Not the end of the world
MANY people believe diabetes only affects adults, but children develop both type 1 and type 2 diabetes, too.
Dr Wu Loo Ling, consultant paediatrician and paediatric endocrinologist at Subang Jaya Medical Centre refutes this misconception, saying, “The prevalence of type 2 diabetes in children is increasing, and the main culprit is unhealthy lifestyle choices. You now see children eating more unhealthy food, not getting enough exercise and putting on excessive amount of weight, making themselves susceptible to develop the disease.”
On the other hand, the cause of type 1 diabetes is multifactorial. The interplay of genetic and environmental factors triggers auto-antibodies production causing progressive destruction of insulinproducing cells in the pancreas. However, as Dr Wu points out, it does not mean that a child with a genetic predisposition of diabetes will definitely develop the disease, various factors are needed to trigger its development.
“Environmental factors such as an infection can cause the body to produce auto-antibodies against the pancreas, resulting in it becoming smaller and ultimately producing very little or no insulin at all,” she explains.
While type 1 diabetes is common in younger children, type 2 is increasingly diagnosed in adolescents and teenagers. According to Dr Wu, symptoms of type 1 diabetes is often acute and dramatic at onset compared to type 2, making it more easily detectable than the latter.
Diagnosis is done through symptom analysis, blood and urine examinations and oral glucose tolerance tests.
Can the child have a normal life?
Treatment for type 1 diabetes is by external insulin administration via injections, while type 2 diabetes requires proper lifestyle modifications, weight loss and oral medications.
“Children with diabetes can certainly lead as normal a life as any other child, provided the diabetes is controlled and managed well. It is crucial for them to lead a healthy lifestyle with well-planned diets, regular exercise and carrying on with treatment as prescribed by their healthcare professionals,” says Dr Wu.
She emphasises that family support is of utmost importance when it comes to managing diabetes in children, saying, “Parents must work together with their children to adopt a healthy lifestyle and eating habits as suggested by healthcare professionals. It should involve the whole family and not just the affected child.
One issue faced by parents of children with diabetes is hypoglycaemia (low blood glucose). Because children are naturally active, many parents may fear that too much activity might cause their children’s blood glucose level to dip dangerously low, causing parents to either overfeed their children or stop them from being active.
Both situations are not ideal, so Dr Wu suggests that parents need to check their children’s blood glucose levels more frequently in these situations and act accordingly as what they had been taught to prevent dangerously high or low levels. Frequent blood glucose checking gives a bigger picture on the trending of glucose throughout the day and night. Preventative or remedial measures can be taken promptly to ensure that the glucose levels are within optimal limits. Hence children with diabetes can exercise safely and do everything like their peers while keeping their blood glucose under control.
Continuous blood glucose monitoring systems are available nowadays to keep track of your blood glucose levels continuously. “There are blood glucose monitoring patches available that can help track the blood glucose levels 24/7. This is particularly good for children who are scared of needles and refused frequent finger-pricking,” she opines.
There are different types and dosages of insulin as well as oral medication, it is imperative that parents listen to their healthcare professionals when it comes to treating their children.
Dr Wu insists that diabetes does not stop children from enjoying their childhood, but shares that in most instances, the level of enjoyment a child experiences comes from the personal care and involvement of their parents in their daily living and diabetes management
She says, “Yes, it can be an overwhelming thing for parents when their child is diagnosed with diabetes, but there are many support groups here in Malaysia and it is advisable that parents join such groups, talk to other parents and do what is best for their children.”