Diabetes In Children: Here's Everything You Need To Know
Diabetes can affect both children and adults. Not just Type-1 diabetes, type-2 diabetes can also affect children. Here's everything you need to know about it.
Type-2 diabetes occurs due to insufficient insulin or insulin resistance in body cells
There is a common notion that children are only diagnosed with Type-1 diabetes. However, this is not true, and it is essential to understand the pathogenesis of Type-1 and Type-2 diabetes in children.
Type-1 diabetes in children:
It is an autoimmune disorder in the immune system which damages the cells in pancreas that produces insulin. In type 1 diabetes, body is unable make enough insulin - leading to hyperglycaemia (diabetes). Insulin is a hormone that helps sugar (glucose) in the blood get into cells of the body to be used as fuel.
It is a long-term chronic disease, which is diagnosed in early childhood (4-8 years, sometimes 10-14 years) and may initiate any time usually by some viral infection or rarely by some unknown precipitating factors. There are of 2 types - immune mediated or idiopathic (unknown cause). It is very common in children as 5-10% of all diabetes patients in children suffer from type-1 diabetes. It is rarely seen in adults. It needs regular and continuous replacement of insulin by either daily subcutaneous insulin injections or insulin pump.
Type-2 diabetes in children:
Over the years, medical scientists and researchers have realized that Type-2 diabetes does not only exists but is on the constant rise among the younger population. Presently about 90-95 % of all diabetic children suffer from Type-2 diabetes. This is an alarming trend in the country.
Type-2 diabetes occurs due to insufficient insulin or insulin resistance in body cells. It may also be due to increased demand of insulin which the pancreas is not able to produce. It occurs due to either hereditary or genetic transmission or can be acquired due to obesity or overweight and poor lifestyle e.g., sedentary habits, fast food intake, less physical activity, and reduced intake of fruits n vegetables etc. In fact, the acquired factors are more common. Obesity seems to have a direct relationship with Type-2 diabetes. For management this type requires oral hypoglycaemic agents in early stage and may require Insulin in later stages along with taking care of the above general lifestyle measures.
A child born to a mother with gestational diabetes is more prone to develop Type-2 diabetes. Low birth weight and preterm babies are also more prone to develop Type-2 Diabetes.
The complications in both types of diabetes are similar. In fact, they are because of sustained high blood glucose levels as a result of insufficient or irregular treatment. Most of the complications occur because of "Arteritis" (damaged blood vessels). High Blood Sugar (glucose) leads to sustained hyperglycaemia leading to high levels of glycogen which gets metabolised in liver and gets converted into lipids. These lipids get deposited in blood vessels leading to narrowing of blood vessels, called arteritis.
Arteritis cause heart and blood vessel disease, kidney disease, strokes in brain, retinal vessel disease which may result in blindness, diabetic foot, nerve damage (diabetic neuropathy) etc. An emerging and alarming complication of Type-2 diabetes are seen in adolescent and teenage girls who are suffering with Polycystic Ovarian Disease Syndrome (PODS) and may result in amenorrhoea and failure to conceive. It is very easily managed by a proper and meticulous treatment.
(Dr Subhash Agarwal, Department of Neonatology & Paediatrics, CK Birla Hospital, Delhi)
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