A basic difference between juvenile diabetes and adult diabetes lies in the insulin situation. In juvenile diabetes there is a complete deficiency of insulin. This entails that the pancreas doesn’t produce even the minimal of insulin necessary for mere survival. Hence, the insulin balance could merely be brought to normal by compensating the deficit via insulin injections.
With a couple of possible exceptions, all juvenile or insulin-deficient diabetics require insulin injections for them to live. On the other hand, a lot of adult diabetics can handle their disease on diet alone.
In juvenile diabetes, boys and girls are evenly susceptible. Obesity isn’t a factor, like in adult diabetes. Instead, the juvenile patient is generally underweight when the disease strikes; he is also many times taller than average.
In children, the onset of juvenile diabetes often appears very sudden. In fact, it may not be as sudden as it seems. The disease could have been growing at a slower, undetected rate, when, as is so frequent among children, mumps, chickenpox, measles, or one of the other ailments of childhood steps in. Then, as a consequence of this other ailment, the diabetes bursts out dramatically, seeming to come out of nowhere.
In children and adolescents particularly, juvenile diabetes is quite unstable. The patient’s need for various insulin dosages shifts erratically as his blood-sugar levels undergo broad fluctuations. This is due to the fact that the requirements of growth impose a need for always increasing calorie intake and for more carbohydrates.
Children are likewise more expected than adults to subject their bodies to greater extremes of physical activity— having more violent bursts of exertion on the one hand and longer duration of sleep on the other.
The diabetic child requires insulin injections from the outset of the disease, and the dosage normally increases more and more as the child grows older. When adulthood is achieved, the dose gets rather stable.
There is one more crucial characteristic of juvenile diabetes—a clear-cut sensitivity to insulin. The juvenile or insulin-deficient diabetic reacts very sharply to its absence or presence. Too little insulin may produce an abrupt rise in blood-sugar. Slightly too much insulin should result in too quick a drop in blood-sugar and induce an insulin reaction.