Throughout the world, incidences of diabetes are on the rise, and consequently so is diabetes among children. And while most children are affected by type 1 diabetes, the number of children and young adults affected by type 2 diabetes is increasing.
GluCare paediatric endocrinologist, Dr Kowshik Gupta, gives us the lowdown on what symptoms to look for, what treatment is available and how you can manage if your child is diagnosed with diabetes.
There are multiple kinds of diabetes, which is the one that children get?
When one speaks about diabetes in children, they are usually referring to type 1 diabetes, otherwise known as insulin dependent diabetes. Type 1 diabetes is an auto-immune condition whereby the body does not produce insulin, a hormone that allows the sugar from food (glucose) to enter cells to produce energy. Without insulin, sugar builds up in the bloodstream and can lead to complications. Type 1 diabetics need to take insulin daily and often other medication.
While most children with diabetes are type 1 diabetics, we have seen an increase in young people with pre-diabetes or type 2 diabetes. Unlike type 1 diabetes, type 2 diabetes is usually diagnosed in adults and happens when the body becomes resistant to insulin or when the pancreas stops making enough insulin. Type 2 diabetes can usually be managed through diet and exercise but if that isn’t enough, oral medication or insulin treatment may be needed.
What causes diabetes in children?
As a medical community, we’re not entirely sure what causes type 1 diabetes to develop, but we do know that it is not related to diet or lifestyle, although it is always a good idea to ensure that your children are active and getting proper nutrition. Researchers and scientists around the world are working hard to find the answers to these questions. Genetics might play a small role as to why a child might develop type 1 diabetes, but there are a lot of other factors that, as of today, remain unclear.
With type 2 diabetes however, there are numerous risk factors that parents should take into consideration given the rise of pre-diabetes and type 2 in children and teens we’re seeing. Among the risk factors for type 2 diabetes is unhealthy eating and lifestyle, being clinically overweight, a family history, a lack of exercise or activities, and sometimes ethnicity and a sedentary lifestyle.
What symptoms will a child with diabetes display, what should parents be looking out for?
Symptoms to look out for include increased thirst; frequent urination, which can sometimes result in bed-wetting; extreme hunger; fatigue; unexpected or unintentional weight loss; change in mood, behaviour, or irritability and fruity smelling breath.
For children at risk of Type 2, it is important that you have regular visits with your doctor if your child is overweight and at risk of becoming obese, if they have a lack of physical activity, and if they are not getting proper nutrition in the form of fresh whole foods.
How is diabetes treated?
Caring for a diabetic child can, at first, feel like having an additional full-time job as diabetes is treated by self-management, or in the case of childhood diabetes, management by both caregivers and child. Prescribed by a doctor, treatment for type 1 diabetes includes constant monitoring and ensuring that they are adhering to a plan that will include monitoring blood glucose levels through either a finger-prick Blood Glucose Monitor (BGM) or a wearable Continuous Glucose Monitor (CGM), insulin shots, and strict adherence to diet and medication plans.
Thankfully due to technological advances, diabetes treatment has become easier and less stressful. For example, Continuous Glucose Monitors (GCMs) that a child can wear, provide a real-time reading of a child’s blood glucose levels. This can be relayed in real time to a parent or caregiver’s phone providing peace of mind in knowing that they are fully aware of what is happening when apart from their child and can make interventions if required.
New care models are also emerging that can help parents and young people. At GluCare, for example, using remote and connected technology including CGMs among other proprietary technology, we’re able to monitor our patients 24/7. For children and their parents, this allows us to make better informed care decisions as also adds a layer of comfort for parents in knowing that us as a care team are able to make the most informed decisions for the health of their children.
How can parents support their child after a diabetes diagnosis?
It’s important to work with your doctor as your child reaches development milestones to decide on how they can assist in their own management, as well as giving them age-appropriate information on what their condition means.
There is also a wealth of online resources plus online communities where parents and children can connect on a range of topics. Twenty years ago, a diabetes diagnosis could seem very isolating, but today many supportive groups now connect online.
There are still challenges of course when it comes to a juvenile diabetes diagnosis. One of the main issues many parents find is that schools are often ill-equipped or not willing to fully allow diabetic children to do all of the other activities that other children are doing. To me, this is unacceptable and an issue that needs to change. For parents, I would suggest reaching out to other parents to discuss their experiences as school’s response or policies vary by school and by administration. Schools need to do the work to ensure that juvenile diabetic children are offered all the same opportunities as their peers.
