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Diabetes is a metabolic disorder characterized by abnormally high levels of blood glucose. Blood glucose is regulated by the hormone insulin secreted by pancreas. Till a few years back, diabetes in children was predominantly Type 1 Diabetes. Other rare diabetes in children include some genetic disorders and some syndromic disorders.
Type 1 Diabetes occurs due to insulin deficiency. This occurs due to autoimmune (damage by the body’s own immune system) to pancreas. These patients require lifelong insulin therapy. By following proper insulin administration and regular blood sugar checkup, along with a healthy diet and physical activity, patients are able to lead a very productive life.
Children with Type 1 diabetes initially have non-specific symptoms. These include:
However, these symptoms are mostly ignored, and the child presents abruptly with abdominal pain, breathlessness and vomiting (a condition called DKA), which if left untreated, can progress to coma.
Type 2 diabetes in children is mostly asymptomatic. However, all the above mentioned symptoms can occur as hyperglycemia worsens. The absence of symptoms delays the diagnosis in most patients. Also, children and teens have a harder time accepting diabetes and many default on treatment to fit in with their peers.
Type 2 Diabetes is the common form of diabetes. However, it occurs predominantly in adults. Type 2 Diabetes occurs due to decreased action of Insulin (insulin resistance). This resistance to insulin occurs due to obesity, sedentary lifestyle, and improper diet.
The mainstay of treatment in Type 2 diabetes is lifestyle changes aimed to achieve weight control by healthy diet and increased physical activity and exercise. If properly implemented, this disease can be reversed in initial stages.
In recent years, the incidence of Type 2 diabetes is increasing alarmingly. IN fact, the impression that Type 2 diabetes is an adult disorder no longer holds true. This is due to decreased activity in children and change in lifestyle.
Increased obesity is due to consumption of calorie dense food and fast food culture. Lack of activity and exercise and stressful and competitive environment. The prevalence of pre-diabetes/diabetes was 12.3% and 8.4% among adolescent boys and girls in India, respectively. This is of grave concern since this predisposes these children to future risk of diabetes complications such as heart ailments, kidney, eye and nervous systemic issues at a very young age.
In conclusion, incidence of both types of diabetes has increased in recent years, however, the increase of type 2 diabetes in children is much more robust. Type 2 diabetes can easily be prevented by adopting a healthy lifestyle and maintaining optimal weight.
At risk children (obese, family history of type 1 diabetes or those with aforementioned symptoms should be evaluated for diabetes). If diagnosed, diabetes can be controlled by following doctor’s advice. If one is willing to do one’s part, diabetes won’t stand in the way of an active and healthy lifestyle.
(The article has been contributed by Dr Phulrenu Chauhan – Consultant Endocrinologist at PD. Hinduja Hospital & MRCH, Mahim, Mumbai; Dr Aasim Maldar – Consultant Endocrinologist at PD. Hinduja Hospital & MRCH, Mahim, Mumbai; and Dr Amritha Prasanth – Senior Research Associate at PD. Hinduja Hospital & MRCH, Mahim, Mumbai)
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