Type 1 diabetes in children: early detection is key to effective management

New Delhi |

December 11, 2020 2:48:04 pm

Not many people know that approximately 3 out of 100,000 children are diagnosed with type 1 diabetes each year. (Source: getty images)

By Dr. Suruchi Goyal

The widespread incidence of diabetes among children is a growing concern in India. A child as young as a few months old can develop type 1 diabetes (juvenile diabetes). With this condition, parents can easily misinterpret the symptoms as a change in the child’s habits that leads to a delay in diagnosis and proper management. Another reason for this is the lack of awareness about the increasing incidence of type 1 diabetes in children.

Not many people know that approximately 3 out of 100,000 children are diagnosed with type 1 diabetes each year. In addition to this, because we do not yet have a single common diabetes registry in our country, there is a suspicion that these figures are underestimated and are only a fraction of the actual figures in India.

Type 1 diabetes is a different form of diabetes that occurs due to a lack of insulin that leads to high blood sugar levels. It is not the same as type 2 diabetes.

The beta cells in the pancreas produce insulin and in patients with type I diabetes, the beta cells are destroyed by the body’s own immune system (autoimmunity), resulting in insufficient insulin secretion and hyperglycemia. Certain infections have also been linked to the immune system trigger.

Symptoms can take months or years to appear. Once they appear, they progress rapidly and can lead to life-threatening events if not caught in time.

It is important to note that type 1 diabetes is not due to eating habits or lifestyle.

The first symptoms of type 1 diabetes in children are (4T):

  1. Thirst: increased thirst

  2. Toilet: increased need to urinate (wet the bed)

  3. Fatigue

  4. Thinner

  5. Irritability

  6. Increased hunger

If these early symptoms are ignored, children can develop a condition called diabetic ketoacidosis, which is the result of a build-up of ketones in the blood that can make the child very ill. A simple finger prick is used to diagnose type 1 diabetes.

Managing type 1 diabetes in children:

  • Type 1 diabetes is managed through a multidisciplinary team with the child and the family in the center supported by the diabetologist, diabetes specialist nurse, educator, nutritionist and psychologist.

  • The goal is to keep blood sugar levels within a strictly controlled range, avoid swings between high and low sugar levels, allow the child to continue activities safely, and prevent long-term complications from high blood sugar levels. .

Insulin forms the main hormone in the management of diabetes and is available only in injectable form. It is given with the help of an insulin pen or an insulin pump and is required for life. Insulin is given many times a day and its dose is determined by:

  1. Blood sugar levels that need to be monitored several times a day with a glucometer or continuous glucose monitoring device.

  2. Carbohydrate count in food eaten.

  3. Level of exercise and activities.

Research on type 1 diabetes in children is a continuous process in which innovations and technological advances are expected. Insulin pumps and continuous blood glucose monitors have helped reduce the need for needles and improved blood sugar controls and flexibility in managing type 1 diabetes in children.

(The author is Consultant – Pediatrics and Pediatric Endocrinology, Columbia Asia Hospital Whitefield).

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