Juvenile diabetes is often synonymous with Type 1 diabetes mellitus or insulin-dependent diabetes which is an autoimmune disease in which the immune system destroys the insulin-producing cells of the pancreas.
Type 1 diabetes mostly has an sudden onset in children or adolescents. It can strike at any age varying from less than a year of birth, up to 40 years of age. Its diagnosis in children is usually straightforward and requires little or no specialised testing. Symptoms include excessive thirst and urination, constant hunger, weight loss, and blurred vision. Children may also feel very tired and weak and sometimes exhibit irritable behaviour.
However now-a-days, the incidence of type 2 (non insulin dependent) diabetes is also increasing. A careful clinical examination will help distinguish the two conditions.
Some patients, particularly children and adolescents, may present with ketoacidosis or coma as the first manifestation of the disease. As insulin deficiency worsens, ketoacids (formed from the breakdown of fat) build up and are excreted in the urine and breath. They cause shortness of breath and abdominal pain, lethargy, muscular cramps, disturbed consciousness, vomiting and severe dehydration. High blood sugar, acidosis and dehydration together cause a condition known as diabetic ketoacidosis or DKA. If diabetes is not treated promptly at this stage, the individual can lapse into a life-threatening diabetic coma.
Management
Since the pancreas can no longer produce insulin, children have to take insulin injections daily, in order to control their blood sugar levels. These four important rules in the management have to be followed.
* Regular insulin therapy
* Eating a healthy diet and following a meal plan
* Check ups at regular intervals
* Regular physical activity
What are the latest advances in treatment?
Several new insulin-delivery systems are under development that may eliminate the need for needle-based introduction. Insulin pens, which are compact, self-contained devices resembling a writing instrument, are convenient, more accurate and less painful. They allow patients to inject more discreetly without using bottles and painful syringes.
Another breakthrough is the insulin pump, a small pager or mobile sized device which delivers insulin from a reservoir inside the pump, through a thin plastic tube, to the body.
Can children with diabetes lead normal lives?
Yes, certainly. One of our patients was diagnosed with type 1 diabetes when she was 2 years old. With regular self monitoring of blood glucose, insulin injections and diet control, she leads a very healthy life despite diabetes. Now she is a proud mother of twin babies.
Hence, the family and diabetes care team should work together to ensure that children with type 1 diabetes can lead normal, healthy lives.