Diabetes Mellitus, commonly known as Diabetes, is a disease when the body can no longer convert glucose into glycogen for storage purposes. It can be either due to inability to produce the hormone Insulin responsible for bringing about this function or because of resistance to insulin. American Diabetes Association defines it as “A group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both”. Long-term hyperglycemia (increased blood sugar levels) may lead to various complications and organ dysfunction e.g. Eyes, kidneys, nerves, blood vessels etc.
Diabetes In Children
As per a study conducted by International Diabetes Federation, “The prevalence estimates indicate that there are almost 500,000 children aged less than 15 years with type 1 diabetes worldwide and 200 children worldwide develop DM type1 every day”.
According to another study by American Diabetes Association, “Until 10 years ago, type 2 diabetes accounted for less than 3% of all cases of new-onset diabetes in children and adolescents. At present 45% of cases are attributed to it.”
Like all other countries, incidence of DM in younger generation is increasing in Pakistan as well. During a training program organized by National Institute of Child Health (NICH) Karachi experts said, “Diabetes in the juvenile population is increasing at an alarming rate.”
Previously, Diabetes type 1 was the only type prevalent in children and young adults whereas Diabetes type 2 was common in adults only. But with passage of time and increasing obesity, both types are quite prevalent in the younger generation. Here is a brief overview of the two types common in younger generation:
Diabetes Type 1 (DM1)
Also known as Juvenile Diabetes Mellitus, this is the more common type of Diabetes in children, characterized by autoimmune destruction of the insulin producing B-cells of pancreas. This mostly happens as a result of viral infections like Mumps. Hence there is complete absence of insulin production.
Diabetes Type 2 (DM2)
This is although more common in adults yet quite prevalent in children as well these days. This occurs as a result of resistance to insulin leading to symptoms of Diabetes. It means that the pancreas produce normal amount of insulin or may be lesser than normal but the cells in the body fail to respond to insulin. This is mostly associated with obesity or hormonal imbalances in children and young adults.
Causes and Risk Factors
This is caused as a result of autoimmune reaction against the insulin producing B-Cells of pancreas. The risk factors include:
1. Family History.
2. Genetic Susceptibility.
3. Certain viral infections.
It occurs as a result of end organ resistance to insulin. The risk factors include.
2. Conditions leading to insulin resistance e.g. Polycystic Ovarian syndrome
3. Sedimentary lifestyle.
4. Unhealthy eating.
5. Race- More common in American-Indians, Asians and Latino groups.
Symptoms Of Diabetes
Clinical features of both the types are similar and are as follows:
Unexplained weight loss
Extreme hunger and increase in thirst.
Dry mouth and fruity smell in breath.
Slow heeling of wounds.
Complications of Diabetes occur as a result of prolong hyperglycemia. Acute complication of Diabetes Type 1 and fairly common in children and young adults is Diabetic Ketoacidosis. DKA or Diabetic Ketoacidosis is a life threatening condition, occurs as a result of high blood glucose levels. It is characterized by severe dehydration, electrolyte imbalances, metabolic acidosis, and hyperventilation. If left unattended, it may lead to coma and death.
Other complications are not that prominent in childhood and occur as a part of chronically high blood sugar levels.
1. Damage to heart and vessels leading to Coronary artery disease and Angina.
2. Nerve damage leading to neuropathies.
3. Retinal damage, Cataract and Glaucoma.
4. Renal damage leading to End stage kidney disease.
6. Gangrene as a result poor heeling and liability of getting infections.
There are no known methods of preventing DM Type 1 but as far as DM Type 2 is concerned the following measures can help reduce the incidence in children and young adults:
1. Increase in Physical activity.
2. Weight control.
3. Healthy eating patterns.
4. Treating the underlying disease causing insulin resistance.
The increase in incidence of Diabetes in the past decade is quite alarming. Preventive measures and proper health programs are required to educate the population and masses in this regard in order to control the increasing rate of DM not only in Pakistan but worldwide.