Today I am going to talk on diabetes in childhood, there are two types of childhood diabetes in childhood one is Type 1 and one is Type 2. Previously we thought Type 1 is the only or the most commonest variety of diabetes in childhood well the presentation is normally excessive hunger, excessive thirst, excessive urination children going to washroom very frequently in the school that is the commonest complaint. Bedwetting ends around child sleeping area or ends around child playing area, falling frequently sick or requiring medical attention very frequently are the commonest presentation of Type 1 Diabetes in children. The other variety that is what we see now very often in last 10 to 15 years is the Type 2 variety which was not seen 15 years back. Why sudden change, the changes because of change in Lifestyle in last 10 to 15 years and as a change in Lifestyle that means there is a change in eating habits children are eating more junk food, a fast food they need to make they need to serve food with a lot of preservatives and food with a lot of processing. In addition to that there is lack of daily routine exercise, increase in sitting timing or increase in the tuition timings, lack of external sports activity, more concentration on TV, television, computer games, mobile games all that reducing the regular activities or exercise in day to day life of children resulting into the insulin resistance, obesity and resulting into Type 2 diabetes or term which we face diabesity. Many times in Type 2 diabetes presentation is not similar to Type 1 diabetes that means very often, it is very very difficult for parents or doctors to suspect that because most of the time the investigations are done are CBC, urine routine or subjective relation testing. However, if blood sugar fasting post lunch is also including in the children who are having a frequent sickness, frequent illness or acquiring medical attention very regularly then possibilities said that this Type 2 diabetes can be detected earlier in absence of classical symptoms of diabetes. How to differentiate whether a child is having Type 1 Diabetes or Type 2, there are some special investigations done which can rule out whether the child is having Type 1 Diabetes or type 2. This investigation is C peptide, serum insulin testing, anti-insulin antibody test and Islet Cell antibody test, these are the test which is very common in Type 1 Diabetes and sometimes you can extract history of childhood measles, mumps rubella or somewhere infection in early childhood. So if a child is a sonography or CT scan of the abdomen is normal and one of this parameter that is C- Peptide or serum insulin levels are abnormal then the possibility of Type 1 Diabetes is there and it can be confirmed by doing additional testing. But if a sonography or a CT scan of the abdomen is normal and blood sugar fasting, PP are abnormal and C peptide levels are normal then in that situation we usually label that child to having Type 2 Diabetes and this Type 2 Diabetes can be treated with Lifestyle modification and if required oral antidiabetic drugs and sometimes even insulin can be given for a short period. However, if a diagnosis is Type 1 Diabetes then probably these children are required insulin lifelong at least as on today. So today I have discussed the presentation of Type 1 Diabetes and type 2 diabetes in early childhood, how to investigate and diagnose and what are the different modalities of treatment.
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