Diabetes Mellitus (DM); the name itself is fearful and more so if in context to children. It is a metabolic disorder with high blood sugar levels. Major Symptoms are increased urination, increased thirst, and hunger. Insulin is the only way by which the body can use sugar. If insulin decreases sugar rises.
4 types: three most common types are type 1, type 2, and gestational diabetes. 4th is due to rare genetic disorders. Most common in children is DM type 1 (Insulin-dependent, IDDM, or Juvenile diabetes).
Type 1DM:
It is an autoimmune disorder in which body starts to destroy its own cell (beta cells of the pancreas that makes insulin). The pancreas loses its ability to produce Insulin.
Type 1 is less common than type 2 DM.
2 main factors: genetics and the environment (certain viruses, toxins which can trigger autoimmune response).
Type 2 DM:
More common in adults but nowadays seen in children too. The pancreas still makes insulin but is not effective (Insulin resistance) It is hard to diagnose in adolescents; as some cases are asymptomatic. Lifestyle changes (which are leading to unhealthy gain in weight) like
- Decrease physical activities
- More screen time
- Fast food
It can be managed with exercise and change in diet but in some cases, medicine or Insulin injections are needed. Gestational DM is diabetes that develops during pregnancy.
SYMTPOMS:
The chart is depicting a few signs and symptoms of adults too.
Early
- frequent peeing (urination) in large amounts (polyuria)
- increase in thirst (polydipsia)
- dry mouth or throat
- weight loss
- increase in appetite (polyphagia)
- feeling tired or weak
- diaper rash that doesn’t improve with medicated cream
Late
- weight loss
- stomach aches
- nausea and vomiting
- heavy, rapid breathing (Kussmaul breathing)
- drowsiness
Diagnosis:
- Random Blood sugar level > 200mg/dl
- Urine test for ketones
It will need further evaluation under the guidance of a child specialist or Pediatric endocrinologist.
Complications:
Life changes full circle at the time when the diagnosis is confirmed.
Coping with the diagnosis is also difficult to start with as parents are in denial /shock. It usually is followed by sadness/fear/anxiety. Some will have feelings of guilt and some will have anger.
Parents (and children as well):
- Need to learn the skills needed to take care of the child (injection insulin, measure blood sugar at home, etc)
- Face Emotional Disturbance
- Lifestyle changes (dietary changes, need to count calories.)
Treatment
Aim:
- Maintain the blood sugar level as close to normal as possible at all times to avoid complications.
- Coping well with disease and trying to have a healthy and productive life.
Basic treatment of type 1 diabetes:
- Insulin ( via injections or pump)
- A balanced meal with help of a dietician
- Monitoring of blood sugar levels
- Regular check-up
Basic Treatment Type 2 diabetes:
- Healthy Lifestyle
- Increased physical activity
- Balanced food
- Weight loss
- In some cases medications
Dietician: Proper Meal plan is needed to have a calorie count. Growth and Development should not be affected and children should be able to live a healthy life. School life should also be not affected.
For any queries refer to your child specialist or Pediatrics endocrinologist. Feel free to contact Maya Clinic.
Stay healthy
Regads Dr. Rahul Varma
Child Specialist
