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Paediatric Diabetes


👤Dr Vijay Viswanath 🕔03/11/2014
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Paediatric Diabetes

Control blood sugar, save the child

Children are the main victims of Type 1 diabetes. Most children need two or more doses of insulin per day and if blood glucose is well controlled in them, they can live a full and productive life

By Dr Vijay Viswanathan MD, PhD, FICP, FRCP

Type 1 diabetes mellitus usually occurs in children when there is almost complete absence of the hormone, insulin, in the body. This is usually due to destruction of most of the pancreas which secretes insulin.

When more than 80% of the pancreas is destroyed, diabetes occurs. Lack of insulin causes the classical features of increased thirst and urination along with severe weight loss. The child may become comatose and need care in an intensive care unit. Since these symptoms are due to insulin deficiency, treatment consists of replacing insulin. This is the reason why life-long insulin injections are given for these children. Most children need two or more doses of insulin per day.   

Insulin and normal blood sugar levels are essential for normal growth and puberty. If blood glucose is well controlled in these children, they can live a full and productive life. Usually, this involves checking their blood glucose in a drop of blood taken from fingertips using an instrument called the glucometer. Ideally, glucose checking should be done at least two times a day in insulin-needing patients. If these measures are not taken and diabetes is uncontrolled, the patient can develop various complications involving the eye, kidney and nerves. Since most of these complications occur silently, it is advisable to check for them regularly.

Insulin dosage and glucose levels are related to the food intake. Therefore, it is mandatory for the patients to undergo nutritional counselling and learn to match food intake and insulin requirements. Since most of the patients with Type 1 diabetes are children, the whole family needs to understand the problem and get thoroughly educated on all aspects of the treatment. Good family support is vital to good diabetes control.

While insulin injections are the current treatment, many other methods of insulin delivery are being researched. Insulin pumps are available, which deliver insulin. Also, inhaled insulin and insulin in the form of pills are being studied. There are tissue markers (HLA types), different types of antibodies to bodyís own tissues (auto-antibodies) and some genes which are found to be strongly associated with the development of Type 1 diabetes in close relatives of patients. Clinical trials are also on to see if Type 1 diabetes can be prevented from occurring. Till such time as these trials bear fruit, we need to fully support and give the best treatment and hope of life to these young patients.

(The writer is Head and Chief Diabetologist, MV Hospital for Diabetes & Prof. M Viswanathan Diabetes Research Centre, Chennai)

 

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