Diabetes can strike anyone from any walks of life. Tomorrow is World Diabetes Day and as we know diabetes is a chronic, incurable disease that occurs when the body doesn’t produce any or enough insulin. Sugar builds up in the bloodstream and is excreted in the urine. Eventually, the high blood sugar caused by the excessive amount of glucose in the blood leads to a variety of complications. Sadly, juvenile diabetes is on the rise. Defects in insulin secretion or insulin action or both cause Diabetes Mellitus and this condition is increasing worldwide. It is called Type 1 Diabetes or Juvenile Diabetes when it affects children between the age group of 0-14 years.
According to the Diabetes Atlas 2015 published by the International Diabetes Federation, the number of people with diabetes in India is currently around 69.2 million and is expected to rise to 123.5 million by 2040. Type 1 diabetes mellitus (T1DM) is one of the most common pediatric endocrine illnesses. India is estimated to be home to about 97,700 children with T1DM. Data collected from hospital-based studies in 1990 from India suggest that young diabetics (onset of diabetes before the age of 15 years) constitute about one percent to four percent of the total diabetic population. India had reported a prevalence of juvenile diabetes (onset below 15 years) less than one percent to 3.61percent between 1964 and 1989. In 2006 the ICMR established the Registry of People with Diabetes with Young Age at Onset (YDR) in 2006 to probe into the history of diabetes in the young in India. In phase 1, the registry enrolled 5546 patients, in which type 1 diabetes mellitus (T1DM) was the most prevalent (63.9 percent), followed by youth-onset type 2 diabetes mellitus (T2DM) (25.3 percent).
Juvenile Diabetes is also called as Type 1 diabetes mellitus (T1DM), It is one of the most common chronic diseases in childhood, is caused by insulin deficiency following destruction of the insulin-producing pancreatic beta cells. Dr Mahesh Chavan, Consultant, Endocrinology, Apollo Hospitals says, “It is one of the most common chronic diseases in childhood, is caused by insulin deficiency following destruction of the insulin-producing pancreatic beta cells. It most commonly presents in childhood, but one-fourth of cases are diagnosed in adults.”
Type 1 Diabetes Mellitus occurs in children, adolescents or young adults when their insulin producing cells in their pancreas are destroyed. The insufficient insulin then causes glucose or sugar to get into the bloodstream instead of being used as energy thereby disbalancing the sugar level.
Avni Kaul, Nutritionist, wellness coach and certified diabetes educator from Project Hope and International Diabetes Federation, says “The reason for this condition to occur is not known exactly. However, an autoimmune disease, in which the immune system misbehaves and destroys the healthy cells in the pancreas, is one of the guilty parties. Heredity also plays an important part when it comes to the occurrence of autoimmune diseases.”
Kaul mentions that excessive thirst, increased appetite, blurring of vision, weight loss and exhaustion are some of the symptoms in children which should be taken very seriously for they may be occurring because of Diabetes Mellitus.”
Diagnosis can be made by considering the information given by the patient or an adult looking after him/her. Urine dipsticks, blood glucose test strips, fasting blood sugar, oral glucose tolerance test, random blood sugar, hemoglobin A1c(Hb1C) are some of the tests that can be done to confirm the diagnosis.
Says Kaul, “It is important for the patient to keep his/her blood sugar level under control.It can be done by monitoring the blood glucose and taking insulin, if necessary. The disease can be managed by making few lifestyle changes like making healthy food choices and maintaining a healthy weight through regular exercises.”
Concentration of blood glucose level should be regularly monitored too so that the fluctuation can be managed to prevent complications. “Deep, rapid breathing, dry skin and mouth, flushed face, fruity breath odour, nausea and vomiting and abdominal pain are some of the symptoms of diabetic ketoacidosis (DKA) which may be fatal and which develops due to the lack of insulin,” adds Kaul.
Excessive hunger, headache, nervousness, rapid heartbeat, sweating, tremors and weakness are symptoms of hypoglycemia or low blood sugar which may occur when the dose of insulin, food intake and exercise do not match each other. A glass of sweet beverage or a couple of sweet biscuits should be given immediately to the person experiencing these symptoms.
If diabetes is not controlled in the initial stages then it may result in a host of complications like foot ulcers and their delayed healing, nerve damage in the legs and feet, problems in the eye and kidney failure. It is, therefore, important to immediately contact a qualified doctor, who besides prescribing the medication will also guide the patient and the caregiver into making lifestyle changes so that you can lead a normal enough life.
Kaul says, “When you have diabetes, you must carefully monitor your carbohydrate intake. This is because carbohydrates are responsible for raising your blood sugar levels. While you can enjoy sugary foods when you have diabetes, it is important to do so in moderation and with some understanding of how it could impact your blood sugar. This includes sugars found in desserts. Knowing the difference between sugar-containing foods and those with less sugar content can help with diabetes management.”
Artificial sweeteners are synthetic substitutes for sugar that have been altered so they will not impact blood sugar. The flip side is that these artificial sweeteners can have adverse effects on the body after prolonged use. Kaul further adds, “Honey is another great alternative. Honey contains minerals, nutrients, vitamins, acids and natural sugar, which table sugar or any artificial sweetener does not have. Honey is both sweeter and denser than table sugar, and hence we end up requiring a lesser amount to use. Honey is also a natural sweetener, and hence a much healthier option to eat.”
Dr Mahesh Chavanstates, T1DM is significantly increased in close relatives of a patient with T1DM:
No family history – 0.4 percent
Child of an affected mother – 1 to 4 percent
Child of an affected father – 3 to 8 percent