Health : Understanding, diagnosing diabetes in children

Diabetes cases are rising in young people.Early detection and treatment in children and teenagers can improve their health and wellness throughout life. In order to understand various symptoms and early detection of Diabetes in children, The Pioneer’s K. Ramya Sree speaks to a few experts, who explain to us in detail about diabetes in children, possible symptoms, early detection, and its treatment .

Diabetes in children and adolescents is on the rise as in adults. On November 14, we observed both Children’s Day and World Diabetes day. Many studies were published on the day standing as a testimonial on the rise of Type I (Insulin dependent) diabetes among children and adolescents.

Diagnosing diabetes in children is a challenge, especially in small children less than six years of age, who are usually unable to understand or articulate symptoms of hypoglycaemia. Today, in this article we will learn how to identify if your child has diabetes, its symptoms and diagnosis.

American Diabetes Association recommends screening of diabetes for children, who are overweight/obese, children whose mothers were diagnosed as diabetic during pregnancy and all children after 10 years of age or at the onset of puberty.

If the result values are normal, it is recommended that the tests be repeated every 3 years.

The frequency of Diabetes is increasing across the world and studies have shown that children are at increasing risk of developing the disease. The types of diabetes mellitus in children are similar to those in adults, but psychosocial problems are different and can complicate treatment.

“Type 1 diabetes is the most common type in children, accounting for two thirds of the new cases. Type 2 diabetes, once rare in children, has been increasing in frequency in parallel with the increase in childhood obesity. It typically manifests after puberty and the decline in beta-cell function and development of diabetes-related complications are accelerated. Diagnosis of DM in children is based on the demonstration of hyperglycemia and presence or absence of symptoms. Children with type 1 diabetes most commonly present with hyperglycemia, with several days to weeks of urinary frequency, polydipsia, and polyuria. Some patients may present on the extremes with asymptomatic hyperglycemia or with life-threatening diabetic ketoacidosis. Polyuria may manifest as nocturia, bed-wetting, or daytime incontinence; in children who are not toilet-trained, parents may note an increased frequency of wet or heavy diapers. About half of children have weight loss as a result of increased catabolism and also have impaired growth.

Fatigue, weakness, candida rashes, blurry vision and/or nausea and vomiting may also be present initially. In type 2 diabetes, the manifestation varies widely. Children are often asymptomatic or minimally symptomatic, and their condition may be detected only on routine testing. However, some children have a severe manifestation of symptomatic hyperglycemia,HHS or DKA,” said Dr. Preeti Goyal, Medical Director of vHealth by Aetna.

According to the doc, the treatment of Diabetes in children parallels that in adults with Insulin being the mainstay in Type 1. In T2DM, lifestyle modifications including calorie restriction and exercise, along with anti-diabetic drugs are successively used.

“Detection of diabetes in a child leads to psychological issues of anxiety, stress and depression for the child as well as the family and need counselling and support. Childhood diabetes should be managed by experts in the field namely Pediatric endocrinologists due to its specific needs and complications,” she added.

Seconding Dr. Preeti, Dr. Geeta Chopra, MD Pathology, VP – Chief of Labs and Technical Operations, North SBU, Metropolis Healthcare Ltd, said, “Children may present with fainting due to hypoglycemia.  Other symptoms may be excessive thirst, excessive hunger, increased urination, bed-wetting, irritability and mood swings, blurred vision, excessive fatigue and unexplained weight loss. Parents as well as the entire family need to understand the disease to be able to give necessary support to the child. It is essential that school is communicated about the disease where the child spends a good many hours and school should be able to closely monitor the child/teen. 

Monitoring of diabetes with blood glucose levels may have to be done multiple times a day, along with periodic Insulin and HbA1c levels.  Also, there is immense importance of a healthy diet, exercise, weight monitoring, Insulin dose regulation (in Type 1 Diabetes) and periodic medical check-up.”

Timely diagnosis, proper treatment, and regular follow up to prevent complications can enable the child to live a normal life.Diagnosis can be at in few months of birth or in the early childhood, added Dr .Sharvari Dabhade Dua, MBBS, MD (Internal Medicine) and Consultant – Rural Healthcare, Medyseva “Nowadays, we are also seeing the onset of Type 2 diabetes in teenagers, and one of the most common reasons is unhealthy lifestyle. Diabetes is spreading like a wildfire, and soon it is going to be one of the leading causes of comorbidities in people. But children are more vulnerable to the complications related to diabetes,” Dr Sharvari added.

Symptoms of diabetes
in children:

l Increased hunger and thirst
l Increased irritability
l Blurring of vision
l Frequent infections
l Fruity odour of breath
l Nausea
l Dry skin
l Fatigue and lethargy
l Weight loss despite good appetite
l Pain in abdomen
l If children develop multiple symptoms amongst these, they should consult an expert immediately.
l Both types of diabetes have similar symptoms, however weight gain or obesity likely causes Type 2 diabetes and not Type 1.

Treatment of diabetes:

l Insulin- Type 1 diabetes requires insulin, which comes in various forms, either rapid acting, long acting or mixed. Some Type 2 diabetes patients require insulin too.
l Oral hypoglycemics – These are drugs that help in secreting insulin, maintain weight or help in carbohydrate metabolism.

l Lifestyle changes – Lesser consumption of sweets, sugary food, junk and processed food, staying active since childhood helps in controlling sugar.

l Prevention of diabetes –

l Type 1 Diabetes is autoimmune or genetic and cannot be prevented with lifestyle, however early diagnosis and good sugar control can prevent children from developing complications related to diabetes. Since Type 2 diabetes is related to lifestyle diseases, one must encourage children to always be active, eat less sugar and processed food including junk food. Obesity is rising in children, and preventing obesity can help in preventing not only diabetes but many diseases related to obesity.

l In conclusion, diabetes in children can be managed well if it is diagnosed and treated in time. Complications related to diabetes can be prevented by managing sugar levels, and children can live a healthy life.