Childhood diabetes needs extra care

When a child is diagnosed with diabetes, along with the child the parents will experience everything as new.

Diabetes mellitus ( DM) is not a single entity but rather a heterogeneous group of disorders in which there are distinct genetic patterns as well as other etiological and pathophysiological mechanism that lead to impairment of glucose tolerance. There are two types of diabetes, those are:

Type 1 diabetes: Type 1 diabetes is an immune system disease where the body makes little or no insulin. It usually begins in childhood or teens. Children with type 1 diabetes need daily insulin shots to help their bodies use food. Type 1 diabetes often runs in families.

Type 2 diabetes: Type 2 diabetes is a disease where the body cannot make enough or cannot properly use insulin. Although this form of diabetes usually occurs most often in adults, it is becoming more common in youth. The average age of diagnosis of type 2 diabetes in youth is 12-14 years. It is more common among girls than boys.

Most of the children suffer from type 1 diabetes, so insulin is the treatment of choice. Some are treated with oral drugs. But proper nutritional plan and exercise can reduce the blood glucose effectively.

When choosing foods for a child who has diabetes, it is important to know how different foods affect blood glucose levels. Children who have diabetes basically need the same foods that all children need to grow and thrive. The recommended calorie intake is based on size or surface area of the child.

The following guideline will help provide a healthy diet to help control a child’s diabetes:

Offer balanced meals at regular intervals every day; Learn how different foods affect the child’s blood glucose level; Offer healthy snacks between meals; Encourage the child to drink water when thirsty; Choose whole-grain foods with higher fiber contents; Limit sweets, regular soft drinks, pastries, candy, jam, and honey; Limit saturated fat and cholesterol; Avoid trans fat (found in foods with hydrogenated or partially-hydrogenated oils) etc.

Aerobic exercise, that gets the heart beating faster and uses the large muscles, can help keep blood glucose levels in balance. It can also help lower cholesterol and blood pressure. Exercise also can help the child sleep better, feel more relaxed and even help concentrate better.

Hypoglycemia during or in the 2-8 hours after exercise can be prevented by careful monitoring of blood sugar level before, during or after exercise, sometimes by reducing dosage of insulin or giving extra snacks

Signs of low blood glucose include confusion, grouchiness, irritability, tiredness etc.

If the child has signs of low blood sugar, check blood glucose levels. If the level is under 70 mg/dL, try one of the following:

Have the child drink ½ cup of grape or orange juice, 1 cup of milk, a juice box, or ½ can of a regular (not diet) soft drink Give the child 1-2 tablespoons of sugar or honey

Parents cannot manage there child’s diabetes alone. The stress imposed on the family around the time of initial diagnosis of DM may lead to feeling of shock, denial, sadness, anger, fear and guilt. Meeting with a specialist to express these feelings at the time of diagnosis helps with long term adaptation. The physician must discuss various aspects of child’s diabetes with the child as also with the parents. The exercise has got to be a continuing programme. This needs a good rapport between the physician on one hand and the child and the family on the other hand. Parents need to learn administration of insulin injection, blood sugar testing, recognition of warning signals of hypoglycemia, hyperglycemia, ketoacidosis, infection etc.

Although children can be taught to perform many of the tasks of diabetes management. They do better when supportive — NOT over bearing-parents continue to be involved in management of their disease. Schools have the responsibility to provide diabetic students with a medically safe environment as well as equal access to the same opportunities and activities enjoyed by other students.

Diabetes is a very complicated and life threatening disease. There is no cure for diabetes, it can be controlled. So people of all corners should work together and create awareness, so that a diabetic child can lead a healthy, active and fun-filled life.

Childhood diabetes needs extra care
Dr Abu Sayeed Shimul
Source: The Daily Star, November 15, 2008