Diabetes

Diabetes is a chronic metabolic disorder characterized by hyperglycemia, the presence of high glucose level in the blood. The level of glucose in the blood is regulated by the insulin hormone. Impaired production, action or both, of insulin, increases the glucose level in the blood leading to hyperglycemia and uncontrolled hyperglycemia damages various organ systems of the body including the cardiovascular system, eyes, kidneys, nerves and blood vessels. Thus, timely detection and management of the blood glucose level at normal is crucial to prevent long term serious complications of diabetes.

Diabetes is classified into four types based on the cause or treatment approaches:

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes
• Secondary diabetes

Type-1 Diabetes

Diabetes in children less than 10 years of age is usually type-1. Type-1 diabetes is caused by the destruction of the insulin producing beta cells of the pancreas by the impaired immune response. Early symptoms include:

• constant hunger
• weight loss
• blurred vision
• increased thirst and urination
• a feeling of tiredness

As the diabetes progresses, the child may complain of stomach pain, vomiting and frequent urination.

The management of type-1 diabetes includes giving insulin either by injection or through an insulin pump, nutrition management and physical activity.

Type- 2 Diabetes

Type 2 diabetes develops because of lack of sensitivity of the receptors to insulin. Receptors are the transport system that enables insulin to enter the cells and metabolize the carbohydrates stored in the cells. Because of loss of sensitivity to insulin, although sufficient amount of insulin is available, the receptors fail to allow the insulin into the body cells, thereby inhibiting the breakdown of carbohydrates in the cells and thus causing hyperglycemia.

Type 2 diabetes was more common in adults, however, in the current scenario the incidence of obesity is increasing in children aged 10 years and above, thereby increasing the incidence of Type-2 diabetes. The symptoms of type-2 diabetes are the same as that of type-1 diabetes and in certain cases the child may not show any symptoms at all. An important aspect of diabetes management is lifestyle changes that include diet modification, increased/moderate physical activity and medical treatment. Medical treatment includes medications to lower the glucose level, known as oral hypoglycemic agents and/or insulin therapy. Regular monitoring of blood glucose level is necessary to prevent long term complications of the disease.

Gestational Diabetes

Gestational diabetes is the type of diabetes seen in some women only during pregnancy. Some pregnant women develop this form of diabetes because of hormonal changes seen during pregnancy. These hormonal changes alter the insulin activity leading to hyperglycemia finally causing diabetes. Gestation diabetes may subside after the delivery of the child, however, the condition may put some women at risk of developing diabetes in the future. Treatment options include oral hypoglycemic agents, insulin therapy, and lifestyle modifications.

Secondary Diabetes

Secondary diabetes is the condition caused as a secondary effect of certain disease conditions such as pancreatic disease, hormonal disorders, adverse effects of drugs, insulin receptor abnormalities, and some of the genetic disorders. The treatment options include the same as other forms of diabetes.