Tackling diabetes in children: A guide for parents from a doctor

By Dr Suruchi Goyal Agarwal

Diabetes in children is increasingly becoming a cause for concern. Type 1 diabetes affects children when the body is no longer able to produce an adequate amount of insulin that is required for healthy hormonal function. It can be a little challenging at the start for both parents and kids to get used to injections and adjusting to a particular lifestyle to accommodate the diagnosis of diabetes. However, proper care and treatment is crucial for the mental and physical wellbeing of the child and parents.

When a child is suffering from Type 1 diabetes, he/she shows some of the below-mentioned symptoms.

* Feeling thirsty all the time: Due to the excess sugar level in the blood, all the fluid from tissues is pulled, making the child feel more thirsty than usual.

* Frequent urination: Due to the increased consumption of water, the child tends to make frequent bathroom visits.

* Increased appetite: Due to a lack of insulin, the child’s muscles and organs are low on energy as a result of which the child feels the urge to eat more often.

* Weight loss: In many cases, despite an increased appetite, the child tends to lose weight drastically in a matter of few days. Due to abnormal sugar levels in the body, the fat reserve and the muscle build shrinks. Rapid and sudden weight loss is the most prominent and earliest of symptoms seen in children with type 1 diabetes.

* Blurry vision: Due to increased sugar levels in the blood, fluids from the eye lenses are pulled back, which makes it difficult for the child to focus his eyesight on a particular point.

* Fatigue: Low sugar level in the body tends to make the child feel lethargic and tired.

* Yeast infection: Type 1 diabetes is known to cause yeast infections in the genital areas of children. Toddlers are prone to catch infection and rashes in the diaper wearing areas.

* Behavioural changes: Mood swings, inability to concentrate, irritation and weak performance in studies and activities may all be signs of a child with type 1 diabetes.

The immune system of the body, which is responsible to fight any foreign bacteria and infections mistakenly starts destroying the islet cells in the pancreas. The islet cells are responsible for producing insulin in the body. Environment and genes are a causal factor for this problem. When the islet cells are destroyed, the body is no longer capable of producing the required amount of insulin, thus causing glucose to accumulate in the bloodstream as a result of which the child becomes diabetic.

Both parents and the child need to formulate a new routine in order to tackle the problem. The most important factor is to keep checking blood sugar levels regularly throughout the day and keeping it in control. The meals need to be on time, more frequent and a better diet plan, along with activity levels that a child requires to stay healthy, are all to be kept in mind. Managing Type 1 diabetes in a child requires a good diet plan, though with the new insulin regimes available now, the diet is flexible and children have no restriction on meals other than eating healthy. Your endocrinologist will help you with catering the regime to activity levels of the child and no sport is restricted. Monitoring blood sugars with meal and activity and injecting insulin adequately (as per carbohydrate count + activity) is the key to successful management of diabetes.

It is advisable that you always carry a snack, again as recommended by your endocrinologist, at times when blood sugar may fall, especially with vigorous activity. The amount of outdoor activity the child is indulging in also needs to be kept in check. Sugar intake needs to be monitored. However, this does not mean that the child is made to feel sick always, though monitoring his/her activities and frequent medical check-ups will all help in providing a total care for the child.

Make the child aware of the condition

The child must be made aware of their health condition. However, the awareness should not come at the cost of stress for the child as it is going to do more harm than good. A healthy diet, monitored blood sugar levels and timely check-ups are all that is required in order to efficiently provide the best medical care. Successful management of Type 1 diabetes in a child involves a healthy partnership between the child, the parents and the medical team. The initial phase, which involves diagnosis and a steep learning curve to its management, especially the insulin administration, can be stressful and the child needs support to tide over this.

(The writer is Consultant-Paediatrics and Paediatric Endocrinology, Columbia Asia Hospital Whitefield.)

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