Endocrine and Immune System Conditions

Diabetes

What is diabetes?

When your child eats, their body turns food into a type of sugar called glucose (glue-kohs). In diabetes (dye-uh-BEE-tees), the sugar level in your child’s blood gets too high.

This happens because of problems with the hormone called insulin. The job of insulin is to move sugar from the blood into the body’s cells so it can be used for energy. Insulin helps keep blood sugar levels normal. It also helps the body use fat and protein. Insulin is made in the pancreas (PAN–cree-us).

There is no cure for diabetes. But your child can stay healthy if they work with their healthcare team, take insulin as needed, eat balanced meals and exercise.

There are 2 common types of diabetes. Both make blood sugar levels higher than normal, but they do so in different ways.

  • In type 1 diabetes, blood sugar levels rise because the body stops making enough insulin. Sometimes this happens because the pancreas is damaged. Over time the cells that make insulin are destroyed. Type 1 diabetes is an autoimmune (awe-toe-ih-mewn) process. This means the body destroys its own cells — the cells that make insulin. Type 1 diabetes is most often diagnosed in children and young adults. People with type 1 diabetes must take insulin for life.

  • In type 2 diabetes, the body makes insulin but does not respond to it properly. Glucose is less able to enter the cells and supply energy. This makes blood sugar levels rise. Most people with type 2 diabetes are overweight. Type 2 diabetes is more common in kids older than 10 and in adults. People with type 2 diabetes may or may not need to take insulin.

Diabetes at Seattle Children’s

We care for your child while helping you and your child learn how best to manage their condition. Each year we treat thousands of children and teens with diabetes. With a top-10 national ranking by U.S. News & World Report for 2019-20, our Endocrinology and Diabetes Program is the highest-ranked program in the Northwest.

If you would like a referral to our Endocrinology and Diabetes Program, talk to your primary care provider. If you have any questions or already have a referral, please contact us at 206-987-2640 for an appointment. Providers, see how to refer a patient.

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  • Dr. Marguerite T. Parisi has been involved in many studies of radioactive iodine (radioiodine, or I-131) therapy, used for overactive thyroid.

    Research on fine-needle aspiration biopsies for thyroid conditions shows our results for children and adolescents are as accurate as the results of doctors doing these biopsies for adults.

    A study at Seattle Children’s showed our patients are ready to leave the hospital sooner after surgery to remove the thyroid. This is because of the ways we carefully manage low levels of calcium in the blood (hypocalcemia) — which can happen when surgery disturbs blood flow to the parathyroid glands.

    • At Seattle Children’s, your family has a full team behind you. We work together and with you to meet your child’s medical needs and improve their quality of life.
    • Our team helps you understand treatment options and handle the challenges of your child’s condition. We link you to community resources and support groups.
    • As they get older, your child plays a larger role in their care. With UW Medicine, we created the Adolescent and Young Adult Diabetes Transition Clinic. The team helps your teen take charge of managing their diabetes and make the change to adult care.
    • We work with many children and families from around the Northwest and beyond. We can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Learn about our services for patients and families.
  • Seattle Children’s doctor-scientists work to improve treatment and quality of life for children and teens with diabetes. What we learn through research affects the care we give all children.

    • Our research team may ask your family if you want to take part in research studies. You always have a choice. Some studies collect information. Others test new medicines or treatments in people to make sure they are safe and see how well they work. Learn about taking part in research at Seattle Children’s.
    • In current studies, we are collecting information about complications of diabetes, quality of life, quality of care and other factors. The largest study is called SEARCH for Diabetes in Youth. This national multicenter study aims to understand more about diabetes among children and young adults in the United States. More than 35,000 youth with diabetes have taken part so far. SEARCH has helped determine the extent of diabetes in the community and its impact on different groups of people. This data has helped shape public health policies for diabetes prevention and treatment.
    • Learn more about current diabetes research studies at Seattle Children’s.
    • In work that holds promise for curing type 1 diabetes, scientists aim to reprogram T cells so they protect the pancreas instead of attacking cells that make insulin. This research uses gene-editing techniques pioneered at Seattle Children’s. Read about new immunotherapies under way for type 1 diabetes.

     

Symptoms of Diabetes

With both types of diabetes, you may not know that anything is wrong at first. The symptoms may take a long time to show up. Type 1 diabetes develops when nearly all the cells that make insulin are destroyed. A child with either type of diabetes may:

  • Pee (urinate) a lot
  • Be very thirsty
  • Feel tired
  • Lose weight
  • Feel very hungry
  • Have trouble seeing
  • Possibly start wetting the bed

Some kids with type 2 diabetes show changes in their skin. Their skin may be darker or have dry patches on their neck, under their arms or in the groin area. This is called acanthosis nigricans (ah-can-THO-sis nig-reh-CANZ).

Diagnosing Diabetes

If doctors think your child may have diabetes, they will test your child’s blood sugar levels. They may also check your child’s blood or pee (urine) for ketones. These are chemicals that form if your child’s body breaks down fat for energy.

Even if your child does not have symptoms, doctors may check their blood sugar if they have risk factors such as being very overweight.

Treating Diabetes

The goal of treatment is to keep blood sugars at a healthy level. Insulin is part of treatment for all kids with type 1 diabetes and for some with type 2 diabetes. Following a healthy diet and getting exercise are important with either type.

We will help you understand the diagnosis and how to give your child or teen the best possible diabetes care at home. When they are first diagnosed with type 1 diabetes, some children stay in the hospital for 2 or 3 days to get care and learn about managing the condition. If your child is at least 5 years old and otherwise healthy, you and your child may learn about type 1 diabetes in a classroom setting. See what to expect and how to prepare for the Living With Diabetes class (PDF).

  • Children and teens with type 1 diabetes need insulin to replace the insulin their body does not make. Kids with type 2 diabetes may need insulin or medicine that helps insulin work better in their bodies. Kids can get insulin from shots or an insulin pump. There is no pill form of insulin.

    Your doctor will tell you what kind of insulin or medicine your child needs. A nurse will show you or your child how to give the shots or use an insulin pump.

  • Your care team will explain how to test your child’s blood sugar levels and how often to do it. Most people test a drop of blood from the tip of their finger. A small handheld machine called a glucose meter will tell how much glucose is in your child’s blood. The machines are also called glucose monitors.

    Keep good records of your child’s blood sugar levels and bring them to check-ups. Your healthcare provider will tell you the blood sugar levels to aim for.

  • Ketones (key-tones) are chemicals that show up in pee (urine), blood or breath when the body breaks down fat for energy. Ketones can build up in your child’s body and make them sick. The body burns fat when there is not enough insulin to allow sugar to be burned for energy.

    Your healthcare team will tell you how to test your child’s ketones and how often to test. Testing tells us if your child is taking enough insulin to turn off ketone production.

    Urine ketone testing is very important. A method for testing ketones must be kept in the home (and taken on trips) at all times.

    Ketones are measured as being negative (our target), small, moderate or large.

    See more information about ketones and what to do if your child is sick and has Type 1 Diabetes (PDF).

  • A dietitian (die-uh-tish-uhn) will help work out a meal plan for your child. Your healthcare team will tell you how strict your child’s diet needs to be.

    When your child eats, their body turns food into a type of sugar called glucose (glue-kohs). Blood glucose (or blood sugar) levels go up. Your child can prevent a sharp, unhealthy rise in blood sugar at mealtime by taking insulin if needed before meals and by eating healthy foods. If your child’s blood sugar drops too low, they may need some quick sugar in the form of juice or candy.

  • Being active is good for a child with diabetes. It helps your child’s cells take in glucose. This lowers the blood sugar levels in their body. Talk to your care team about an exercise plan that will be fun for your child, such as walking, soccer or swimming. Check with your doctor before your child makes a big change in exercise habits or starts a new sport.

    When your child exercises or goes on an outing, first check their blood sugar. If your child takes insulin, bring a bag packed with:

    • A water bottle
    • Glucose tablets, hard candy or juice for emergency low blood sugar
    • A healthy snack such as crackers and cheese or a sandwich
    • Supplies needed to check blood sugar
  • Regular checkups with the healthcare team will help keep your child healthy and find any problems early. High blood sugar levels can damage your child’s eyesight, kidneys, heart and nerves. Diabetes increases the chance of high blood pressure or high levels of fats in your child’s blood. We keep a careful watch to prevent problems.

    See details on home care for Type 1 Diabetes (PDF), such as what to do when your child is sick.

  • As your child gets older, we help them get ready to manage diabetes without relying on their parents. Our step-by-step plan helps teens make the change to an adult healthcare provider at their own pace.

    We have teamed up with UW Medicine to create the Adolescent and Young Adult Diabetes Transition Clinic. Teens get help dealing with insurance, making appointments, managing supplies and finding support at school or in the community. The team includes doctors (both adult and pediatric endocrinologists), a psychologist, a nurse educator, a dietitian and a social worker. Patients also have the option to take part in research studies.

Contact Us

If you would like a referral to our Endocrinology and Diabetes Program, talk to your primary care provider. If you have any questions or already have a referral, please contact us at 206-987-2640 for an appointment.

Providers, see how to refer a patient.