World Diabetes Day 2022: How to manage disease in kids with Type I and II diabetes

According to a report by the Indian Council of Medical Research that was released for the management of Type I diabetes this year, India has nearly 95,600 cases of Type I diabetes among children below the age of 14. What is even more alarming is that around 15,900 new cases are reported in this age group every year.

What is diabetes?

It is a condition in which the body can’t make enough insulin, or can’t use insulin normally. The commonest of diabetes in children and adolescents is Type I Diabetes Mellitus (T1DM) which is an autoimmune disorder. The body’s immune system damages the cells in the pancreas that make insulin. T1DM is a long-term (chronic) condition.

According to Dr Abhishek Kulkarni, consultant Paediatric & Adolescent Endocrinologist, Department Co-ordinator & Fellowship Program Director, SRCC Children’s Hospital, Mumbai, T1DM may start at any age.

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“It’s important to work closely with your child’s healthcare team to create an ongoing plan that works for your child”

–Dr Abhishek Kulkarni, consultant Paediatric & Adolescent Endocrinologist, Department Co-ordinator & Fellowship Program Director, SRCC Children’s Hospital, Mumbai

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”Insulin from the pancreas must be replaced with insulin injections or an insulin pump. T1DM often appears suddenly. In children, Type I diabetes symptoms may be flu-like symptoms. But they can be a bit different in each child. They can include, high levels of glucose in the blood and urine when tested, unusual thirst, dehydration, frequent urination, excess hunger but weight loss, loss of appetite, weakness, fatigue, and infections that are not getting better. If the condition goes untreated for long nausea, vomiting, and alteration of consciousness set in,” Dr Kulkarni warns.

Children with Type I diabetes must have daily injections of insulin to keep their blood glucose levels within normal ranges. Insulin is given either by injection or insulin pump. “Treatment will also include eating the right foods to manage blood glucose levels. This includes timing meals and counting carbohydrates, exercise, regular blood testing to check blood-glucose levels, prevention, detection, and management of acute hypoglycaemia, urine testing during sick days to check ketones and prevent the development of ketoacidosis, and adjustment for special situations. Most children with Type I diabetes mellitus can lead productive healthy lives with a near-normal lifespan,” Dr Kulkarni said.

According to Jaisal Kaur Sidhu, an alumna of Apeejay Svran Global School in Faridabad and a food technologist (QA) at Mrs Bectors Food Specialties (Cremica) there are so many options available to parents when it comes to food that they can give to a child if he/she has Type I diabetes.

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“If a child has Type II diabetes, his parents must ensure that their ward goes for regular exercise or plays a sport on a regular basis”

–Jaisal Kaur Sidhu, Food Technologist

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“Most parents think that giving sweet fruits like mango and banana is a no-no. But if the child’s blood sugar levels are constantly monitored these can be given in moderation. The kids from an early age must be introduced to a variety of veggies and other fruits as well so that by the time they start going to school, they have developed the habit of eating all kinds of vegetables and fruits. Children must also get at least seven to eight of hours of proper sleep daily,” Sidhu said.

What is Type II diabetes?

It is a metabolic disorder usually caused by insensitivity the endogenous insulin. This may have an underlying polygenic predisposition. It usually takes other factors like obesity, to bring on the condition. Type I Diabetes Mellitus (T2DM) may have an asymptomatic, indolent presentation, and may be detected while screening or may present with frank symptoms as in patients with T1DM.

“Treatment will include a healthy diet, weight loss if needed, regular exercise, regular checking of blood sugar levels more so initially, oral medicines, if needed and insulin replacement in certain situations. Children with T2DM are at risk for problems such as high blood pressure, high cholesterol, non-alcoholic fatty liver disease, depression, and eating disorders,” Dr Kulkarni said.

Diet for such children should include plenty of protein, Sidhu adviced. “Besides, giving fruits and vegetables, there must be an equal amount of protein in the diet like paneer and or even eggs if the school allows it. Tiffin is another issue that crops up for such children. Ensure there is a balance of protein, fruits, and vegetables instead of just roti/parantha and sabzi. If a child has Type II diabetes, his parents must ensure that their ward goes for regular exercise or plays a sport on a regular basis,” Sidhu stressed.

As Type II diabetes is a chronic condition, it requires lifestyle changes to keep healthy blood glucose levels. “It’s important to work closely with your child’s healthcare team to create an ongoing plan that works for your child. It helps if the whole family makes lifestyle changes together to develop healthy habits,” Dr Kulkarni said in conclusion.