Pregnancy and paediatrics

If your child has been diagnosed with Type 1 diabetes, you’re not alone – about one in 500 children worldwide end up with the disorder.

Paediatric endocrinologist Dr David Segal tells us what we need to know.

In most people with Type 1 diabetes, the body’s immune system mistakenly destroys insulin-producing cells in the pancreas, resulting in a condition where the body no longer produces the hormone insulin. Insulin does the critical job of moving sugar (glucose) from the bloodstream to your body’s cells. You need insulin to survive, so if it’s missing, it has to be replaced.

What are the warning signs in children?

Diabetes presents from birth onwards, although it’s very rare in the first year of life. Its incidence peaks between the ages of three and six, then again between nine and 14. But it’s a myth that Type 1 diabetes presents only in kids– about 50% of cases present in adulthood.

The signs and symptoms can develop quickly, and include increased thirst, frequent urination, weight loss, thrush infections or new-onset bed-wetting. Your child may be very tired and irritable, his school performance may suffer, and his vision may be blurred.

What should you do if you’re concerned?

The most important thing is to go with your gut feeling. If you (or someone else close to the child, such as a grandparent) think your child’s behaviour has changed or he’s showing any of the signs or symptoms, see a doctor. And insist the doctor screen for diabetes.

What is thought to cause the condition?

Nobody has a clue. There’s a genetic component but the condition needs an environmental trigger, such as a viral infection at some point in the past. The things we know don’t cause it are cow’s milk and vaccinations.

How should parents work with healthcare practitioners plus how should they manage their child’s condition at home?

The most important thing is to work with a specialist in diabetes. Then, children with Type 1 diabetes need constant care and monitoring of their food and insulin. Management is a combination of routine, meal planning and dietary adjustments, plus frequent blood-glucose tests and injections (up to five a day).

What advice do you have for parents teaching older children to manage their condition?

Transition carefully – hand over responsibility very gradually and with continued supervision. Relinquish certain behaviours and tasks one at a time and monitor how the child is coping. Even once management is handed over, continue to give supervision and support. If something goes wrong, no teenager can manage diabetes on their own.

Any hope of future cures or improved treatment?

Any cure would involve stem-cell treatment and that is still a while away, although treatments are improving all the time. The latest advance is a ‘closed-loop’ insulin pump. This measures blood sugars and delivers insulin automatically.

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