Type 1 Diabetes and Children

Whan a person has diabetes, the doctor will order blood and urine tests on a regular basis.  The results of these tests will be used along with the daily blood glucose records to change the care plan if needed. These tests are as followed:

• Glycohemoglobin or Hemoglobin A1c
• Thyroid hormones
• Cholesterol
• Urine Microalbumin

Hemoglobin A1c

This test is used to measure the amount of sugar on the hemoglobin portion of the red blood cell.  Red blood cells live 3 to 4 months.  The body is constantly making new red blood cells and destroying old ones. By measuring the suar attached to the red blood cell, one can estimate the average blood sugar of a person for the past 3 to 4 months. This makes it necessary to check these levels every 3 to 4 months.

Many scientists believe that, in addition to red blood cells, other body proteins, such as cells found in the eye, kidney, blood vessels, and nerves may also be sugar coated.  A research study called the Diabetes Control and Complications Trial, showed that people with near normal hemoglobin A1c levels had much fewer complications from diabetes. 

Check with your local hospital about Hemglobin A1c levels.  Different machines have different ranges for normal A1c levels.

Thyroid Hormones

Hypothyroidism means that thyroid hormone levels are too low.  Children with hypothyroidism may not grow as much as they should.  They may also have other medical problems. When a child has hyperthyroidism, his or her blood sugar levels can go up and down too much.  Hypothyroidism is common in people in general.  It is even more common in people with diabetes.  Of people with diabetes, 1 in 10 will have hypothyroidism in his or her lifetime.

Hyperthyroidism means that the thyroid hormone levels are too high.  Hyperthyroidism is not as common as hypothyroidism.  However, children with diabetes are more likely to have hyperthyroidism than other children.

Thyroid Hormone Tests:

There are two types of Thyroid Hormone Testing, T4 and TSH.

T4 is one of the thyroid hormones.  It is also called thyroxin. If the result of this test is low, it could mean that someone has hypothyroidism. If the T4 level is high, it could mean he or she has hyperthyroidism.

TSH stands for thyroid stimulating hormone. this hormone comes from the pituitary gland and controls the thyroid gland. TSH levels are usually low,  If the result of the TSH is high, it means that the body is trying to make the thyroid gland work harder. This means that the thyroid gland is not producing enough thyroid hormone. A child with a high TSH result may have hypothyroidism. Wehn a child has hyperthyroidism the TSH results are usually very low.

These tests will be preformed more often if the results are not normal or if there are signs of hypothyroidism. If someone has hypothyroidism, it is easy to treat with a daily thyroid pill.

Cholesterol Tests

The cholesterol tests tell how well the body is using fat. If the cholesterol test result is high, there is too much fat in the blood stream. Some of this fat can build up in the lining of the blood vessels.  Fat deposits make it harder for blood to flow. This is called hardening of the arteries, or antherosclerosis. Insulin controls how the body uses fat.  Beacause of this, children with diabetes are more likely to have high cholesterol test results. 

For children and teens, a recommeded cholesterol level is less than 180.  If someones cholesterol is more than 180, your physicain should work with you to lower it.  For children with diabetes, your endocrinologist my suggest changing the care plan, including the meal plan, insulin doses, and exercise plan.

Cholesterol tests are usually ordered once a year, but more tests may be needed if the result is high. 

Microalbumin Urine Test

The microalbumin urine test is a test that screens for kidney disease.  The word micro means small and the word albumin means protein, so this test measures small amounts of protein in the urine.  This test will be performed yearly at a clinic visit.  This test uses the same machine used to conduct the hemoglobin A1c test.  If the results of this test are not normal, it does NOT mean that the child has kidney disease. It just means that further testing is needed.  A 24 urine collection for microalbumin will be ordered.  If the second one is high, the child will be treated for microalbumin. 

The normal kidney does not spill very much protein.  When there has been damage to the kidney, albumin (protein) can be found in the urine.  Kidney damage can occur after years of high blood sugar levels.  Careful control of blood sugar levels and the use of medicines at this stage can delay serious kidney problems.