The Financial Express
By Dr. V Kavita
Diabetes mellitus is a chronic metabolic disease requiring long term or life- long monitoring and treatment. Most importantly, It is not caused due to consumption excess sugar, sweets and carbohydrates. It occurs as a result of deficiency in an important hormone called insulin which converts sugar into energy or saves as fuel for later use.
When the insulin is completely deficient in our body the condition is referred to as type 1 Diabetes mellitus and survival is not possible without taking regular prescribed insulin injections. While the insulin secretion is inadequate and/or the receptors not utilising secreted insulin effectively ie peripheral insulin resistance, the condition is referred to as type 2 Diabetes mellitus.
Although type 1 Diabetes is the most common type in children, type 2 Diabetes, which was once rare in children, has been increasing in frequency with increase in incidence of childhood obesity. Type 1 Diabetes commonly occurs before 10 years of age; while type 2 Diabetes occurs after puberty which is 15 to 19 years of age.
Children with Diabetes may remain asymptomatic or sometimes present to hospital with life threatening complications like Diabetic ketoacidosis with associated severe dehydration and vital organ dysfunction. The usual symptoms include frequent urination, increase in thirst, bed wetting and day-time incontinence. A few serious symptoms including progressive weight loss, blurry vision and fungal skin infections can also happen.
Type 1 Diabetes is immune mediated. Insulin is the hormone of “feasting” and facilitates the utilization and deposition of ingested nutrients into the body tissues. Progressive insulin deficiency leads to a starvation like state and the patient presents with an increase in glucose levels. Although it is inevitable that the onset of type 1 Diabetes cannot be stopped, early diagnosis and maintaining normal glucose levels in such children can help in decreasing the progress of disease and preventing complications.  Insulin therapy is mandatory and needs to be provided adequately.
Under the pressure of commercial interests, children have learned to eat a lot, eat very fast and eat the wrong food.  The children with a strong family history of Diabetes and obesity are at higher risk of developing type 2 Diabetes. Type 2 Diabetes can be easily prevented by simple and important lifestyle modifications. Children should be taught to eat the right food in the right quantity and at the right time. This starts right from the time of weaning by introducing traditional foods, avoiding refined sugar, limiting salt intake and minimising the intake of processed foods.
In addition, physical activity like sports, riding bicycle or walking needs to be inculcated in the daily routine. Screen time like watching television, laptops or mobile phones needs to be limited to less than 2 hours a day. This will help to break the sedentary lifestyle in children. Children should be trained to get enough sleep.
The children with risk factors may be subjected to Diabetic screening like fasting plasma glucose level and glycated haemoglobin (HbA1c) level assessment. Early diagnosis, monitoring of plasma glucose levels by taking adequate medications and bringing healthy lifestyle changes can certainly help in not only slowing down the onset of complications of Diabetes but also enable them to live a normal, healthy and active. For instance, Wasim Akram the great cricketer and top tennis player Alexander Zverev possessed immaculate physical abilities and have never let type1 diabetes limit their performances and achievements.
So, in all type 1 diabetes with early suspicion, prompt diagnosis and treatment can let children achieve their dreams while in case type2 diabetes responsible habits and motivational lifestyle of the parents can delay or even prevent the onset in children.
(The author is AVP Lab Operations TN & APT, Metropolis Healthcare Limited. Views expressed are personal and do not reflect the official position or policy of the
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