Increased thirst and frequent urination, extreme hunger, weight loss, fatigue, blurred vision, and frequent behavioural changes — have you noticed any of these symptoms in your child? If yes, then you should get them screened for diabetes. While there is no nationwide registry or any consolidated official data on the prevalence of diabetes among children in India, the incidence is high.
“Type 1 diabetes is one the most common endocrine illness. The incidence of childhood diabetes is on the rise worldwide with a reported increase of two to five per cent per year,” says Dr Sumit Gupta, consultant pediatric at Columbia Asia Hospital.
The Diabetes Atlas 2017 estimates that there are 128,500 children and adolescents with diabetes in India. According to a study published in the Indian Journal of Endocrinology and Metabolism, it is estimated that India is home to about 97,700 children with type 1 diabetes mellitus. The actual figures might be higher since a lot of cases might not be reported or fail to get diagnosed.
Dr Ashutosh Goyal, senior consultant – endocrinology and diabetes, Paras Hospitals, Gurgaon, confirms that there has been a rise in type 1 diabetes incidence across the world. “In fact, there has been an increase in the incidence of auto immune conditions in general; type 1 diabetes is an auto immune condition itself. Autoimmunity of the pancreatic β-cells results in a situation where the body stops producing required amount of insulin. Auto immune diseases are mostly genetic. However, environmental factors play a critical role in activating those genes and causing full fledged disease in an individual,” he shares.
According to him, a variety of theories are used to explain this rise in incidence of auto immune diseases. One of the most commonly cited theories is the hygiene theory which blames our increased penchant towards creating super hygienic and sanitised environments.
“Evidence shows that exposure to a variety of microbes and pathogens during early childhood acts as a protective factor against type 1 diabetes. Less exposure to a wide variety of microbes and pathogens is associated with an increase in allergic conditions as well as auto immune conditions. Apart from this, other environmental factors such as exposure to toxins in our food chain, environmental pollution etc are all believed to play a role,” he adds.
Some of the most common red flags of the condition include increased urination, weight loss and infections. However, children at risk can also be identified by getting a screening before its onset. Delayed diagnosis leads to Diabetic Ketoacidosis, a life threatening condition.
“Diabetes in children can develop at any age but usually it shows after one year of age. Given the autoimmune nature of the disease, the condition cannot be prevented. The most common form of diabetes in children is Type 1 diabetes. However, increased childhood obesity has resulted in increased prevalence of Type 2 diabetes due to insulin resistance,” says Dr Anurag Bajpai, consultant pediatric and adolescent endocrinology, Fortis Memorial Research Institute, Gurgaon.
So, like adults, do children also need to be injected with insulin?
“Yes,” says Dr Gupta, adding that insulin is the only treatment available for type 1 diabetes. Concurring, Dr Goyal says, “Type 1 diabetes in children is a condition in which your child’s body no longer produces an important hormone (insulin). Your child needs insulin to survive, so you’ll have to replace the missing insulin by injecting it in his/her body. These kids need multiple injections daily.”
Besides insulin, certain lifestyle changes, regular physical activity and healthy eating help in control of childhood diabetes, says Dr Bajpai. Suggesting a diet which includes carbohydrates from fruits, vegetables, whole grains, legumes, low fat milk and light fibres, Dr Gupta points out that the child’s school should also be prepared to handle the situation.
“It is very important to make your child aware of of the condition since it is a disease that requires significant lifestyle modification. Until and unless, a child takes initiative of leading a healthy life, none of the external factors can help him/her to control the disorder. A child with this condition need extensive counseling sessions to educate him/her about the condition and the need for leading healthy lifestyles,” suggests Dr Goyal.
“Parents themselves need in-depth education about the disease and its management to be able to guide their child. Parents must talk to the child in an age-appropriate way and offer him/her confidence in his/her ability to manage the disease. They should be taught that diabetes doesn’t mean the end of the world. It only means that with a little effort and good lifestyles, they can lead healthy and productive lives. Give them examples of celebrities living with this condition such as Wasim Akram, Sonam Kapoor, Nick Jonas, among others. Answer all their questions patiently pertaining to diabetes. Make sure that the child doesn’t get too much bothered about the disorder and feel sorry about it,” he says.