Diabetes Mellitus in Children

Diabetes mellitus (also called Juvenile diabetes) is a fairly common metabolic disorder in children. The disease results from an interaction of genetic and environmental factors. It can be inherited from both parents. If mother and father both have diabetes, the chances of the child having diabetes are very high. If one parent has diabetes the chances decrease, and if neither of them has diabetes the child is not likely to get the disease.

The major forms of diabetes

Type 1 Diabetes Mellitus. There is deficiency of insulin secretion due to damage to â-cells present in pancreas. Insulin is required for proper utilization of glucose, thus its level rises in blood, leading to the condition known as diabetes. The onset is usually around 5 years of age. The only treatment for this type of diabetes is insulin injections.

Type 2 Diabetes Mellitus. There is resistance to the action of insulin at the level of muscles, liver and adipose (fatty) tissue , associated with some degree of insulin deficiency also. Glucose is utilized by muscles, liver and adipose tissue with the help of insulin. In this type of diabetes insulin is not able to act at these places. Thus glucose is not utilized and its level rises in blood. This type of diabetes is usually seen in obese children and adolescents, with the usual age of onset being around 13 years. These children also require insulin injections. Metformin is an oral drug, which can be combined with insulin, especially in obese children. Glitazones are a class of drugs, which decrease the resistance to insulin action, but due to liver toxicity are not approved for use in children.

How to diagnose diabetes?

There are three cardinal features of diabetes:

• Polydipsia - The child has excessive thirst and drinks a lot more water.
• Polyuria - The child passes urine more often, and may start wetting the bed.
• Polyphagia - The child eats more than usual but still does not gain weight, or even starts loosing weight.