What To Do When Your Kid Has Been Diagnosed With Diabetes?

Diabetes is a chronic medical condition that affects millions of children and adolescents throughout the world. A report released in June 2022 by ICMR (Indian Council of Medical Research) indicates that India has about 95,000+ cases of Type 1 diabetes in children below 14 years, and about 15,000+ cases are being reported every year. 

The most common type of diabetes in children is type 1, which occurs when the body is unable to produce enough of the hormone insulin, which is responsible for regulating the body's blood sugar levels. Without insulin, the body's cells cannot absorb glucose, leading to dangerously high levels of glucose in the blood. Type 1 accounts for 90% of the diabetic cases in children and the remaining are usually Type 2 diabetes. Type 1 diabetes also known as insulin-dependent diabetes mellitus is an autoimmune disease with genetics, environment, and viruses playing a role in triggering autoimmunity. In this type of diabetes, the immune system attacks and destroys the beta cells of the pancreas that produce insulin. Whereas Type 2 diabetes, broadly referred to as non-insulin dependent diabetes, usually happens in older children and adolescents. It is associated with diet and lifestyle issues such as lack of physical activity, junk food intake, and increased screen time resulting in overweight and obese children with insulin resistance. 

What to do when your child has been diagnosed with Diabetes?

Identifying the signs 

It's important for parents to be aware of the basic signs and symptoms of diabetes. Some key signs of Type 1 diabetes include increased urination (both during the day and at night), occasional bed wetting, excessive thirst and hunger, rapid weight loss, and extreme fatigue. In the case of type 2, if the child is obese or overweight with a high BMI, it's always recommended to visit a paediatric endocrinologist and screen for Type 2 diabetes. 

Be their emotional support but don't treat them as ‘patients' 

Although diabetes is a chronic condition, it does not mean that a child cannot lead a normal life. It can be challenging for parents to come to terms with a diabetes diagnosis, and it is common for them to experience a period of grief and denial. However, it is important for the child's well-being that parents accept the diagnosis and focus on treatment and management. One way to do this is by treating the child as normally as possible and not coddling or overprotecting them. 

If parents are struggling to come to terms with their child's diabetes diagnosis or simply need to talk about their feelings, it can be helpful to seek support from other parents who are going through a similar experience. There are various support groups available that can provide a sense of community and offer a safe space for parents to discuss their concerns. 

Treatment and Management 

If a child has been diagnosed with Type 1 diabetes, treatment will typically involve insulin injections. Insulin medication cannot be taken orally or in tablet form, as stomach acids destroy the insulin. There are two types of insulin injections: short-acting and long-acting. Short-acting injections are typically given before meals to help regulate the sugar in the food, while long-acting injections are usually given once a day. It is important for parents to be consistent with the timing and frequency of insulin injections, as well as with the timing of meals. Insulin injections are ideally given multiple times a day to mimic normal body physiology. Additionally, parents should make sure to monitor their child's blood sugar levels frequently and schedule check-ups with the child's healthcare provider every two to three months. Type 1 diabetes is a life-long condition and parents have to know how to prevent both acute and chronic complications and take active measures to manage the condition. 

In the case of type 2 diabetes, diet and lifestyle modifications are very important. Adopting a healthy diet, regular physical activity, and taking active steps for weight management can potentially reverse type 2 diabetes.

It is important for parents to educate themselves about the disease and for the school to be informed about the child's diabetes. The child may require insulin and blood sugar monitoring during school hours, and the doctor can provide a card to present to the school administration in order to facilitate any necessary additional care. 

What can children eat if they are diabetic?

In children, there is no special diabetic diet. Any healthy diet is the ideal diet. We don't restrict any specific food in children because it's their growing years and they need a balanced meal consisting of carbohydrates, proteins, healthy fats, and fibers. For children with Type 1 diabetes, a healthy and balanced meal containing 50-55% carbohydrates, 20% proteins, and 10-15% fat is recommended. It is suggested that children consume 1-2 fruits and 3-5 vegetables per day. To encourage children to follow a healthy diet, it can be helpful for the whole family to adopt these dietary habits. 

It is important to teach parents ‘carbohydrate counting' so that the insulin required can be matched to the number of carbohydrates in each meal. This helps in keeping blood sugars under control while giving flexibility to children to choose what they want to eat. 

Follow the Plate Method

To create a balanced meal, use a moderate-sized plate and divide it into three sections. Fill one-third of the plate with fruits and vegetables, one-third with protein, and the remaining third with carbohydrates. It is generally recommended to reduce carbohydrate intake and add on more complex carbohydrates, but one should not completely eliminate carbohydrates from the diet. Children with diabetes can eat everything but in moderation.

What to avoid?

It is important to avoid junk food and processed food as much as possible. This includes cakes, biscuits, chips, and other bakery items. While it is okay to indulge in these types of foods in moderation on occasion, it is generally recommended to limit their consumption. 

Can my child play and participate in sports?

Children with diabetes should be encouraged to stay active and participate in physical activity for at least one hour per day. However, it is important to monitor their blood sugar levels during exercise, as there is a risk of low blood sugar. If a child will be engaging in prolonged physical activity, it is recommended to provide a snack and to bring a glucometer to check blood sugar levels. If low blood sugar is detected, the child should be given a snack to bring their blood sugar back to a normal range. 

Think and act like a pancreas

● Checking your blood glucose at least 4 times each day

● Taking insulin at least 4 times each day

● Counting carbohydrates in the foods you eat

● Learning what makes your blood glucose vary and making changes accordingly 

● Keep your blood glucose in the target range

Technology and Diabetes

Technology is transforming diabetes care. From rapid insulin analogs, smart pens, and continuous glucose monitoring systems to insulin pumps and closed-loop systems, diabetes care has advanced to make life easier for parents and children, however, they can leave a hole in the pocket. Hence, discussion with the doctor and tailoring care accordingly are of much importance. 

Content by: Dr. Tejasvi Sheshadri, Consultant Paediatric Endocrinology, SPARSH Hospital

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