Diabetes in children: new mountains to scale

As Rebecca* scouts for a new school to enrol her 10-year-old daughter Maria,* she is anxious.

Will they be able to support her little girl if she feels weak or her blood sugar-levels drop, asks Rebecca, fearing a repeat of the experience at a previous school.

Maria was eight years old when they found she had Type I or insulin-dependant diabetes. Despite a family history, they were not prepared for one of their youngest to be diagnosed with diabetes.

Still less prepared, though, was her school. Her teachers said it would be difficult to watch out for symptoms in one child in an entire class, says Rebecca, who then took her child out of that school. Two years of private education and a year in a neighbourhood school, Maria now looks to return to a new school next year.

Though adult diabetes is discussed in India, diabetes in children is less spoken about. And though children spend most of their time at school, these institutions remain largely ill-prepared to support children with diabetes. In some unfortunate instances, the condition is stigmatised since the child injects himself with insulin.

As diabetes rapidly increases in number, cases of early onset are also on the rise, says Srinath Reddy, President, Public Health Foundation of India. There needs to be greater support for Type 1 diabetes, besides a recognition that Type II, largely known as “adult diabetes” is increasingly being seen in younger people in India, he adds.

Schools and teachers need training to pick up symptoms like low-sugar or fainting. On the contrary, teachers and fellow-students instead of empathising, sometimes end up ridiculing them, says Reddy.

India has the second largest number of people with diabetes in the world, at over 65 million. But there is no registry on how many have Type 1, says diabetologist V Mohan. Besides, Type II increased by leaps and bounds in young people, he says, adding that 20 years ago there were zero cases.

Schools should be discouraged from selling junk food and colas, and the importance of fresh fruits and playgrounds need to be stressed, says Mohan. He does not recommend screening children, but advises to watch for risk factors, including being overweight or having a family history.

Diabetes can be controlled in children through diet, physical activity and medicine to prevent the complications of an early onset that could affect the eye, feet and heart, say diabetologists.

But the challenge with children is, they are too young to understand the seriousness of diabetes. Rebecca recalls, “Since she (Maria) was too small, I used to wake up at 3 am, check her blood-sugar and give her the insulin.”

Despite improvement, Maria is still restricted from playing too much or having junk food. But she has been considerably lucky with friends who feel bad that she has to take “three injections” (insulin shots) every day, says Rebecca.

Engineering student and avid swimmer, Eshaan Shevate was 12 years old when a routine test before a swimming meet found him to be Type 1. It meant taking two injections (insulin) and stopping swimming, says Eshaan, now 19. “Initially, I was very upset,” he recalls, adding, “it was the biggest setback for me.”

Months later, with medication controlling his blood sugar levels, Eshaan got back to swimming and went on to win silver at a State swimming meet.

Eshaan has since scaled more mountains, becoming the youngest team member and only Indian to participate in a trek to the Inca settlement at Machu Picchu, organised by drugmaker Sanofi to raise awareness on Type I diabetes. Last year, the trip was to Mount Kilimanjaro.

Still enthusiastic from the July trek, Eshaan says, “Every moment was a new moment, where I was waiting to be surprised.”

“Since I was the youngest, others in the team constantly supported me and cheered me up,” he says, now doing his bit in spreading support and awareness to dispel myths on diabetes, even as he tries his hand at a new sport – hockey, to push his personal limit.

(*Names changed to protect identity of the child and mother)

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