ill.
Learning to manage
For most families, it will take two or three days to learn the basics of diabetes care. If extra support is needed at the beginning, your diabetes team may arrange for home care to help you with injections and monitoring.
Knowledge is the basis of managing diabetes. Learn as much as you can about diabetes and how to manage it. This will help you feel more secure, and reduce your fears and concerns. The goal of diabetes management is to help children live long, healthy, productive lives, as much like any other child as possible.
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