India is home to a whopping 69.2 million people suffering from Diabetes and is anticipated to rise to as much as 123.4 million by 2040. The major point of concern is that it is not just a burden for older adults in the country. As per data, an estimated 97,700 children in India suffer from Type 1 Diabetes Mellitus which is one of the most common pediatric endocrine illnesses. It is VERY essential to be aware of the facts about juvenile diabetes and parents must be extra careful in taking measures to prevent their children fall prey to a chronic condition like this.

Type 1 Diabetes, also known as Juvenile Diabetes typically occurs among those in their adolescence when the immune system damages beta cells in the pancreas that are responsible for producing insulin. As body insulin is the hormone primarily responsible for moving sugar or glucose into the body tissues, damage to beta cells cuts off that process. As the sugar does not move into cells due to the absence of insulin, it gets accumulated in the blood thereby causing the cells to starve. This results in high blood sugar that can eventually cause dehydration, weight loss, diabetic ketoacidosis (DKA) and damage the body. The body starts losing water due to excessive urination and there is a generation of ketones, a chemical in the body that can result in ketoacidosis, a life-threatening condition if not treated promptly. It can affect eyes, kidneys and heart and can cause atherosclerosis that can lead to heart attacks and strokes.

Juvenile Diabetes and its causes

While genes play a vital role, the exact cause of Type 1 Diabetes is not known. However, it is associated with a virus that directs the immune system to destroy the beta cells and those suffering from diabetes display signs of an attack known as autoantibodies. Additionally, it can occur among those with other autoimmune diseases like Grave’s disease or vitiligo.

Signs to watch out

Although the symptoms are mostly subtle, they can become severe as well. The signs include heavy thirst, increased hunger after eating, dry mouth, nausea and vomiting, pain in belly, frequent urination, unexplained weight loss despite eating adequately, fatigue, weakness and tiredness, blurred vision, heavy, laboured breathing, infections and rashes in skin, urinary tract or vagina, shaking and confusion, rapid breathing, fruity smell in the breath, belly pain and rare loss of consciousness.

Lifestyle medication can help 

Although at present there is no way of preventing juvenile diabetes, there are ways of leading a healthy life by keeping blood sugar in check. It is mandatory to have a regular check on the blood sugar levels, adjust insulin, maintain a proper diet and regular exercise. Exercise plays a prominent role in treating Type 1 Diabetes. It is also important to balance the insulin dose and the food that one consumes with simple physical activities including the daily tasks around the house. Also, an eye must be kept to check if the blood sugar level is dropping too low and that should be avoided. A snack with carb helps in doing so.  

What juvenile diabetes can lead to in the long run?

If juvenile diabetes is not dealt with appropriately, it may lead to several other life-threatening conditions in later life. Here are some of them that one must know:

Retinopathy: Although this does not occur commonly before puberty, those with juvenile diabetes have a greater risk of developing this retina disorder when they get into their adulthood.

Kidney damage: Those with type 1 diabetes commonly suffer from a condition called nephropathy. It generally shows up 15 to 25 years after the onset of diabetes and can result in several serious problems like kidney failure and heart disease.

Other consequent disorders include poor blood circulation and nerve damage. 

With adequate monitoring, a healthy lifestyle and an appropriate diet, juvenile diabetes can be controlled and well-maintained to improve the quality of life of children suffering from this chronic condition.

Dr. Harish Kumar
Aster CMI Hospital
Sahakar Nagar, Hebbal
Bengaluru -560092
Ph: 080 4342 0100

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 There are different types of diabetes like Type II diabetes, Latent autoimmune diabetes in adults (LADA), Maturity-onset diabetes of the young (MODY), Juvenile diabetes or Type I diabetes, Diabetic ketoacidosis. But only few  types of Diabetes are common among youngsters. Types of Diabetes commonly affecting the young can be understood with this article.

Type II diabetes are uncommon among children but cases can be seen in young population of early 30’s today. Risk factors include – obesity, associated thyroid problems, eating disorders, lack of lifestyle activities and history of family suffering from diabetes. There are other types of diabetes common in young people –Latent autoimmune diabetes in adults (LADA), a slow progressing form of autoimmune diabetes and Maturity-onset diabetes of the young (MODY), a rare kind of diabetes. The condition rises due to a mutation, in one of the genes that impairs the process of insulin production. Due to this, it affects the way the body uses and stores sugar from food. The treatment process differs so a proper diagnosis is important.

Juvenile diabetes or Type I diabetes is a chronic condition where the children have a defective pancreas by birth that causes the pancreas to produce little or no insulin. There is no cure for this condition but medication can help to lead a normal life. They are insulin dependent and are more prone to develop Diabetic ketoacidosis. Diabetic ketoacidosis is a serious diabetes complication that requires medical attention. In this condition, the body produces excess blood acids also known as ketones. Symptoms include stomach pain, vomiting, lethargic, fatigue and dizziness.

Importance of starting Insulin Therapy at an early stage:

Insulin therapy is imperative part of treatment for people with Type I diabetes, often the medicines do not work so they require lifelong insulin therapy. Some people with Type II diabetes also require this therapy to keep the blood sugar levels at normal.

Starting insulin therapy at an early stage lowers the risk of developing long term complications of diabetes such as kidney and heart diseases. It also helps the patients to avoid frequent hospitalisation. Associating with this year theme – Family and Diabetes, the following can be practiced by the family members in the management, care, prevention and education of diabetes.

• Compliance to see that the patient gets the medication in time
• Hypoglycaemia– Look out for low sugar symptoms such as dizziness, sweating and confusions. It is advisable to give simple sugar to the patients immediately if they are experiencing these symptoms, consult a doctor in case the symptoms continue to persist. One can check for the sugar levels in the blood using a Glucometer (a device to monitor concentration of glucose in the blood), anything below 70 mg/dl is considered to have low sugar level
• Adhere to a diet plan as advised by the doctor
• Ensure regular exercise of the patient

Case Scenarios:

Case 1: 26-year-old Anil (name changed) was presented with complaints of feeling tired quickly and increased thirst for the last 6 months. He was overweight and hardly performed any exercise and was heavily dependent on outside/junk food. Anil’s father was on treatment for diabetes, this clearly shows that he has a family history of diabetes. Lack of exercise, sedentary lifestyle and consumption of high calorie food trigger the onset of diabetes in Anil. Despite being young, he had Type II Diabetes Mellitus and needed to be started on treatment. A healthy lifestyle, regular exercise and avoidance of overindulging in high calorie food can prevent or delay onset of diabetes mellitus.

 Case 2:Mrs Anitha (name changed), a 62-year-old woman who is a known patient of diabetes was admitted with high grade fever and unresponsiveness and found to have Hypoglycaemia (low blood sugar). Fever work up showed E.coli in urine and CT showed infection in the kidneys which is a severe form of urinary infection and was getting treated for that and was improving symptomatically with injectable antibiotic.Meanwhile, patient had concerns regarding her leg pain and weakness. On examination patient was found to have reduced power in the thigh muscles for which muscle and nerve studies were done which revealed nerve damage which can be attributed to uncontrolled diabetes. Neurology team were involved and opined as diabetic amyotrophy (occurs more in patients with diabetes with type II than type I) for which she was initiated on muscle strengthening exercises and supportive medication. Anitha got discharged after a week of hospital stay and is on rehabilitation and physiotherapy with which she is gradually improving.

There are some complications of the disease which are rare but very bothering and can restrict a patient’s mobility and diabetic amyotrophy is one of them. Treatment for Diabetic Amyotrophy-control blood sugar level in blood, physiotherapy and rehabilitation.

Dr Subrata Das
Internal Medicine & Diabetology
Sakra World Hospital, Bengaluru- 560103
Ph: 080 4969 4969

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