DIABETES IN CHILDREN

New Delhi, November 13, 2018 :

Diabetes mellitus is a very serious metabolic disor­der that hinders with the normal breakdown of sugars (carbohydrates) by the body. It can potentially damage the heart, blood vessels, kidneys, and neuro­logical system and can cause a progressive loss of vision over many years.

WHAT ARE THE FORMS OF DIABETES?

The two most common forms of diabetes are called type 1 and type 2 diabetes. Both forms can occur at any age, but children are more prone to develop type 1 diabetes.

Type 1 Diabetes: Type 1 diabetes is caused by insufficient production of the insulin hormone by the pancreas. In this condition, the body is unable to properly metabolize sug­ar that builds up in the bloodstream. Hence, these sugars (also called glucose) are excreted in the urine as they cannot be used by the body. While type 1 diabetes can begin at any age, there are peak periods at about ages five to six and then again at ages eleven to thir­teen.

Type 2 Diabetes: In type 2 diabetes, the body either resists the effects of insulin or doesn’t produce enough insulin to maintain a normal glucose level. Even though it is more common in adults, type 2 diabetes are now been seen in children as well due to increase in obesity. As with adults, the cause of childhood diabetes is not understood. It probably involves a combination of genes and environmental triggers.

WHAT ARE THE SYMPTOMS OF DIABETES IN CHILDREN?

Many children and young people are not diagnosed with Type 1 diabetes until they develop diabetic ketoacidosis(DKA), a life-threatening condition that requires urgent medical attention. Symptoms that are more typical for children include:

• Tiredness
• Headaches
• Increased thirst
• Increased appetite
• Behaviour problems
• Pains in the abdominal
• Unexplained weight loss
• Urinating more often, especially at night
• Itching around the genitals due to yeast infection

Symptoms of type 1 diabetes in children tend to develop rapidly over a period of a few weeks. Type 2 diabetes symptoms develop more slowly and may go undiagnosed for months or years.

WHAT ARE THE 4 TS?

1. Toilet – Needing to visit the toilet more often than usual, going during the night when you usually don’t or having very short breaks is one of the main symptoms of type 1 diabetes. Frequent bedwetting can also indicate a sign of diabetes.
2. Thirsty – Some signs of unusual thirst may include:

• Regularly getting up to drink during the night
• Drinking a full glass or bottle of liquid and still being very thirsty
• Having only gaps between bouts of thirst
• Being really thirsty and not being able to quench the thirst.

        3.Tired – When the body lacks insulin, the cells of the body cannot take the glucose from the blood for energy which can leave the body tired and unnourished.

     4.Thinner – A lack of insulin means the body cannot get enough glucose from the blood into cells and so the body starts to break down fat and muscle into ketones to use as an alternative source of energy. And hence, person have diabetes may see signs of exaggerated and/or unexplained loss of body weight.

HOW IS DIABETES TREATED IN CHILDREN?

Insulin treatment is required to treat most of the children suffering from diabetes. Often in the first year after diagnosis, your child may need only a small dose of insulin. This is referred to as ‘the honeymoon period’. Very small children normally don’t need an injection at night, but will need one as they grow older.

WHAT ARE THE PRECAUTIONARY MEASURES?

It is believed that type 1 diabetes is hereditary and cannot be prevented. However, there are certain steps that a child can take to reduce the likelihood of developing type 2 diabetes:

• Maintaining a healthy weight: Overweight children are at risk of developing type 2 diabetes as their body is more likely to have insulin resistance.
• Staying active:  Keeping a physically active lifestyle helps to reduce the insulin resistance and also keeps the blood pressure in control.
• Limit sugary food and drinks: Consuming lots of foods that are high in sugar can lead to weight gain which can prove serious for the insulin level. Eating a balanced, nutrient-rich diet, with plenty of vitamins and fibre will help to lower the risk of type 2 diabetes.

WHAT ARE THE ROLES OF PARENTS?

Although there is no cure for diabetes, children with this disease can lead a nearly normal childhood and adolescence if their disorder is kept under control. Parents should carefully monitor the intake of insulin as too much insulin in their blood can result inrapid heartbeat, nausea, fatigue, weakness, and even loss of consciousness. On the other hand, too little insulin can lead to weight loss, increased urination, thirst, and appetite. Developing good diabetes management habits when a child is young can have a dramatic impact on their management habits as they get older and can help to tackle the long term damage

Advisory by Dr. Nidhi Malhotra, Senior Consultant and Coordinator, Endocrinology, Jaypee Hospital, Noida