All About Diabetes in Children

India is known as the diabetes capital of the world. As per the Diabetes Atlas 2021, we are home to approximately 2,29,400 children and adolescents with type 1 Diabetes Mellitus.

The two forms of diabetes mellitus seen in children are Type 1 (most common) and Type 2. In Type 1 diabetes, the body’s immune system attacks and destroys the insulin-producing beta cells of the pancreas, leading to the production of very little or no insulin. In Type 2 diabetes the body makes enough insulin but is unable to use it properly; this is called insulin resistance. Lifestyle factors like obesity, lack of exercise, diet, etc., are strongly linked with type 2 diabetes. With the changing lifestyles of children today, the prevalence of type 2 diabetes has also increased in them in the past few years. Insulin is a key hormone that allows blood glucose to enter the cells to produce energy. Without insulin, blood glucose would keep rising outside the cellsresulting in diabetes mellitus.

Common symptoms of diabetes in children include increased thirst, frequent urination, loss of weight, and increased tiredness. On some occasions when the above symptoms are not recognized on time and the child is left undiagnosed, the ketones and acids in the blood may increase giving rise to a condition called Diabetic Ketoacidosis. The symptoms of this condition are stomach ache, nausea, vomiting, fast breathing, drowsiness, or coma. This needs immediate attention and treatment or else it can prove life-threatening.

The goal of management for diabetes in children is to maintain blood glucose in an age-appropriate healthy range. This requires frequent blood sugar testing, calculating carbohydrates in meals, physical activity, taking insulin injections on time (in Type 1), or taking pills (in Type 2).

Technology has been a game changer in the management of diabetes. Today there are continuous glucose monitoring sensors (CGMs) that can detect blood glucose throughout 24 hours. Further, numerous smartphone apps can help track blood sugars, count carbohydrates, and monitor physical activity. Insulin pump, also called as the artificial pancreas, is the latest useful tool to deliver insulin to the body constantly. There are automated insulin pumps available in India now that can connect with the CGMs and automatically titrate the insulin dose based on blood sugar inputs.

It is important to understand that Type 1 diabetes is not reversible. The fear and anxiety surrounding Type 1 diabetes, its chronicity, and complications lead some families to get misguided by programs or organizations that falsely claim that they can cure Type 1 diabetes completely. Parents should be aware of such fraudulent claims and follow medical advice properly. Insulin injections should never be stopped in Type 1 Diabetes.

Children with Type 1 or 2 diabetes can accomplish everything, like their peers. They can go to school, play sports, pursue a career of their choice, travel, and relax. It’s important for families to learn about the various factors that affect blood glucose levels and be prepared to manage them appropriately. A paediatric diabetes clinic comprises a team of pediatric diabetologist, dietitian, diabetes educator, child psychologist, and social worker who work hand-in-hand to educate and support families through various challenges in diabetes management and ensure a good quality of life for children.