Once viewed as an ailment suffered exclusively by overweight adults and senior citizens, diabetes today is rapidly becoming common among school-going kids.
Notes Dr Nitish Mishra, a specialist in endocrinology at Raffles Hospital, “Type 2 diabetes used to be rare, but is becoming more common. About 10 per cent of secondary school children have type 2 diabetes now.”
Almost 350 million people worldwide have diabetes ― a chronic disease that develops when your body starts building up sugar (glucose) from the food that you eat, instead of burning it into energy. This happens when your body is producing an insufficient amount of insulin. Insulin is a hormone that “opens the door” of our body’s cells, allowing sugar to enter where it’s converted into energy the body burns. So, when there’s insufficient insulin or if it’s unable to do a proper job, the sugar level in your blood spikes. The result is diabetes, which wreaks havoc on your health.
In 2012, diabetes was the direct cause of some 1.5 million deaths worldwide, according to the World Health Organisation. The organisation also predicts that this health condition is set to become the seventh leading cause of death by 2030. Read on to find out what’s causing this epidemic…
Dr Nitish, how is diabetes classified?
Type 1 is an autoimmune issue where the body develops antibodies that damage insulin cells, causing a deficiency of insulin in the body. This is also known as known as juvenile diabetes as it affects babies and toddlers. Type 2 is polygenic where there are multiple genetic defects. It usually stems from family history where one or two parents are diagnosed with diabetes. There’s also a third, neonatal diabetes, which is very rare, but can occur in newborns. It’s caused by a change in the gene which affects insulin production. Every year, I see about 20 child-related diabetes cases, which includes new cases and follow-ups.
“Type 2 diabetes used to be rare, but is becoming more common. About 10 per cent of secondary school children have type 2 diabetes now.”
What are signs and symptoms of diabetes that parents can look out for?
Symptoms are same for type 1 and 2 diabetes. When sugar levels in your blood are high, your body becomes dry because the blood is “sucking” water from your skin. This leads to dehydration and you feel thirsty all the time. You are also prone to extreme hunger from having too much insulin [if it isn’t working properly]. You’ll lose weight, since the glucose cannot be used as energy, which causes the body to metabolise fat. High glucose levels will thicken blood, causing the flow to slow down, which results in fatigue. A child feeling fatigue will also be irritable and behave unusually. If glucose forms behind the eye, it can result in blurred vision. Also, since diabetes lowers your immunity, girls are more at risk of fungal infections.
How is diabetes diagnosed?
Usually through a blood test that measures the ketones and glucose levels. A Glutamic Acid Decarboxylase test (GAD test) is also done to measure if the body is producing a type of antibody which destroys its own GAD cells. That’s a sign of diabetes as well.
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What treatments are there?
Diabetes is managed with tablets and insulin injections. With type 2 diabetes, you can get away with oral meds, such as Metformin to Empagliflozin, for the first few years. Oral meds are usually given simultaneously with insulin shots. For type 1 diabetes, it’s a full dependence on insulin shots from day one. Insulin is only available as an injection and has to be administered two to four times a day, usually in the stomach area. If left untreated, complications can arise in the nerve, kidney, eye and cardiovascular areas.
Are you seeing any trends with kids and diabetes these days?
More school-going kids are getting type 2 diabetes due to their lifestyles, they are not looking after their health and diet. Type 2 diabetes is also related to family history, so if one parent has it the chances of the child getting it is at 50 per cent. If both parents are diabetic, it increases to 75 per cents.
I keep advising my patients, young and old, to exercise and maintain a healthy lifestyle. Our forefathers lived a very simple life and ate simply. That’s what our genes are used to. These days, our diet is filled with rich foods because of the easy availability, but unfortunately our genetic makeup is not ready for that. This is why we are seeing a rise in diabetes amongst young and old.
“If a pregnant woman is diagnosed with gestational diabetes, she can pass the condition on to her baby.”
Can childhood obesity affect fertility later on?
Yes, in women, diabetes reduces the number of eggs you have. It also gets worse during pregnancy as the insulin resistance increases then. If a pregnant woman is diagnosed with gestational diabetes, she can pass the condition on to her baby, plus, her chances of getting lifelong diabetes increases by 20 per cent within five years of giving birth.
Living with diabetes can be overwhelming for little ones and their parents. What advice can you give parents to help their child, and themselves, cope with the condition?
Parents have to accept that diabetes is chronic and can be well-controlled in the long run with proper management. You have to work life around it instead of the other way around. It’s also good to know that medicine is constantly advancing to make our lives easier and a new machine that helps to manage diabetes easily is in its infancy stages right now. It’s called the closed loop system and it’s worn as a belt around your mid-section. It automatically takes your blood glucose reading and injects insulin accordingly. Set to be available within the next five to 10 years, it will be very helpful in making sure glucose levels are controlled in kids.
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