Understanding Your Blood Sugar: What Happens When Insulin Stops Working Right

When your body can't properly manage blood sugar levels, it creates a cascade of symptoms that can be serious if left untreated. Diabetes occurs when the pancreas doesn't produce enough insulin or when cells stop responding to insulin properly, causing glucose to build up in the bloodstream instead of entering cells for energy.

What Are the Different Types of Diabetes in Children?

Understanding the various forms of diabetes helps families recognize which type might affect their child. Type 1 diabetes is the most common form in children, accounting for about two-thirds of all pediatric diabetes cases and affecting 1 in 450 children by age 19. In this condition, the pancreas produces little or no insulin at all.

Type 2 diabetes works differently—the pancreas can still make insulin, but the body's cells don't respond adequately to it, a condition called insulin resistance. This creates what doctors call a "relative insulin deficiency" because the pancreas simply can't produce enough insulin to overcome the resistance.

Prediabetes represents a middle ground where blood glucose levels are too high to be normal but not quite high enough for a diabetes diagnosis. Among children, this condition is more common in adolescents with obesity and may be temporary in some cases, though others will develop full diabetes, especially if they continue gaining weight.

How Do Doctors Diagnose Diabetes?

The diagnostic process involves multiple tests to confirm both the presence and type of diabetes. Doctors typically start with blood glucose measurements, either fasting (before eating) or random (regardless of meals). Children are considered to have diabetes if they show symptoms and have a fasting glucose level of 126 mg/dL or higher, or a random glucose level of 200 mg/dL or higher.

The hemoglobin A1C (HbA1C) test provides a longer-term view of blood sugar control. This protein forms when glucose attaches to hemoglobin in red blood cells over time, reflecting average blood glucose levels over a 2- to 3-month period. An HbA1C level of 6.5% or higher indicates diabetes.

Screening recommendations vary by risk factors:

• Family History: Children with siblings or parents who have type 1 diabetes may receive screening for the disease
• Weight and Risk Factors: Overweight children with additional risk factors like family history of type 2 diabetes, maternal gestational diabetes, high blood pressure, abnormal cholesterol levels, polycystic ovary syndrome, or low birth weight are screened starting at age 10
• Oral Glucose Tolerance Test: This may be used for children without symptoms or with mild, atypical symptoms to provide additional diagnostic clarity

What Symptoms Should Parents Watch For?

The classic symptoms of diabetes stem directly from how high blood sugar affects the body. When glucose builds up in the blood, it eventually spills into the urine, pulling extra water with it. This creates the hallmark signs of excessive urination (polyuria) and increased thirst (polydipsia) as the body tries to replace lost fluids.

Many children experience excessive thirst and urination as their first noticeable symptoms, though others may have vaguer signs like fatigue. Some children show no initial symptoms at all, making regular screening important for at-risk groups. In serious cases, the first sign of diabetes might be a dangerous complication like diabetic ketoacidosis, which occurs when the body breaks down fats and proteins for energy in the absence of usable insulin.

Blood glucose levels normally stay within a narrow range of about 70 to 110 mg/dL in healthy people, rising after meals and returning to pre-meal levels within about two hours. When this delicate balance breaks down due to insufficient or ineffective insulin, the resulting high glucose levels trigger the body's attempt to eliminate excess sugar through increased urination, creating the cycle of symptoms that often leads to diagnosis.