Busting myths around diabetes in children and helping them live fuller lives

Six-year-old Priya’s parents heave a sigh of relief as she gets better after a turbulent time in the Intensive Care Unit (ICU), her second time in two months. They have had a steep learning curve and have now resolved to listen to their doctor and give Priya her injections four times a day for the rest of her life. Omitting the injections, they realise, can end up getting Priya into the ICU.

Though the child was pulled out in time from the jaws of death, her hospitalisation was entirely avoidable. In an effort to control the child's diabetes, the family had, totally of their own accord, kept her off rice, potatoes and sweets. She was also prevented from indulging in too much physical activity for fear of altering her blood sugar levels.

Priya has a life-long condition called Type 1 diabetes, also called juvenile diabetes. In stark contrast to the form of diabetes that affects adults, juvenile diabetes has no cure, but can be controlled by taking four injections a day to administer insulin drug. Tablets have absolutely no effect on this form of diabetes.

Children start with relatively innocuous symptoms: they drink a lot of liquids, pass urine several times, eat much more than normal, and still lose weight. These symptoms in a child of any age and witnessed for more than four days should prompt a visit to a paediatrician. When diagnosed quickly and treated properly, children do well, despite needing to take daily injections. On the other hand, if not managed appropriately, it could lead to the rapid sinking of the child’s condition, like in Priya’s case, and valuable lives have also been lost in such a manner.

Juvenile diabetes brings with it many misconceptions about keeping the child totally off sweets, rice and potatoes. The reality, however, is that children need nutritious food to grow tall and clever, and starving them to control their diabetes does not work. Another common myth is that the children need to be kept away from any physical activity. The truth is that they need to be able to participate in regular children’s activities like birthday parties, school activities and sport.

The care of the child needs to be inclusive, integrating them into routine societal activities. The idea is that care should be more holistic, not merely controlling blood sugar, but also taking care of the child’s emotional, mental and social well-being.

Care of such children in more developed nations is along these lines and it is possible to achieve this in India too. A package of care that educates caregivers to encourage healthy eating patterns with the occasional treat, along with teaching them how to alter the doses of insulin injections is needed for this. Also, education on how physical activity and sport affect blood sugar levels, and how one can manage these should be part of such a care package. And this could do a great deal to help children with diabetes live a healthy, happy and a much fuller life of achieving whatever they want.

The writer is a Paediatric Endocrinologist, a children’s doctor who specialises in hormonal conditions, with 12 years’ work experience in Europe. Views are personal.

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