Diabetes is a metabolic disorder or disease in which the blood sugar levels remain high for a longer duration of time. Either insufficient production of insulin by the pancreas or even where there is sufficient production of insulin the body is unable to properly respond to it is the incidence of diabetes. Pancreas are long and flat glands in the belly which produce insulin.
Type I diabetes in children
Kids and children are generally affected by type I diabetes which is called juvenile diabetes. Insufficient production of insulin by the pancreas in kids make them juvenile diabetics. Insulin is the hormone vital for converting the sugar in the blood into energy required by the body (1). The metabolism of carbohydrates, fats and proteins consumed by a person is regulated by insulin which promotes the absorption of glucose from the blood.
Type 2 diabetes in children
In recent times children are also known to be affected by tyope 2 diabetes also as in the case of adults. The primary reason for such diabetic conditions is due to obesity and other environmental conditions. The real cause of diabetes in kids may not be ascertainable. It may be due to genetic factors or due to the environment (2). As the kid grows, the immune system also develops. In the normal course of its function, the immune system destroys the harmful bacteria. While doing so inadvertently the islet, which are insulin producing cells, in the pancreas are also destroyed to some extent. This eventually leads to insulin resistance in the child and the disorder called juvenile diabetes surfaces(3).
Symptoms of Juvenile Diabetes
Much of the symptoms of juvenile diabetes are similar to the symptoms experienced by adult diabetics. The precise symptoms in a juvenile diabetic are:
- The breath of the child smells sweet. This is due to insufficient conversion of sugar leading to burning of fat which emanates some substances like ketones producing the sweat smell.
- Increase in the frequency of urination and heavy nappies or bed wetting in babies (4). If the child which is trained to use toilets experience bed wetting then it is presumed to have been affected by the disorder.
- Irritation while urinating or otherwise. This may be evidenced by erratic moods exhibited by the child or when it is observed that the child is not active as usual (5). Irritation may be due to yeast infection of the genital area or may be due to diaper rashes also.
- Unabated thirst even after taking liquids frequently. When the excess sugar in the blood squeezes liquid from the tissues the child becomes thirsty.
- Fatigue and weight reduction (6).
- Increased hunger even after eating. When the excess sugar is not converted into energy due to insulin resistance developed, there is lack of energy required by the tissues and muscles. To compensate this phenomena, the child gets repeatedly hungry (7).
- Blurred vision. Higher level of sugar in the child’s blood could drain the fluid from the lenses on account of which the vision gets blurred (8).
- Lack of concentration is also a symptom if the child is not otherwise playful.
If the child is affected by type 2 diabetes other symptoms like itching of the skin, slow healing of cuts and wounds, obesity, family history of type2 diabetics etc. In other words almost all the symptoms experienced by an adult diabetic are bound to appear in the child also.
Normally type 2 diabetes affect children who are obese or with a family history.
While the causes and symptoms of diabetes in kids resemble that of an adult mostly, diagnosis of the same is very important. If a kid is affected by diabetes it poses a number of issues relating to the health as no classic symptom may be evident making diagnosis difficult. Unlike adults it is difficult to adopt any therapeutic regimen that may be appropriate. It is essential to prevent hypoglycemia in the kid affected by diabetes, as it has the potential to impact brain development. Hence diagnosis of the disorder based on the symptoms or causes is of paramount importance. For example a child taking frequent drinks and passing out urine frequently alone need not be construed as symptoms of diabetics. A comprehensive diagnosis module is needed to confirm the disorder in the child taking a holistic view of all the causes and symptoms. Moreover even at the stage of diagnosis it may be difficult to handle the child due to behavioral problems.
Treatment of Juvenile diabetes
Once diagnosed that the kid has juvenile diabetes or type 2 diabetes, the treatment involves both psychological and physiological factors. More than the child, parents are required to provide counselling to the child in order to make it realize the problem in addition to regularly preparing the child to adopt to the alternate diet pattern (9). Due to the younger age the child may not be able to comprehend the problem. It is here that the parent has to be patient in making the child to adjust to the situation.
Some of the important points to be remembered in treating a child are basically in the consultation process. Close monitoring of the diet pattern of the child and ensuring that the intake do not increase the sugar in the child is the first important thing. At this stage it is essential to softly handle the child as it may be adamant in eating or drinking certain foods and beverages that may be detrimental to its health.
If the disorder is due to genetic factors or due to family history nothing much can be done about preventing it rather than treating the issue. But if it is diagnosed that the same is due to environmental factor preventive measures can be taken.
The general feeling that diabetics cannot be prevented may be true if genetic factor is involved. But diabetics caused due to life style habits or environmental factors can be by and large prevented more particularly in kids.
Some such preventive measures are:
- If the child is suspected to be affected by type 1 diabetes, tests must be conducted to find out antibodies in the child in order to undertake relevant treatment. Even though there appear to be no treatment to cure antibodies steps can be taken to ensure reducing the destruction of islet cells (10).
- The child need to be protected from the attack of viruses by boosting the performance of the immune system. Some viruses are capable of destructing the islet cells in the pancreas which are responsible in secreting insulin.
- Substituting cow’s milk for breast milk at a too early stage is considered to be an important factor contributing to type 1 diabetes in kids. Hence mothers should try to breast feed the child as long as possible in order to prevent the disorder in addition to enhancing the overall immunity of the child. Like introduction of bottle milk, introduction of cereals also play an important role in increasing the sugar level in the child. Gradual introduction of milk or cereals before totally stopping breast milk can solve much of the problems.
If it is confirmed by appropriate diagnosis that the child is suffering from type 1 or type 2 diabetes. It is necessary to introduce treatment options.
Any treatment for both types of diabetes in a child must be based on diagnosis. Both types require measures to increase the insulin secretion by the pancreas. Including substitutes for breast milk must take into account whether such intakes are capable of spiking the blood sugar level of the child. If yes, the diet options must be changed without affecting the consumption of other nutrients by the kid.
If the management of diabetes in the child require hospitalization care must be taken to keep the child in the clinic for a minimum number of days only in order to protect the child from psychological problems. Even during these few days of hospitalization periodical checking and observations as frequently as may be needed or possible is important to monitor the development and progress.
If no hospitalization is recommended then the parents must follow meticulously the diet pattern, medications and observations prescribed by the doctor.
In case there is requirement of dosages of insulin to be administered extra care is essential in injecting insulin into the body of the child. Since presently there are no oral insulin supplement, dependence is only an injection. As the patient is a child, complications that may arise while piercing the body with a needle need to be borne in mind. Similarly the time intervals specified between successive injections have to be strictly followed (11). Toddlers and babies may be given very smaller doses of insulin in comparison with young adults or adults.
Having followed the procedures prescribed at the post hospitalization stage further consultations with the doctor periodically will quicken the process of stabilization of the blood sugar levels. If periodical insulin injections are advised by the doctor withdrawing the injection must also be done with proper consultation only.
With all the precautionary measures and treatment given the kid may continue to exhibit the symptoms if its daily activities are not closely observed (12). Till such time the child is able to understand the disorder it has, it is the parents who have to be careful in taking extra care in providing the conducive environment.