Why some children develop diabetes

Diabetes is a disease that many thought only affects old people. The fact that a child can develop this disease many cannot imagine. However, this is one disease that may occur in them due to such infections like mumps, reports Sade Oguntola.

The occurrences of several diseases at a particular age in life remain a big puzzle that scientists continue to work day and night to unravel. One of such diseases is diabetes in a child that experts suggest could occur as a result of the child having had an infection early in life or an aftermath of malnourishment.

In many countries of the world, the rate of new diabetes cases has doubled in the last 20 years among both adults and children and Nigeria is no exception. Diabetes is a condition where the blood sugar level is higher than normal and could affect new born babies, toddlers and even adolescents.

Dr. Omolola O. Ayoola, a consultant paediatrician that specialises in treating diabetes in children, talking at the last World Diabetes Day celebration at the University College Hospital (UCH), Ibadan, said there is actually no age group or gender that cannot develop diabetes. However, its occurrence increases with age until puberty and then declines, even though its onset in the first year of life is unusual.

Quite unlike what many may be aware of, she said diabetes is a condition that in some children has been associated with long-term protein malnutrition and endemic childhood infections such as mumps and rubella.

The commonest type in children is that called Type 1 diabetes and is due to the blood sugar in the child remaining higher than normal either because the pancreas is producing little or no insulin. She said its rate in many countries have doubled in the last 20 years.

In Sudan, an African country like Nigeria, the case is found in one child out of every 10,000. The case is higher in Nigeria where it is found in about one out of every 3,000 school children.

Even through there is always a genetic tendency for some children to have diabetes, Dr Ayoola said conditions such as malnutrition and childhood infections end up prompting the manifestation of this genetic traits earlier. According to her, they lead to a situation where the body makes antibodies that end up fighting against the beta cells in the pancreas, the organ responsible for production of insulin needed by the body to regulate the sugar level of the blood.

“The trigger for this is not known but a popular theory is that a virus triggers the immune system to make these antibodies. From studies done, before and after the onset of the disease, indicators for this disease called Beta cell markers, are seen in 90 per cent of newly diagnosed cases.

She said Type 1 diabetes is not inherited even though it has been found that a first-degree relative of someone with Type 1 diabetes has about 6 in 100 chance of developing Type 1 diabetes. This is higher than the chance of the general population, which is about 1 in 250.

Dr. Ayoola said that breast-feeding and delayed introduction of cow’s milk may provide protection for a child against developing diabetes.

“A protein in cow’s milk has properties similar to islet cell antigen, so stimulating production of antibodies that destroy islet cells in the pancreas,” she said.

“Also, some people have been shown to experience severe life events prior to the onset of diabetes. This stress affects their body’s resistance to infection and if such a person has genetic susceptibility, he may develop diabetes.”

Too much affluence means opportunity to eat all sorts of foods and become obese, Dr. Ayoola said. This is a big problem in that obesity was previously common in children.

This is of importance because now as 33 per cent or more of new patients with Type 2 diabetes in USA are children.

“Before, what is known is that Type 2 diabetes runs in families, and the belief was that more blacks and those that lived sedentary lifestyle had it. But in children, having Type 2 diabetes, more females, infants born with a small weight at birth or who remain short, or with pancreas not secreting enough insulin are mostly affected.

However, the symptoms of diabetes such as urinating often, feeling thirsty and losing weight, she said tend to develop quite quickly, over a few days or weeks in children with Type 1 diabetes, unlike in Type 2 diabetes where it develops gradually (over weeks or months).

Meanwhile, preventive strategies such as such people with a family history of diabetes being given injectable or oral insulin have not been found to be successful in preventing or delaying diabetes.

Since children who develop diabetes are more likely to have had cow’s milk at infancy, in comparison to those exclusively breastfed, she said the recommendation now is that children who have parents or siblings with diabetes should be breastfed and their intake of cow’s milk minimized.

In addition, she said breastfeeding might play a critical role in helping to lower the risk of excessive weight gain in children at a higher risk of diabetes and obesity, because of their family history.

Given that Type 2 diabetes which is upcoming in children is preventable, she encouraged that children be made to eat healthier meals; plenty of fruits and vegetables and whole grain foods, and not to binge in-between meals as well as stay active most days of the week.

However, Mr. Tunde Ajobo, a dietician at UCH said the problem should be extensively tackled at the adolescence stage when the independent character of an individual is established in order to ensure fewer cases of diabetes.

Though, adolescents may need more nutrients and have more appetite for food, he said dietary and other measures for the prevention of chronic diseases like diabetes are important at this period of life.

“Education is the key to prevention of diabetes in young and adolescents at school and at home. They need to know what diabetes is, its effect on health and the relationship between diabetes and their eating habits. They need to be told the importance of healthy eating and physical exercise,” Ajobo said.

He added: “This is no way out aside young ones and adolescents choosing a way of living that includes a prudent diet, sufficient physical activities, rest and recreations and not depend on alcohol, nicotine or other drugs. So many diseases are preventable if people would make better choices. Prevention is better and cheaper than cure.”

According to him, “parents may over estimate the benefits of gymnasiums and presume children can eat more junk foods, but Food Centre for Food Policy and Obesity at Yale University has reported that a child can burn 20 calories from the exercise but take 200 calories from a milkshake.”

Mrs. Modupe Salami, chairperson, Diabetes Association of Nigeria, UCH branch, a living witness of the reality of diabetes, declared that whether as an adult or youth, a comprehensive medical check up should be embraced.

According to her, “such routine check will ensure early detection of diabetes and other diseases and would go a long way to stem the tide of sudden deaths, not for diabetes alone but for other ailments.”

Mrs. Salami stated that the staggering rise in childhood obesity and diabetes worldwide is a problem that cannot be ignored, especially when diabetes care is unaffordable to many people, and there are lots of misinformation in the community on the disease.

Reducing the burden of diabetes, she declared, will require that “patients should be empowered to modify their risk factors, early diagnosis and effective care, educating all stakeholders and providing good and accessible diabetes care. Also, diabetes care should be free or subsidized for working-class people and be made free for children and retired people.”