Children
and Diabetes
Diabetes
is a global epidemic, and children are not spared
from it. Diabetes is one of the most common chronic
diseases of childhood. It can strike children at any
age, and type 1 diabetes has been found to be prevalent
in pre-school children at an alarming scale. This
is due to the fact that the condition is often diagnosed
late, or is misdiagnosed completely.
In many
developing countries around the world, insulin, the
main life-saver for diabetic children, is either not
available or not accessible. Another crucial factor
is the lack of knowledge in recognising the signs
and symptoms of this dreadful illness amongst family
members and healthcare practitioners
Throughout
the world, incidences of diabetes are on the rise,
and consequently so is diabetes amongst children.
Most children are affected by type 1 diabetes, although
the number of children and young adults affected by
type 2 diabetes is beginning to rise, particularly
in America. Approximately 90 per cent of young people
with diabetes suffer from type 1 and the number of
patients who are children varies from place to place.
A figure of 17 per 100,000 children developing diabetes
each year has been reported. As metabolic syndrome,
obesity and bad diets spread, so too have the first
incidences of type 2 diabetes, previously incredibly
rare.
How is
diabetes caused in children?
The actual
causes of the diabetic condition are little understood,
in both children and adults. It is widely speculated
that diabetes occurred when inherited genetic characteristics
are triggered by environmental factors such as diet
or exercise. Many type 1 diabetic children do not
have diabetes in their families however, so the exact
cause remains a mystery.
Type 2 diabetes amongst children is usually caused
by an extremely bad diet from a very young age, coupled
with a sedentary lifestyle without exercise.
What symptoms
do children with diabetes exhibit?
Like adults,
a number of symptoms may give early warning that diabetes
has developed. One or more of the following symptoms
may be associated with diabetes: Thirst, tiredness,
weight loss, frequent urination. Amongst children,
specific symptoms may include stomach aches, headaches
and behavioural problems. Recurrent tummy pains and
an unexplainable history of illness should be treated
as possible heralds of diabetes.
How are
children with diabetes treated?
After diagnosis,
a child will usually be referred to a regional diabetes
specialist. Most children with diabetes are cared
for by their hospital as opposed to their GP. Because
type 1 typically means that the vast majority of islet
cells have been destroyed and insufficient or zero
insulin can be produced, the only certain method of
treating diabetes in children is insulin treatment.
Usually a diabetes care team will plan an insulin
regimen suited to individual requirements and habits
of the child.
Fast-acting
insulin will generally be administered during the
day, and nocturnal levels will be controlled by a
slow-acting dose. Insulin pumps are also common amongst
children. Sometimes, in the initial period following
diagnosis, small children will only need a very small
dose of insulin, but this will unfortunately change
as they grow older and larger. Good glucose control
is essential in the management of all diabetics’
conditions.
Treating
type 2 diabetes in children depends entirely on how
far their condition has developed. At an early stage,
it may be possible to treat the condition with an
abrupt lifestyle change incorporating a healthier
diet and exercise.
What can
the parents of children with diabetes do?
Keeping
a strict eye on the blood glucose levels of your child,
avoiding lows and highs, can be a large part of being
a parent of a child with diabetes. Parents must be
aware that children with diabetes have diet restrictions,
and that their activity levels need to be closely
monitored. Initially, and throughout the lifetime
of the disease, diabetes can be a serious strain.
Patients and their families alike should know that
support is available.
Initially,
the procedure for management and treatment of the
disease can seem very complicated. Understanding how
the disease affects your child, being adaptable and
patient, are essential to successfully managing diabetes.
Some things
to bear in mind include:
You may
have to deliver insulin injections at first, and even
if you do not need to then you should know how to.
There are two major delivery sites, above the abdomen
and in the thigh, but your healthcare team will elaborate.
You should
become familiar with the symptoms of low blood glucose,
and also diabetic acidosis. As well as recognising
these conditions, you should know what to do if they
occur.
Monitor
your child’s blood sugar levels, and as soon
as they are old enough teach them how to do this.
Similarly, as children become older they need to learn
how to administer their own insulin injections.
Make sure
that people know your son or daughter is diabetic,
and that they also know what to do if the symptoms
of low blood glucose manifest themselves.
Ensure
that glucose is always available.
What sort
of diet should children with diabetes eat?
Diabetics
can eat exactly the same food as normal people: it
is a myth that they can only eat food with no sugar
for instance. However, diet is an extremely important
consideration for any diabetic, particularly young
diabetics. A dietician will be able to advise you
further, but it is certainly essential that your child
has a balanced and healthy diet, high in complex carbohydrates
and fibre.
Although
you will have to build your family meals around your
diabetic relation, there is no reason why this has
to be a problem. A healthy diet benefits anyone. The
quantities of food that your child can enjoy depend
entirely on his or her size and age, and will be established
by the dietician and parents.
It is up
to both you and your child to understand how their
body copes with different foods, avoiding the ones
that are negative. It is necessary to be careful with
sweet food, but it need not be 100 per cent off the
menu.
What kind
of exercise should children with diabetes do?
Exercise
is the second major factor in controlling type 2 diabetes,
and it is incredibly important for all children suffering
from diabetes. Recommendations stand that children
with diabetes should try to exercise every day. However,
parents should be aware that physical activity lowers
blood sugar levels.
It may
be necessary for your child to reduce their dose of
insulin, as in conjunction with exercise it can significantly
lower blood sugar levels and result in hypos. When
carrying out physical exercise your child should be
near sugar. Physical activity also governs how much
your child can eat.
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