WORLD DIABETES DAY: NOV 14

Diabetes

The most chronic disease in childhood

So you thought that diabetes strikes only when you are in your thirties? Here’s a reality check. It hits early, very early, even when you are in pre-school or in the rocking bed, as a toddler. Quite fittingly therefore, the theme of this year’s World Diabetes Day campaign – on Nov 14, celebrated as Children’s Day in India - is Diabetes in Children and Adolescents.

Diabetes is one of the most common chronic diseases of childhood. Yet diabetes in children is often diagnosed late, when the child has diabetic ketoacidosis (DKA), or it is misdiagnosed completely. In many parts of the world, insulin, the main life-saving medication that children with diabetes need to survive, is not available (or is available but remains inaccessible for reasons of economy, geography or constraints on supply). As a consequence, many children die of diabetes, particularly in low and middle-income countries. Those closest to the child - family, school staff, family doctor - may not be aware of the ominous signs. The World Diabetes Day 2007 and 2008 campaigns set out to challenge this and firmly establish the message that ‘no child should die of diabetes’.

Today, more than 240 million people worldwide are living with diabetes. Within 20 years, this number is expected to grow to 380 million. Children are not spared from this global epidemic, with its debilitating and life-threatening complications. Type 1 diabetes is growing by 3% per year in children and adolescents, and at an alarming 5% per year among pre-school children.

It is estimated that 70,000 children under 15 develop type 1 diabetes each year (almost 200 children a day). Of the estimated 440,000 cases of type 1 diabetes in children worldwide, more than a quarter live in South-East Asia, and more than a fifth in Europe. Type 2 diabetes was once seen as a disease of adults. Today, this type of diabetes is growing at alarming rates in children and adolescents. In the US, it is estimated that type 2 diabetes represents between 8 and 45% of new-onset diabetes cases in children depending on geographic location. Over a 20-year period, type 2 diabetes has doubled in children in Japan, so that it is now more common than type 1. In native and aboriginal children in North America and Australia, the prevalence rate of type 2 diabetes ranges from 1.3 to 5.3%.


Diabetes is different for children

Diabetes has a unique impact on children and their families. The daily life of children is disrupted by the need to monitor blood glucose levels, take medication, and balance the effect of activity and food. Diabetes can interfere with the normal developmental tasks of childhood and adolescence, which include succeeding in school and transitioning to adulthood. To help the child and family cope, and to ensure the best possible physical and emotional health of the child, care should be delivered by a multidisciplinary team with good knowledge of paediatric issues.

Support must also be given to caregivers and to school personnel. In this way, children with type 1 or type 2 diabetes can reach adulthood with as little adverse impact as possible on their well-being. For children with diabetes in developing countries the situation at present is bleak.

The campaign aims to raise awareness of the rising prevalence of both type 1 and type 2 diabetes in children and adolescents. Early diagnosis and early education are crucial to reducing complications and saving lives. The healthcare community, educators, parents and guardians must join forces to help children
living with diabetes, prevent the condition in those at risk, and avoid unnecessary death and disability.

Diabetes in Children and Adolescents

• No child should die of diabetes

• More than 200 children get diabetes every day

• Diabetes is different for children

• Care for children is best when a multidisciplinary approach is adopted involving health professionals from all areas that concern children.

• Diabetes hits the poorest hardest.

• A child’s access to appropriate medication and care should be a right not a privilege.

• Diabetes costs more than money.

• Over 50% of type 2 diabetes can be prevented.

• All diabetes is on the rise in children.

• Children die because their families cannot afford the medication they need