How to tackle juvenile diabetes as a family

Although the number of juvenile diabetes cases in the UAE is on the rise, with a few lifestyle changes, children can lead a normal life despite their diagnosis.

Insulin is now available in pen devices with small needles, making administration painless. Alamy

We normally think diabetes is caused by obesity, inactivity and lots of sweets, but the most common form for children is actually type 1, an autoimmune condition unrelated to weight or lifestyle.

In type 1, the pancreas – a small gland behind the stomach – produces little or no insulin (the hormone that regulates blood glucose), whereas in type 2, there is insulin but the body has become resistant to it.

Type 1 diabetes usually appears before the age of 40 and normally in childhood, hence its former name of juvenile-onset diabetes.

Only 10 per cent of all diabetes is type 1, but it is the most common type for children.

Worldwide, 415 million people – one in 11 – has diabetes, according to the International Diabetes Federation, with 35.4 million in the Mena region, a figure expected to rise to 72 million by 2040.

But in the UAE, that number more than doubles to one in five, according to the UAE National Diabetes and Lifestyle Survey.

While there are no statistics for childhood diabetes in the UAE, the IDF estimates 60,700 children aged 0 to 14 across the region have type 1 diabetes, with more than 10,000 diagnosed each year. Dr Amani Osman, a consultant general paediatrician at the Imperial College London Diabetes Centre in Al Ain, says it is important to understand that a child with diabetes can live an “absolutely normal life with no exclusion”.

“We need to be very positive about the way we describe diabetes,” she says. “It is important that parents don’t call it a ‘disease’. It is a condition where your body does not have enough insulin. Our treatment involves giving back that insulin.”

She says it is also important that parents speak openly with their child and make sure they understand that the diabetes will not go away, particularly for type 1, but “it does not mean they cannot live an absolutely normal life and achieve anything they want”.

A lack of insulin means that glucose stays in the blood and isn’t used as fuel for energy. The body tries to reduce blood glucose levels by getting rid of the excess glucose in the urine.

Osman says the warning signs for parents to watch out for are frequent urination, bed-wetting even after a child has been toilet trained, feeling very thirsty, weight loss and lethargy.

Insulin administration has “evolved from the painful process it once was”, says Osman.

Today it comes in “colourful, fun-looking” pen devices with a very small needle, making administration painless. It can also be administered through a patch, changed every three days, or an insulin pump.

Osman warns parents not to exclude children with diabetes from fun activities like school trips or parties.

“We never say the child is on a restricted diet,” she says. “They are on a healthy diet with foods that avoid dramatic spikes in blood sugar levels. They can still go to birthday parties and eat cake, in moderation and with insulin.”

And she says parents need to ensure the whole family is involved in diet and lifestyle changes – and not to single out the child by giving them a different diet. “Parents must ensure that healthy eating applies to everyone in the family so the child does not feel different.”

She encourages children with diabetes to exercise for an hour a day, at least five days a week, preferably in family-friendly sports such as football, swimming, basketball and tennis. Dancing, theatre, scavenger hunts or ice skating can be considered exercise and active games on consoles such as the Wii are ways to stay active indoors during the hot summer months.

“When a child has been diagnosed with diabetes at a young age, it’s like a wake-up call,” says Osman. “Families start to realise the importance of eating lots of fruit and vegetables, lean meats and drinking plenty of water.”