Hindsight : A look into the onset of Diabetes in a child

Recently, my youngest son had serious health issues — probably near death by the time we got him to the ER.  He was in such bad shape the ER just focused on stabilizing him so he could be life-flighted to a children’s hospital (about an hour away by helicopter).  The ER staff were great, and the children’s hospital staff were great — they determined that our son (at 8 years old) had Diabetic Ketoacidosis that accompanied the onset of type 1 diabetes.  There is no one in our families with either type 1 or type 2 forms — but it turns out to be an autoimmune issue, and so the other autoimmune issues in our families were pertinent.

Starting to Think It Over

Over the last week or so, I’ve been thinking back about all the symptoms we rationalized away.  Diabetes wasn’t even on our radar.. and even when we were taking him into the ER we were thinking more benign things like mono, heat exhaustion, walking pneumonia or the flu.

Also over the last week or so, I’ve been thinking about the frustration with the current state of pediatrics.  Our son had just had a well child checkup 10 days earlier, and a simple test that costs less than $5 would have alerted the doctors to look deeper into his health and prevented a near-death experience.  It turns out that many people in the diabetes community we’ve already hooked up with had experiences where doctors were oblivious to the condition — despite the fact that 1% of Americans have it. I know this is frustration speaking, but it seems the American Academy of Pediatrics is more focused on guns than on actually helping kids who have health issues.  Why they aren’t advocating for better practices for something that is easily preventable (at least preventing near-death events) is beyond me.

So, I’ve had it on my heart to write this post — in the hopes that it finds someone with a child (it can happen to infants, so don’t use age as a way to filter out your concern!) that needs some help, and isn’t getting it.  If you would like  a more personal account, I suggest you read my wife’s account of the events.

Diabetes Symptoms that were Manifest

I’m going to list the different symptoms our youngest son had over the last 6 months or so, and in parenthesis what we used to explain them away:

  1. Sunken eyes/shiners ( allergies run in our family, so maybe allergies, or maybe not enough sleep)
  2. Trouble sleeping (this was especially in the last month or so — we just figured he was troubled emotionally about something)
  3. Cold, but no fever (we thought this was part of heat exhaustion since he’d been outside in the heat a lot the week prior)
  4. Not as engaging, more distance (we thought that was part of adolescence)
  5. Food not tasting good – even food he usually liked (we thought that was pickiness and being stuck in a rut).
  6. Lots of urination (we thought this was only when he was bored — since he could play computer games and forget to go)
  7. Funny smell on his breath (something he ate)
  8. Less energy, and more tired (allergies or sickness)
  9. Slow healing — scratches would take weeks to heal.
  10. In the last week before coming down with DKA:
    1. One occurrence of rapid breathing and vomiting in the middle of the night (we thought it was being sick and would get better — in hindsight this breathing was a very strong predictor)
    2. Light and sound sensitivity (this is something we have in our family, and especially when sick).

Understanding the Symptoms of Diabetes (a lay person’s view)

Sometimes our minds are our enemies — we rationalize warning signs away because most of the time they aren’t that critical and life-threatening.  But I want to encourage you, if you are wondering about a slew of symptoms with your child, look into it. Here’s how the DKA / Diabetes worked in our child — where type 1 diabetes is where the body stops making insulin which is the transport mechanism of sugar from the blood stream to the inside of the cells:

  1. Sunken eyes and trouble sleeping are common symptoms associated with diabetes (not sure why off the top of my head)
  2. Being cold (without fever) also now makes sense — his cells weren’t getting enough energy, so he couldn’t produce enough heat.  And 6 months ago, it was common for us to joke of him as our family furnace — now that he’s on insulin, he’s back to being the furnace.
  3. Being more distant and light/sound sensitivity are because the nervous system runs on carbs (according to the nutrionist that we talked to at the children’s hospital), and his body is consuming fat/protein to provide him with energy.
  4. The funny smell on his breath and food not tasting good are associated — a diabetic without treatment will have a fruity smell which is because in order to get energy, fat is burned with saturates the body with ketones and the breath develops an acetone-like smell.  Which also messes with the taste of food – everything tastes off for the young patient.  (On insulin, our youngest loves eating again, everything tastes much better).
  5. Frequent urination is explained by the fact that the ketones are acidic in nature, and the body is trying to get rid of the acid in the blood stream.
  6. Less energy and slow healing have to do with not having easily usable energy (carbs/sugars) available to the cells, and only able to rely on energy from fats and proteins.
  7. The rapid breathing and vomiting are the critical state — if you’ve reached this state with the child, this is very dangerous — take your child to the ER immediately (and don’t waste time at an Urgent Care like we did).  The DKA breathing is the body’s attempt to breath out CO2 (which is acidic), and the gasping is not something the child has much control over.  The throwing up is also the body’s futile attempt at getting rid of acid.

Take Charge of Your Child’s Health

Here’s an easy way to gauge the risk of diabetes with your child.  This is useful because checking for diabetes is not part of most well child checkups:

  1. For about $10, you can buy a batch of ketone strips (if bought at the local pharmacy, but if you are willing to buy a larger quantity, Amazon may make sense).
  2. About once a month, have your child pee into a cup.
  3. Use the ketone strip according to instructions (for example the one I liked to above: dip the strip in the urine, quickly remove, wait 15 seconds, then compare to the chart).
  4. If the ketones are more than minimal on the scale, then you should take your child the pediatrician and mention that ketones are present.  Unless your child is in a low-carb diet, ketones really shouldn’t be present.

My hope is writing this will help at least one person catch the onset of diabetes before an ER visit is needed.  If you are that person — please let me know!

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