Diabetes mellitus is a life long condition that affect the way our bodies handle energy found in food.
Normally, our body breaks down carbohydrates into small blocks called glucose which act as fuel for the cells in our bodies. Cells in our bodies can only utilize this fuel (glucose blocks) with the help of an hormone called INSULIN.
Contrary to popular belief, diabetes can and do also occur in children.
What is Insulin and what does it do?
Insulin acts as a key that opens the door of the cells so that glucose goes in for its use. Insulin is produced by an organ in our bodies called the pancreas.
With Diabetes mellitus, it’s either you do not produce insulin or the insulin is produced in insufficient quantities or the insulin produced cannot be used or a combination of all. Since the cells can’t use glucose, it will therefore build up in our blood and find its way to the urine dragging along plenty of water with it. Cells are starving now and so there is great hunger and desire to eat. So we have the symptoms of passing large volumes of urine, eating very large quantities of food and drinking so much to replace our loss.
As long as glucose still remains unavailable to the cells, our body look for alternative sources of fuel: protein in fat.
Do children have Diabetes : YES.
What are the symptoms?
So there is breakdown of proteins (muscles) leading to weight loss. Breakdown of fat which produces substances called ketones, whose accumulation will cause vomiting, abdominal pain and deep and rapid breathing. This is a vicious cycle with no end in sight if insulin doesn’t become available.
The very high levels of glucose in our blood damages the vessels in our kidneys, heart, eyes, nervous system. Other symptoms that may be observed include skin rash that will never go away, vaginal discharge and itching.
Types of Diabetes
There are several types of diabetes : type 1, type2 and others.
Type 1 is more common in children while type 2 is seen more in adults. In type 1, there is absolute insulin lack, so it means children with Diabetes mellitus require INSULIN for LIFE.
What causes type 1 diabetes mellitus?
It is believed that the body starts fighting itself. For several scientific reasons, body develops antibodies which should fight foreign agents but however fights it’s own cells called autoimmunity.
Again, the symptoms of diabetes in children also includes excessive urination, excessive drinking, excessive eating, weight loss.
So if your child have these symptoms, what should you do?
You need to see a doctor who would ask for blood tests. Blood tests include the fasting blood sugar. The sugar level above 126mg/dl or 2 hours post meal sugar level above 200mg/dl with symptoms is diagnostic of diabetes mellitus.
So what next after diagnosis?
Children with Diabetes mellitus requires insulin for life. Unlike adults, children can not take oral medications but will need insulin for life. Kindly do not give them herbs or native concoction.
Care of the child with Diabetes
- Frequent blood glucose testing (up to 6 – 8 times a day).
- Careful meal planning. Family that has a diabetic child will need nutritional overhaul. Balanced healthy meals at regular times. No refined carbohydrates. E.g. cakes and sugar drinks. Adequate fruit and vegetables.
- There is nothing called diabetic diet. The child with Diabetes mellitus can have treat days once in a while. He can get a piece of cake when other kids are getting but on a few selected days.
- So this means, that the other children in the home and the entire family should eat from the same pot. Regular and balanced meals is the KEY word. Portion control is also essential. This will also prevent the child from developing depression and truancy ideas like stealing. Children with diabetes can snack but of course healthy snacks e.g. carrots.
- The idea of wheat meal being beneficial is a common belief but wrong because research has shown that wheat has been involved in autoimmunity and that it has a high glycemic index (that is after a wheat meal, your blood glucose hits the roof rapidly).
- Daily exercises – the child with Diabetes mellitus should live a normal life. They can play and get involved in sports. Blood glucose monitoring should be done before and after intense sporting activity.
- Regular monitoring of HbA1C, which is a blood test that estimates blood glucose levels over a period of 3 months and helps identify your risk of complications
Type 2 diabetes mellitus
It is increasingly being found in children especially in adolescents. They would still require INSULIN. Some receive a combination of oral medications and insulin. Note that the diabetic child requires insulin and that is not negotiable.
Conclusion
Complications of diabetes mellitus are the same irrespective of the type. These include : cardiovascular disease, stroke, kidney failure, damage to the eyes and ulcers especially on the foot that never heal.
Hence, the diabetic child requires regular checks of their eyes, urine, blood pressure etc.
This article was culled out of ATP Facebook group discussion presentation on the topic by Dr. Nwaoma Leslie Nwaogu, Consultant Paediatric Endocrinologist and one of ATP professionals and Facebook group Admin.