Diabetes in children

The term diabetes mellitus describes as a metabolic disorder of multiple etiologies characterised by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects of insulin secretion, insulin action or both. Type 1 diabetes mellitus is the most common endocrine metabolic disorder of childhood and adolescence , with important consequences for physical and emotional development. 10% of all diabetes are childhood diabetes.

Globally 15 million children suffers from Diabetes. Polyuria, polydipsia, polyphagia, fatigue and weight loss are the predominant features of diabetes in children. Sometimes they may present with Diabetic ketoacidosis.

Fasting plasma glucose > 7 mmol/L and 2 hours after breakfast > 11.1 mmol/L and RBS > 11.1 mmo/L are diagnostic. Interestingly it has been seen that only 10% of the diabetic children having the family history of diabetes and in identical twin 25-50% suffers from diabetes.

Autoimmune destruction of beta cells of pancreas has been demonstrated in Type 1 DM. Environmental factors and some viral infections (Mumps, Coxasakie virus, Cytomegalovirus) trigger the onset of autoimmunity in genetically susceptible individuals.

Acute complications are hypoglycemia, ketoacidosis and chronic complications are irreversible micro and macrovascular pathology, which includes retinopathy, nephropathy, neuropathy.

Management of diabetes in children is a challenging task as they do not always like to obey the given instruction. Diet, discipline and drug are the main stay of management. Here insulin is the drug to be used to keep blood sugar in control.

People with type 1 diabetes have a three-times increased risk of developing epilepsy later in life, concludes research published in Diabetologia, the journal of the European Association for the Study of Diabetes (EASD).

Type 1 diabetes mellitus is one of the most common autoimmune disorders in children, with a 3% annual increase in the global incidence rate since the 1980s.In recent decades, the incidence of type 1 diabetes has increased in children and adolescents, particularly those aged younger than 5 years. Patients with diabetes are at increased risk of severe health problems and mortality.

Help of parents, relatives and teachers are very crucial in proper management of diabetes in children. Long, active, healthy, comfortable normal life can be enjoyed with proper management.

The author is a Professor of Paediatrics at Community Based Medical College (CBMC), Mymensingh.
E-mail: mmukkhan@gmail.com