Diabetes in childhood: what is it?
The most common form of diabetes in children is Type 1 diabetes, in which the massive destruction of the insulin-producing cells of the pancreas causes a rise in blood sugar levels. Treatment with subcutaneous insulin several times a day is essential for survival.
Detecting diabetes early in a child is crucial to prevent severe acute complications and to bring the condition under control quickly, allowing the child to live a life like any other.
It should not be confused with Type 2 diabetes, the most common form of diabetes (90% of cases), which mainly appears in adulthood and is closely linked to obesity, a sedentary lifestyle and an unhealthy diet high in fat and carbohydrates and low in fibre. This form is rare among Portuguese children and young people, but is significantly more prevalent in regions such as the USA, Brazil, Africa and Japan. In this type of diabetes insulin production is sufficient, and often even high, but the organs stop responding to it, so — as in Type 1 — excess sugar builds up in the blood.
Symptoms to watch for
If you notice this set of symptoms in your child, pay attention: they match the typical presentation of Type 1 diabetes:
- Excessive thirst
- Urinating very often and in large amounts
- Ravenous appetite
- Weight loss
- Fatigue
Type 2 diabetes develops very slowly and silently, and does not usually present in this way — much less in this age group.
What to do
If diabetes is suspected, the child should have their blood sugar measured immediately. This can be done with a finger-prick test at a pharmacy, health centre or hospital.
If the reading is 200 mg/dl or above, the paediatrician is the first specialist who can help. It is essential to refer the child to one of the paediatric diabetes centres available across the country, where the best strategy for controlling the condition and maintaining a healthy lifestyle will be set out.
Treatment
Insulin, physical exercise and a healthy diet are the pillars of treatment for diabetes in children (Type 1). If blood sugar is well controlled, the child can lead a normal life — educational, professional and social — like other children of the same age. This requires the involvement of the whole family and of the community around the child.
Poor blood sugar control and an inadequate insulin regimen, on the other hand, prevent metabolic balance, putting the child at risk of acute decompensation such as coma, and of long-term complications affecting mainly the eyes, kidneys, heart and blood vessels.
Type 2 diabetes is initially treated with tablets (oral antidiabetic drugs), with insulin reserved for more advanced cases that respond poorly to oral medication. In children and adolescents this type of diabetes is still rare in Portugal, and treatment is the same as in adults.
Prevention
With current knowledge it is not yet possible to prevent Type 1 diabetes. Despite the efforts of the scientific community, genetic susceptibility, environmental factors and the involvement of the immune system mean that this disease still cannot be prevented or cured.
Type 2 diabetes in adults, however, can be prevented by acting in childhood — above all by preventing obesity from infancy through to adolescence. To do so, encourage healthy habits in your family:
- Keep to a healthy diet: avoid fast-absorbing sugars (soft drinks, biscuits), reduce saturated fats (fried food, margarine and butter) and always include fibre-rich vegetables and fruit in main meals
- Encourage 60 minutes of physical exercise a day
- Limit screen time to two hours a day
Your paediatrician should keep track of your children's weight percentiles and refer them to a Nutrition or Paediatric Endocrinology consultation if they are not responding to non-pharmacological weight management.