Updated: November 14, 2019 12:11:59 pm
By Dr Neetu Talwar
Diabetes mellitus is a chronic medical disorder in which sugar (glucose) levels in blood are unusually high. This could be due to lack of or decreased insulin production or failure of adequate response to the insulin produced. It is important to be aware of this condition and make the diagnosis at the earliest because the long-term consequences can be disabling or even life-threatening. Usually, Type 2 diabetes is more commonly associated with adults and is fact called adult-onset diabetes. But this condition has been on the rise in children, largely because of the obesity epidemic.
Types of diabetes
There are two types of diabetes:
In Type 1 diabetes, the pancreas does not produce any insulin. This is because of autoimmune destruction of pancreatic beta-cells, due to a variety of triggers in genetically predisposed children. Due to the underlying etiology, these children with are also at a higher risk of other autoimmune disorders like thyroid disorders and celiac disease.
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Type 2 diabetes on the other hand is a condition in which insulin is produced in the body, but is either insufficient or the body’s cells respond sub – optimally to the insulin produced (insulin resistance). Hence, glucose metabolism is affected and blood glucose levels are high resulting in various metabolic abnormalities.
Symptoms in children may develop gradually. About 40 percent of children suffering from this condition might be completely asymptomatic and may be diagnosed during routine physical examination.
Some other symptoms may be:
· Increased thirst and frequent urination. Increased levels of sugar in the child’s bloodstream pulls fluid from tissues. As a result, he might be thirsty and drink more fluids and subsequently has more than usual urination.
· Weight loss. Significant weight loss may occur, although it is less frequent in children with Type 2 diabetes as compared with children with Type 1 diabetes.
· Fatigue. Lack of sugar in your child’s cells might make him or her tired and lethargic.
· Blurred vision. Due to high blood sugar levels, fluid may be pulled from the lenses of the eyes resulting in an inability to focus clearly.
· Slow-healing sores or frequent infections. Type 2 diabetes affects the child’s ability to heal and resist infections.
When to see a doctor
In case you notice any of the above symptoms, do consult your paediatrician at the earliest. Undiagnosed, the disease can cause serious damage. Diabetes screening is recommended for all children and adolescents who are overweight and have at least two other risk factors for Type 2 diabetes. Risk factors for this condition include obesity and a positive family history (60 to 90 per cent have a first or second degree relative with Type 2 diabetes). Onset is usually before the age of 25 years.
Other metabolic derangements can be associated with insulin resistance and can be present at diagnosis of Type 2 diabetes. These include:
· Disorders of cholesterol and lipids leading to atherosclerosis
· Polycystic ovary disease
· Obstructive sleep apnea
· Fatty liver
As parents and caregivers, there is a lot that we can do to manage or prevent Type 2 diabetes in children. We can encourage children to eat healthy foods, get plenty of physical activity and maintain a healthy weight.
(The writer is Senior Consultant, Paediatric Pulmonology, Fortis Memorial Research Institute, Gurugram.)
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