Childhood is full of life and optimism wanting to embrace the future with open arms. Parents have a vision for their children, be it academics, sports or any other thing children wish to achieve. The hint of a (suspected) ill health in your child is likely to result in lost enthusiasm and enjoyment to a great extent.
A condition, like diabetes, can restrict the passion for living life to the fullest until taken care of with timely intervention. Therefore, it is prudent to bring out the ill health with early and timely diagnosis. Diagnosing an abnormality in children’s health can pave way for its betterment and (possible) elimination of more complications in future, making life better and more sustained.
Risk Factors for Diabetes
Children having a body mass index (BMI) above 85th percentile of his/her age may be at risk for type 2 diabetes. Those weighing more than 120% of the ideal weight are also at risk for diabetes. Family history, skin problems (as acanthosis nigricans), high cholesterol and blood pressure also indicate the need for testing diabetes in children. Children belonging to special groups including Asian Americans and African Americans are also at risk for developing the condition. Abnormal level of liver enzymes is also another risk factor for diabetes.
Major Diagnostic Tools for Revealing Diabetes in Children
Diabetes (type 2) may not reveal itself through noticeable symptoms; the condition can become the target of attention during a blood or urine test done for reasons other than diabetes.
In case of absence of any diabetes symptoms, the doctor can recommend more than one blood test to be done on separate days. An A1c test is done to estimate blood sugar levels for past 2-3 months. The A1c test, also called glycated hemoglobin test, provides an average value of your blood sugar indicating the percentage of blood sugar in hemoglobin. If the A1c level is 6.5 percent or more on two individual tests, it indicates diabetes.
However, the American Diabetes Association (ADA) usually indicates a higher A1c level. Children below 6 years should have an A1c below 8.5 percent to be called diabetic. Children between 6 and 12 years should have A1c below 8 percent to be diagnosed diabetic. Teenagers have a still lower level (7.5 percent). A1c is a trustworthy indicator for outlining the treatment plan your child should adopt for effective diabetic management. For example, elevated A1C levels signify the need for changing the insulin regimen or the meal plan.
Another blood test, called blood glucose test, is done while fasting for about 8 hours (overnight). Blood sugar below 100 mg/dL is considered normal, between 100-125 mg/dL suggests prediabetes and 126 mg/dL or above on two individual tests suggests diabetes. Thereafter, a glucose tolerance test is done where the child drinks something sweet with a specified glucose content.
Some More Tests for Confirming Diabetes
Sometimes, it becomes difficult to differentiate type 1 from type 2 diabetes. The doctor can do a C-peptide test for confirming type of diabetes to implement appropriate treatment. If diabetes is diagnosed, your doctor can check the auto antibodies to distinguish between type 1 and type 2 diabetes. Auto antibodies are produced as a result of the body’s immune system not working correctly.
When there are ketones (byproducts of fat) in child’s urine, there is indication for type 1 diabetes. For determining type 2 diabetes, the doctor carries out physical examination, blood glucose testing and looks into the medical history of the child. Besides the above tests, the doctor can also suggest periodic checkups for growth, thyroid function, celiac disease, liver and kidney function. A confirmatory diagnosis may need months of screening during which the child’s blood sugar levels should essentially be kept under tight control.
Proceeding Once the Diagnosis is Confirmed
Diagnosis of diabetes, particularly type 1, can be difficult to be accepted by you and your child. Suddenly, there is an ‘abnormal’ need to change lifestyle, adjust to the injection schedules, pay regular visits to the doctor for careful follow up of treatment, monitor blood sugar levels through regular tests and keep a watch over the most trivial components of living which mainly remained unattended till now.
If a child is diagnosed with type 1 diabetes, wherein the pancreas cannot produce the required amount of insulin, you need to replace for the loss before it takes a toll over the child’s health. Type 1 diabetes in children, also referred to as juvenile diabetes or insulin-dependent diabetes, requires meticulous care and management. Thankfully, the advances in blood sugar monitoring and insulin delivery can aid effective its management.
Type 2 diabetes, which generally develops in adulthood, can also affect children. The number of children being diagnosed with type 2 diabetes is actually showing a rising trend. Early teenage, which is the time for rapid development, can create a mismatch between the demand and supply of insulin by putting extra load over the pancreas. Additionally, children with type 2 diabetes are usually found to be overweight, adding to the insulin resistance.
Since type 2 diabetes is a recent development among children, it is not easy to find the exact reason behind worsening of the condition over time. The duration of diabetes and blood sugar control are important factors in preventing long term complications of the condition. Since a child can have diabetes for a longer duration (as the onset is early), the ill effect(s) of diabetes are likely to worsen.
An estimate points out that there are over 4.40 lakh children (under 2-15 age group) suffering from disease worldwide. Unfortunately, childhood diabetes has a high mortality rate; lack of diagnostic provisions can be a reason and ambiguity in symptoms may be another.
Usually, a routine viral fever or an infection can also lead to type 1 diabetes in children. Failure to identify early symptoms can adversely affect pancreas and cause the blood sugar to reach abnormal levels. However, with careful planning, monitoring and care, it is possible to live a healthy and ‘normal’ life even with diabetes. Diabetes, or no other condition, should keep your child from achieving the highest ambitions and dreams in his/her life. You can find a number of Olympic athletes, successful professionals, actors and other inspiring people living successfully with diabetes. The determination to overcome an adversity is a crucial tool in fighting a battle and emerging triumphant.