Diabetes Mellitus and Child

The incidence of diabetes is constantly increasing: type 1, being an autoimmune disease, seems to follow the increased prevalence of these diseases, while type 2 follows the obesity epidemic that exists in our country.

Type 1 diabetes
Type 1 diabetes seems to be occurring at younger ages (below the age of 6), increasingly. One would think that it would be easy to treat, with the administration of insulin, but practice would have disproved it. The challenges and pitfalls for the physician as well as for the patient appear even from the diagnosis and are certainly exacerbated by the young age of the patients.

With the announcement of the diagnosis to the patient and his family, there is, almost always, a “mourning” for this fact. Mostly the family of the newly diagnosed diabetic, especially if this is a young child, considers that the “end” has come for him. It is in the hands of the trainers and the family, that this is overcome quickly.

Diabetes family education has several points to cover: different circulating insulins, new type of insulins, hypoglycemia, hyperglycemia, exercise, diseases, nutrition, how to give insulin, blood sugar measurement, diabetic day plan, diabetes psychology, goals for diabetes and the patient.
These goals must be realistic, depending on the age of the patient and the level of the family, without overlooking a good control. For t

for the best and most complete education, as well as for contact with the family, the presence of a team of experts is necessary: ​​a nurse trained in diabetes, a dietitian, a psychologist and last but certainly not the most important, the doctor. Each team member will focus on the part of treatment they know best. This team should communicate with each other in order to assess any particularities of the patient and his family.

Setting Diabetes mellitus
Diabetes management, regardless of age, is a balance between insulin, diet and physical activity. This is exactly what scares parents of young children with diabetes: will they easily agree to take measurements and injections? Will they be able to control their diet and activity? Will they be able to detect hypoglycemia? The fact that children are small is their advantage. Their behavior can be shaped and taught. Parents and the diabetes team play a key role here. There is no doubt that insulin delivery systems (pen or pumps) as well as glucose control technologies with many colors, shapes and a minimum amount of blood (3 ml) are extremely child-friendly and their familiarity with them is amazing. Diabetes deprivation diets are now a thing of the past. Combined with the new insulins, we can be more flexible in the nutritional plan of young children with diabetes, regarding the amounts of food and the timing of meals. As for hypoglycemia, frequent control and time will bring their perception.

Many parents with young children with diabetes worry that they will develop complications from it, as they will have the disease longer than an older child. This seems not to be true. Studies that have been done have shown that the age of onset of diabetes does not play a role in the occurrence of complications. What definitely plays a role is diabetes control and that is where the diabetic team and family should focus.

Type 2 Diabetes Mellitus
Type 2 diabetes is a disease caused by a malfunction of the insulin molecule at the cellular level. It is characterized by an increased body weight of the affected individuals. Greek children are among the most obese children in the world. While a few years ago, we saw quite a few children with glucose intolerance (pre-diabetes), now we are starting to see quite a few children with type 2 diabetes. Treating them is a challenge: a key part is controlling body weight to correct resistance to insulin, as medication is limited in these ages.

in conclusion
Diabetes in children should not be scary. Children adapt extremely well to whatever challenges are presented. New technologies achieve better control in perhaps a more complex but also more child-friendly way. Parents, after the initial disappointment should be optimistic.

Written by:
Nikolaos Kefalas
Pediatrician – Endocrinologist
MITERA Children’s Diabetic Clinic

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