Monday 06 / May / 2024
Crystal (name changed), an 8- year-old girl frequently complained of tiredness after coming back from school or after playing even for a short while. She would often doze off to sleep for hours and feel sluggish and weak on waking up. Crystal’s mother often complained about her frequent moodswings and this continued for a while till Crystal had a fall in school. It was a minor cut on her knees which did not heal for weeks.
A blood test detected her of having Type 1 diabetes, or what we know as juvenile diabetes. Crystal is not the only one. Type 1 diabetes, that is affecting millions of children worldwide, is a lifelong condition found in children but with the right support and proper medical intervention it can be managed.
Highlighting this growing problem Dr Muneer, senior diabetologist at Dr Mohan’s Diabetes Specialties Centre, says that diabetes is a chronic disease that affects almost every system of our body if not well controlled from the time of diagnosis.
“Previously, it was thought children can get only Type 1 diabetes that needs lifelong insulin treatment. But there are other types of diabetes that affects children; starting from newborn baby,” he tells.
As per the International Diabetes Federation statistics, in 2015 overall there were 415 million people have diabetes, which means 10 per cent of world’s population has diabetes. This figure will rise to 642 million in 2040. Alarmingly, almost half of the adults with diabetes are undiagnosed and more than half a million children are suffering from Type 1 diabetes and the percentage of Type 2 diabetes, especially in obese children have also increased tremendously.
Talking about the symptoms of diabtes in children, Dr Muneer tells that a child of 10 years or younger if suddenly starts passing urine frequently, is frequently thirsty, or losing weight, should be immediately investigated to rule out diabetes.
“Sometimes it is mistaken to be a simple urinary tract infection and is treated accordingly but in significant number of cases the child ends up in the hospital with Diabetic Ketoacidosis (DKA) as a first presentation of Type-1 diabetes. Along with earlier symptoms, abdominal pain and vomiting also are key symptoms of DKA,” he tells.
In children, diagnosis of the type of diabetes is very important. If a child is diagnosed to have diabetes before the age of 6 months then it is Type 1 unlikely. It is due to a single gene defect that might be temporary or permanent neonatal diabetes or some other rare genetic syndromes. “Unlike Type 2 diabetes, Type 1 is not inherited from family. It is an autoimmune disease,”
informs the doctor.
Further he tells that many causative factors are responsible for Type 1 diabetes due to its genetic heterogeneity. “The disease initiates in genetically susceptible persons after being triggered by environmental agents. So genetic markers must be present from birth, whereas immune markers develop after the initiation of autoimmunity,” he adds.
Sometime, diabetes is diagnosed in a family without any history of Type 1 but it is 15 times more common in siblings with Type 1 than in general population. “Siblings have an average risk of 6 per cent. In offspring, the risk is 2-3 per cent in case of affected mother and 6-7 per cent in case of affected father,” he adds.
According to World Health Organisation (WHO), Type 1 diabetes (sometimes called insulin-dependent, juvenile or childhood-onset diabetes) occurs when the pancreas do not produce enough insulin, a hormone that regulates blood sugar. The cause is not known, but it is thought to be the result of a combination of genetic and environmental factors. Many countries are documenting higher numbers of newly diagnosed cases of Type 1 diabetes, particularly in younger children. Interestingly, some disease patterns among children resemble infectious disease epidemics.
Type 1 diabetes can affect vital organs of a child’s body including the heart, blood vessels, nerves, eyes, and kidneys and it is important to keep the child’s blood sugar level normal. In the long run if Type 1 diabetes is not controlled then several complications arise which include cardiovascular problems, nerve and kidney damage, retinopathy which can lead to blindness, and other conditions like osteoporosis and skin disorder.
Once diagnosed with Type 1 diabetes, it is mandatory to visit the doctor on a regular basis. A child’s cholesterol levels, thyroid function, liver function and kidney function must be checked periodically. Also it is essential to encourage healthy eating and regular physical activity.
Type 2 diabetes, also called non-insulin-dependent or adult-onset diabetes, occurs when the body cannot effectively use the insulin it produces. Often preventable, it can result from excess body weight and physical inactivity, and sometimes, a genetic predisposition.
Recently, Type 2 diabetes has increasingly been reported in children and adolescents, so much so that in some parts of the world, Type 2 diabetes has become the main type of diabetes in children. The global rise of childhood obesity and physical inactivity is widely believed to play a crucial role. Healthy eating and lifestyle habits are a strong defence against the disease.
Diabetes in children is an important health concern, same like that in adults. To prevent the complications of diabetes, both healthcare providers and parents must work hand in hand to get optimum results. Diabetes-structured education is an essential tool for children along with healthy diet and regular exercise to keep ideal body weight. With right support and medical guidance your child can remain healthy for years to come. —[email protected]
Dr Muneer is a senior diabetologist at Dr Mohan’s Diabetes Specialties Centre, Azaiba, Muscat
Email: [email protected]
