DIABETES IN CHILDREN
When a child is diagnosed with diabetes, it is an occasion for utmost worry—first for the parents and then for the child who is subjected to many restrictions to which he is not formerly accustomed. Diabetes is of two types :
DIABETES ISPIDUS
When there is a profuse and frequent flow of urine, this condition is not serious as there is no sugar in urine or blood, and it is easily manageable. After short intervals, the child passages large quantities of urine and gets weaker and tired.
DIABETES MELLITUS
Of the two types, it is the most disturbing aspect of diabetes when, in addition to the aforementioned symptoms, there is the presence of sugar in urine and blood. First, there is the presence of sugar in the blood, but later on, when blood sugar is not controlled, the sugar content passages into urine also.
HEREDITY FACTOR
Heredity factor is a potent factor in causing diabetes in the offspring. It is not true that if a mother is diabetic, her child would also be a born diabetic. The only factor worth recognizing is that child of a diabetic mother is more exposed to the onset of diabetes. Still, it is unnecessary that a diabetic mother’s child will also be born as a diabetic. Due to the use of certain drugs during pregnancy, the mother may develop diabetic symptoms, but if detected and treated in time, she can be freed from diabetes and its effects. But those mothers, who are confirmed diabetics before conception and remain so even during the course of pregnancy, are most likely to pass on this symptom to their offspring. The reason is that the foetus is nourished by the food the pregnant woman consumes.
It is simply a metabolic disorder. The fact remains that children of diabetic parents may or may not be born as diabetics, but ‘Risk Factor’ still looms large on them. On the other hand, non-diabetic parents may have diabetic children. The least the diabetic parents can do is to guide their children about factors that are believed to be causatives of this disorder, as a ‘Forewarned child becomes a forearmed child’. This applies especially to either or both the diabetic parents who are lazy, inactive, and sedentary, avoid any physical activity, eat frequently and in huge quantities, consume carbohydrates in plenty, do not use fibre, and eat less leafy and green vegetables. In short, they do not perform any physical activity which could enable them to burn/expend the calories generated through indiscreet food consumption.
PROBLEMS IN TREATING THE DIABETIC CHILD
1. If too many dietary restrictions are imposed, the child’s growth pattern will be adversely affected and, thus, recoil his mental and physical development.
2. If carbohydrates, proteins, and fats are withdrawn or partially tapered, his overall progress will be disturbed, and he may lack physical activity, studies, games and other extracurricular activities.
3. It is an uphill task to adjust the insulin dosage and quantity of food intake.
4. Insulin injection is a painful experience for the child, and the child resists and avoids such injections and is generally unable to keep pace with diet and insulin injections.
5. Dosage of insulin must be adjusted and moderated as per the rise or fall in the sugar level, which requires to be simultaneously adjusted with diet.
6. If the diet is not taken immediately after the insulin injection, the sugar level is bound to fall suddenly.
7. If insulin injection is not taken at the designated time and in the recommended dosage, the blood sugar level will rise.
8. Sudden rise or fall in blood sugar level will interfere with the child’s normal activity, studies, games and other allied extracurricular activities. In short, his entire routine will get disturbed.
9. Close and constant monitoring is required in relation to insulin, diet and activity, which a child finds difficult to adhere to.
It is the duty of parents to keep in mind the above-mentioned problems. It is known that diabetes is fully manageable, treatable and controllable but cannot be cured once forever: ‘once a diabetic, always a diabetic’ should be borne in mind. it is like Blood Pressure which also can be controlled but never cured. The parents should always cheer up the child and never scare him or portray a depressing picture. Try to animate and keep up his spirits, boosting his self-confidence and morale. Do not scare the child or impose unnecessary restrictions on diet and activity or interfere with his studies.
TREATMENT
A patient has no option but to depend upon Insulin—as far as a child or an adult is concerned, though elderly persons can be managed by oral anti-glycemic drugs, which are easier to manage. As far as proper treatment and diet are concerned, the patient should be kept under the supervision of a doctor, who is the only right person to advise on the adjustment of insulin dosage and diet. Considering all such considerations, I avoid suggesting any mode of treatment and diet which aspects ought to be conducted by a doctor. However, follow-up action is to be performed by the parents and the child.
If diabetes is not controlled in time and allowed to prolong, complications may arise.
1. Late healing of wounds and appearance of leg ulcers.
2. Digestive disorders.
3. Hardening of blood vessels (Arterio Sclerosis).
4. Damage to Peripheral Nerves (Peripheral diabetic neuropathy).
5. Damage to kidneys and hardening of soft tissues (Diabetic Nephropathy).
6. Damage to eye-sight (Particularly damage to the retina called Retinopathy).
7. Skin problems include boils, pimples, rough skin, rashes, Pruritis, Urticaria, etc.
8. Loose teeth and spongy gums.
9. Impotency, Sterility, Phimosis or Paraphimosis.
REACTIONS OF INSULIN
PRIMARY SYMPTOMS (HYPOGLYCAEMIA)
1. Sudden fall in sugar level.
2. Unconsciousness or/and listlessness.
3. Rapid pulsation of the heart.
4. Excessive hunger.
5. Trembling, convulsions.
7. Sinking of body energy to its lowest ebb.
8. Staggering gate and darkness before eyes.
9. Short-term memory failure, mental instability, disorientation, forgetfulness.
SECONDARY SYMPTOMS
1. Unbearable itching (Pruritis), hives/urticaria.
2. Nausea, Vomiting and loose motions.
3. Bloating of the abdomen.
4. Black/dark rings or spots around eyes or/ and on skin.
5. Shedding of fat and general run-down condition.
6. In some cases, patients put on extra weight even.
Hypoglycaemia can be easily managed by ingesting sugar-rich beverages or dissolving sugar or sugar cubes in water, which will remove the above-mentioned complications. Diabetics are advised to keep some sugar with them, preferably dissolved in water, as a handy tool to meet emergent situations. Even sweet biscuits, toffees, sweets, chocolates should be kept in readiness to meet such sudden situations.