Normally, diabetes is not common in childhood, but when it occurs it is too much severe and causes dangerous problems. But in recent days, the cases of children are more frequently diagnosed and so it has become an area of great concern. The disease affects one in 700 school going children in the United States. Diabetic children should not be isolated from rest of the world. They can lead to a normal life can to school, participate in games and sports activities, can go on trip, organize camps; can go for hobby classes, summing, riding, etc. But the need is proper education of parents regarding the good control of diabetes as much as possible.
The principles of treating children with diabetes are same as for adults who have insulin dependent diabetes. The nutritional needs to diabetic are some as that of other children but because of growth their calorie requirements are large in proportion to their size, as comparison with adult standards. It may be difficult to provide enough calories because children’s preferences for foods are often unpredictable.
On the other hand the child must not become too fat because hypoglycemia due too much insulin can lead to excessive appetite and hence to obesity. A dietician mainly helps the child and the parents in such cases. Diabetic children must not have sugar or sweets. In this way, their diet differs slightly from their friends. But the children must be convinced for that with proper affectionate words. Once trained, they may take part in same type of activities as their friend performs. The British Diabetic Association runs special camps for diabetic children.
The treatment for diabetes in children, should aim to maintain normal blood glucose level. It should remove the symptoms as soon as possible and develop a feeling of emotional and physical well being in children. Along with the normal blood glucose level, normal cholesterol level, normal blood pressure level, normal physical growth, etc must also be ensured. Day to day requirements for insulin are very much variable. The therapeutic problems of matching the dose of insulin to the food intake raise practical difficulties. Moreover, children’s emotions and activities fluctuate unexpectedly - sometimes wildly active and sometimes very dull. This things have an important effect on the daily needs of children for insulin because excessive activity may result in hypoglycemia while lethargy or dullness may lead to hypoglycemia. The hypoglycemia may also be caused by any one of the numerous infections diseases to which all children are prone. A combination of unmodified insulin and a depot insulin before breakfast and repeated before the evening meal is the most suitable treatment for diabetic children. Preprandial wine tests should be done and dose of insulin to be administered can be altered. But for this, the children and parents need to have sufficient knowledge. But during alteration of dosage, certain relevant factors such as exercise and illness must be taken into consideration.
Along with Insulin administration, the child should be encouraged to exercise according to his age. Exercise improves blood circulation in them, lowers blood glucose level and maintains the weight of children in normal range. Artificially sweetened eatables or special snacks must be given to the children who perform strenuous physical, activity like cricket, hockey, football etc. This is done in order to prevent low blood sugar. Diabetic children should also be given snacks between the meals. Because, the children who are treated with injected insulin, in them the insulin continues to work even when no food is eaten. Even if there is delay in child’s meal, a snack should be given in between and the meal size is decreased accordingly. But the snacks should be highly nutritive in value. They must not have sugar rich soft drinks, pizzas, burgers, pastries, patties, ice creams etc.
It has been noted that, if cow’s milk is given to the infant them chances of diabetes are increased many more times in them. It is because the proteins in cow’s milk develop certain antigens due to which the immune system of the body acts against its own tissues inhibiting insulin secretion and thus, leading to Type 1 diabetes. That is why during the first year of life the infant is kept away from dairy milk. Instead they are breast fed for much longer period, especially if there is a history of diabetes in the family. So, the infant is saved from the diabetes resulting from allergy the most critical period i.e. first year of the life.