DIABETES IN CHILDREN
The incidence of Diabetes in children has increased steadily over the last 20 years and now affects around 2 per 1000 children by 16 years of age. Both genetic predisposition and environment precipitants play a role. In case father of the child is a Diabetic , child has a chance of developing Diabetes 1in 20 to 40. Whereas if mother is a Diabetic, he has a chance of 1in 40 to 80.
Classification of Diabetes.
1. Type 1 Diabetes, is also known as Juvenile Diabetes is caused by a defect in the immune system leading to destruction of Insulin producing cells of Pancreas. These children require Insulin on daily basis.
2. Type 2 Diabetes or Adult type Diabetes occurs in older children, obesity related, positive family history and not dependent on Insulin.
3. Mature onset Diabetes of the Young (MODY) is due to a defect in the Beta cell function of Pancreas.
Symptoms
• The most common symptoms are excessive thirst, frequent urination and weight loss and these symptoms are “classical triad” of Diabetes.
• Headache and tiresomeness
• Tummy pains
• Diabetic ketoacidosis
• Skin infections
Diagnosis
The diagnosis is confirmed by markedly raised blood sugar and raised Glycosylated Hemoglobin (HbA1c)
Treatment
• Injection of Insulin is the mainstay in the treatment of Diabetes. Besides insulin therapy, educational programme is needed for the PARENTS and the child to cover the following.,
• A basic understanding of the pathophysiology of Diabetes.
• Injection of Insulin--- technique and sites.
• Diet , regular meals and snacks, reducedrefine carbohydrate, healthy diet with not more than 30 percent fat intake.
• Matching food intake with Insulin and exercise
• “ Sick day rules” during illness to prevent ketoacidosis
• Blood glucose monitoring and recognition of symptoms of Hypoglycemia ( low blood sugar).
• Psychological needs of parents and the child.
