If you think diabetes happens among adults only, think again!
“Diabetes is one of the most common chronic diseases of childhood,” reports the Brussels-based International Diabetes Foundation (IDF). “It can strike children of any age, including infants and toddlers. Yet diabetes in children is often diagnosed late, when the child has very high, potentially life-threatening, blood-glucose levels. Sometimes, it can be mistaken for something else, such as the flu.”
In the Philippines, children are now more prone to diabetes due to changes in diet and technology. In an interview on DZMM’s “Magandang Gabi Dok,” Dr. Susana Campos, a pediatric endocrinologist, said that fast food and candy commercials on television greatly influence the children’s food preferences. This increases the risk of children with diabetes.
Children in the past used to enjoy the following games: shatong, ting-ting cross, patintero, luksong baka, luksong tinik, Chinese garter, bahaw-bahaw, piko, iring-iring, kapitang bakod, piko, and sipa.
“Those are really fun games, competitive, teamwork and socializing aside from being healthy games,” said Dr. Roy B. Ferrer, an assistant secretary of the Department of Health (DOH) and diabetologist.
Unfortunately, most of those games are now unheard of. You don’t see children doing those games anymore. “Instead of indulging in field sports and street games – which were popular during our era – today’s children are hooked on their computers,” Dr. Ferrer lamented.
Among urban children, a study conducted by the International Life Sciences Institute of Southeast Asia among 1,208 children aged eight to 10 showed that on average, they spent 106 minutes a day watching television, but up to only 37 minutes playing outdoor games.
Not only that, most children are not eating healthy foods – thanks to fast foods and the availability of junk foods anywhere.
“Across the globe, more people (including children) are consuming high-fat foods that are heavily processed and low in fiber,” the IDF notes. “Increasingly, families are eating food prepared outside the home.”
In the past, diabetes among children was uncommon. But today, the scenario has completely changed. More and more children are suffering from this debilitating disease.
Right now, no one knows exactly how many Filipino children are having diabetes. But Dr. Ellen Du, immediate past president of the Philippine Society for Pediatric Metabolism and Endocrinology told Manila Bulletin that “based on the registry of the Philippine Pediatric Society, there were around 3,000 cases of type 1 diabetes among the four million admissions from 2006 to May 31, 2021.
“This is an underestimate because the data is only from pediatric training hospitals and this doesn’t also include those patients who were diagnosed in the clinics as outpatients,” she clarified.
Johanah Co, a member of the International Diabetes Federation Young Leaders in Diabetes Program, was 13 when he was diagnosed with diabetes. “I knew something was wrong because I would always be thirsty, I would get tired easily and ants were attracted to my urine,” he told Philippine Star. “That’s when my parents decided to seek medical help.”
Diabetes has something to do with insulin. It is a protein hormone made in the pancreas, a gland located behind the stomach. Insulin allows the body to use glucose – a type of sugar found in many carbohydrates – for energy.
Actually, there are three types of diabetes. In insulin-dependent diabetes mellitus (or type 1 diabetes), which affects mostly children, there is very little insulin around because the special cells that produce it within the pancreas have been destroyed by the body.
The most common form is the noninsulin-dependent diabetes mellitus (type 2 diabetes), which involves insulin resistance. A person may be making insulin, but his body is not using it properly. This type comes on gradually, making it difficult to detect.
At one time, type 2 diabetes was called adult-onset diabetes as nearly all its victims were over 30. But now, such a kind of diabetes affects children as young as four, which could become “the most widespread and potentially devastating disease to attack children since polio.”
A third type of diabetes develops during some cases of pregnancy. Other rarer types of diabetes also exist. Some children diagnosed with diabetes may have elements of both type 1 and type 2 diabetes. This phenomenon is often referred to as “hybrid,” “mixed,” or “double” diabetes.
Maturity-onset diabetes of the young is a rare form of diabetes in children that is caused by a single gene that results in the faulty secretion of insulin. This form of disease is thought to account for up to 5% of all cases of diabetes in children. It often goes unrecognized.
“Type 1 diabetes is growing by 3% per year in children and adolescents, and at an alarming 5% per year among preschool children,” IDF discloses. Around the world, 70,000 children under 15 develop type 1 diabetes each year.
Untreated or uncontrolled type 1 diabetes results in diabetic ketoacidosis (DKA). This life-threatening consequence occurs because there is low or no insulin available in the body to help the organs and tissues take up glucose for energy.”
“DKA is the leading cause of death and disability in children with type 1 diabetes around the world,” IDF states. “If left untreated, it has a 100% death rate.” (Up to 90% of all DKA-related deaths result as a consequence of cerebral edema or swelling of the brain.)
On the other hand, the global incidence of type 2 diabetes in children “looks likely” to increase by up to 50% over the next 15 years, according to IDF. In the United States, some doctors saw maybe one or two kids a year with the condition. Today, in children’s hospitals and pediatric clinics, up to 46% of all new diabetes cases are of such kind.
Because diabetes is almost always associated with adults, children are neglected of being diagnosed with diabetes. “A doctor cannot tell that a child is diabetic until he starts to complain and usually that is already late as far as complications are concerned,” said Dr. Ricardo Fernando, founder of the Institute for Studies and the Diabetes Foundation.
“(Diabetes) has no cure,” Dr. Fernando stressed. “What doctors can do is just minimize the complications or push its onset a little later because the disease is more manageable among older people.”
Parents need to know more about diabetes – or else they may lose their children from complications of the disease. “The silent plague is haunting our children, and it’s time we broke the age misconception, talked about it more and took it very seriously,” urged Terence Repelente in an article which appeared in Philippine Panorama.
The website healthline.com says diabetes in children is most common in those aged 10 to 19 years old. A child may have an increased risk for Type 2 diabetes if he has a sibling or other close relative with Type 2 diabetes, shows symptoms of insulin resistance, including dark patches of skin, and overweight or obese.
“Symptoms of Type 1 diabetes in children tend to develop rapidly over a few weeks,” writes Honor Whiteman for Medical News Today. “Type 2 diabetes symptoms develop more slowly. It may take months or years to get a diagnosis.”
According to Whiteman, children and adolescents with diabetes usually experience four main symptoms, but many children will have only one or two. In some cases, they will show no signs.
“If a child suddenly becomes more thirsty and tired or urinates more than usual, their parents may not consider diabetes a possibility,” Whiteman said. “Doctors, too, since diabetes is less common among very young children, may attribute the symptoms to other, more common illnesses. For this reason, they may not diagnose diabetes at once.”
As for Type 2 diabetes, younger people also seem to have a higher chance of complications, such as kidney and eye disease, earlier in life than children with Type 1 diabetes. “There is also a greater risk of high blood pressure and high cholesterol levels, which raise a person’s risk for blood vessel disease,” Whiteman said.
For Type 1 diabetes, treatment involves lifelong insulin use and blood sugar monitoring. In addition, diet and exercise management must also be observed to help keep blood sugar levels within the target range.
“If your child has type 1 diabetes – especially a young child – you’ll be involved in diabetes care on a day-to-day basis, from serving healthy foods to giving insulin injection to watching for and treating hypoglycemia (low blood sugar),” the US Centers for Disease Control and Prevention (CDC) says.
The parents also need to stay in close contact with their child’s health care team. “They will help you understand the treatment plan and how to help your child stay healthy,” CDC says.
On the other hand, type 2 diabetes can be managed through a change in diet, more exercise, and maintaining a healthy weight. In some instances, a child may need medication.
Diabetes has been identified by both the World Health Organization (WHO) and health department as one of five noncommunicable diseases that kill more Filipinos; the other four are heart disease, stroke, cancer and chronic diseases that affect the airways and lungs.
“(All five diseases) take almost 300,000 lives in this country every year,” Health Secretary Francisco Duque III pointed out. “While these diseases affect different parts of the body in different ways, they often share common origins. The good news is, many of these factors are avoidable.”
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