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Jan 28
Diabetes in children
The World Health Organisation (WHO) estimates that there are more than 346 million people worldwide suffering from diabetes. According to International Diabetes Federation (IDF), India tops the list with more than 50 million people with diabetes.

The Juvenile Diabetes Research Foundation (JDRF) states that there are about 10 lakh children with type I diabetes in India. Type II diabetes among children is also on the rise because of an increase in obesity among children. It is high time we understand the burden of this disease and spread awareness among everyone to combat this menace.

Prior to the discovery of insulin, children with diabetes did not live for longer than six months from the onset of symptoms. Thanks to Banting, and his team at the University of Toronto, this amazing discovery has changed the lives of millions of diabetic patients. Diabetic patients these days can lead a reasonably normal life provided they follow their diet plan and insulin regimen.

Diabetes is a condition that causes high sugar in our blood. This happens due to a lack of or resistance to insulin, a hormone required for the transport of glucose to different parts of our body. There are different types of diabetes. Children almost always develop Type I diabetes (juvenile diabetes). However, more recently, because of the obesity epidemic worldwide, Type II diabetes is also on the rise among children.

How do children develop diabetes?

As mentioned earlier, diabetes is characterised by increased levels of glucose in blood. Glucose is a source of energy. Normally, when glucose level in the blood increases (after eating), insulin is secreted for the absorption of glucose into the liver, muscles etc. Type I diabetes results when our body makes too little/ no insulin. Even though the exact cause for diabetes in children is not clear, an autoimmune mechanism (where parts of the pancreas (islets) which make insulin are destroyed by the body's own immune system) is proposed. Some environmental factors or simple viral illness can trigger this. Genetic factors also play a role. Children do not develop Type I diabetes by eating too much sweets.

What are the symptoms?

Passing more urine and more frequently, drinking water too much and more often, weight loss, weakness and lethargy, excessive hunger (sometimes loss of appetite), infections such as 'thrush' (candidiasis), bedwetting at night in a previously 'dry at night' child. Some of the symptoms (excessive drinking, passing more urine, bed wetting at night) may be difficult to notice in a very young child. These symptoms may be present for one week to six months prior to the presentation at the hospital.

Some patients (about 25%) with Type 1 diabetes may present Diabetic Ketoacidosis (DKA) - a more serious form of symptom. In this case, the child will have vomiting, tummy pain and dehydration (dry mouth, lips, sunken eyes etc). Awareness of diabetes helps parents recognise the symptoms early and prevents their child going into DKA.


Diabetes is diagnosed based on the symptoms mentioned above and is confirmed with a blood test. A urine test (to check for glucose and ketones) and a few other blood tests also may be required at the time of diagnosis.

Treatment of Type 1 diabetes

Type I diabetes cannot be cured, but can be kept under control. Insulin is the only treatment for this type of diabetes. Insulin, diet and exercise play an important part in the management of diabetes. Insulin is administered in the form of an injection.

Depending on the timing of the onset, various types of insulin are available. These are classified as short-acting, intermediate acting and long-acting insulin. In addition, there are rapidly-acting and slow-acting insulin analogues. Availability of various forms of insulin gives flexibility to how we treat diabetes. Insulin injections can be given using various devices. The simplest and most cost-effective way is to inject using a needle and a syringe. A more expensive device but easy to use is 'insulin pens'. Using these devices require guidance.

Diabetes and schools

A majority of Type I diabetics are school children and schools should be sensitive to their condition. Teachers and school nurses should be able to recognise diabetic emergencies and perform first-aid treatment. This is very important when a diabetic child is hypoglycaemic (having low blood sugars). Two spoons of sugar, glucose or a sugary drink should be given to the child while awaiting medical help. Parents should always inform the teacher or concerned authorities about the diagnosis. Medical care of a child with diabetes does not stop at school.

Obesity among children

Type II diabetes, which was rare among children in the past, is becoming very common these days due to a rapid rise in overweight and obese children. Obesity can lead to insulin resistance. This results in improper working of insulin in the body. Rapidly changing lifestyle with imbalanced dietary habits with excess consumption of calories, simple sugars, saturated fats and consumption of less fibre, and markedly reduced physical activity may be blamed for this condition.

Professionals should help to increase awareness in their community regarding this matter. Healthy eating and physical activity can prevent obesity and its disastrous consequences. Parents should set an example for their children in maintaining a healthy lifestyle.

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