Confronting childhood diabetes

Diabetes in children poses unique challenges for parents, requiring a multifaceted approach to management. Understanding the types, causes, symptoms, and treatment options is crucial.

Common Types of Diabetes in Children

1. Type 1 Diabetes: The immune system destroys insulin-producing cells which ultimately leads to complete insulin deficiency

2. Type 2 Diabetes: Marked by variable combinations of insulin resistance and insulin deficiency. It is commonly associated with obesity and a sedentary lifestyle.

3. Maturity Onset Diabetes of the Young (MODY): This is a genetic form

Other rare types of diabetes include:

• Drug or chemical-induced diabetes: eg steroid-induced

• Diseases of the exocrine pancreas - eg cystic fibrosis

• Infections – eg congenital rubella

• Genetic defects of insulin action

• Neonatal diabetes

• Genetic syndromes with diabetes- eg Downs syndrome, Turner syndrome, Klinefelter syndrome

Symptoms

Each type manifests itself through a different set of symptoms:

1. Type 1 Diabetes Mellitus- Most children with Type 1 diabetes present with a history of polyuria (Excessive urination volume) polydipsia- (excessive thirst), polyphagia (extreme, insatiable hunger) and weight loss for several weeks, with hyperglycemia (high blood sugar or high blood glucose, ) glycosuria (the presence of reducing sugars in the urine). About 30–60% present with moderate to severe DKA (Diabetic ketoacidosis), a serious diabetes complication when there isn't enough insulin in the body. Younger children are more likely to present with DKA and nocturnal enuresis (involuntary urination at night)

2. Type 2 Diabetes Mellitus- It is more common in overweight adolescents, with signs of insulin resistance such as acanthosis nigricans. They are usually detected on a medical checkup.

Managing Diabetes

Children with diabetes must have their condition managed with a mix of medicine, lifestyle changes, and close observation. It is significant to remember that the particular treatment plan may change depending on the patient's unique circumstances and the type of diabetes (Type 1 or Type 2).

Frequent Medical Checkups: Seeing a doctor on a regular basis is crucial for keeping an eye on a child's general health, modifying treatment programmes, looking for complications, and resolving any issues.

Insulin Therapy: Since the body cannot create insulin on its own, insulin is necessary for children with Type 1 diabetes. The use of an Insulin pump or several daily injections are possible forms of insulin therapy. The medical team treating the kid will determine the best course of action for the dosage and kind of insulin, which may differ from child to child.

Blood Glucose Monitoring: In order to effectively manage diabetes, blood glucose levels must be regularly checked. This is taking your blood sugar several times a day, usually before meals and before going to bed. Blood sugar levels can be monitored in real-time with the use of continuous glucose monitoring (CGM) devices.

Dietary Management: A balanced meal plan works like magic. Avoiding processed foods, including more fruits, vegetables, whole grains, lean proteins, healthy fats and regular water intake are the dietary recommendations for children with diabetes.

Physical Activity: Encouraging regular physical activity is important for overall health and can help control blood sugar levels and maintain a healthy weight.

Prevention

• Although there is no single dependable way to prevent diabetes, parents can lower their child's chance of developing the disease by adopting a number of healthy lifestyle choices, particularly for Type 2 diabetes.

• A balanced and nutritious diet

• Limiting the intake of sugary snacks, processed foods, and sugary beverages

• Controlling body weight for their age and height.

• Regular physical activity

• Ensuring adequate and quality sleep

The well-being of children with diabetes is largely dependent on early detection, efficient treatment, and an emphasis on leading a healthy lifestyle. Parents can enable their children to manage their diabetes and thrive despite its obstacles by creating a supportive atmosphere and remaining informed.

Dr Vipin V P is a Consultant in endocrinology, at Aster Medcity Kochi