Diabetes is one of the most common chronic diseases of childhood
                             
♦    Almost 200 children under the age of 15 develop type 1 diabetes
every day 
 
♦    More than 88,000 children with diabetes live in the EU
 
♦    The number is growing by 3% to 5% every year

What is diabetes?

Diabetes is a serious progressive chronic condition that occurs as a result of problems in the production and supply of insulin in the body. Insulin is the hormone responsible for helping tissues to use glucose (sugar), the body’s energy source. Without an adequate supply of insulin a person with diabetes is unable to keep glucose levels in balance.

Poor glucose control can lead to hypoglycemia (low blood glucose), a condition that, if poorly manged, can result in coma or death- or hyperglycemia, a condition associated with higher than normal blood glucose values, which can contribute to long-term complications, including blindness, kidney failure and amputation. Diabetes is also a major factor in both cardiovascular disease and impotence. The life expectancy of children with diabetes is reduced by up to 15 years. The two most common forms of diabetes are  type 1 diabetes and type 2 diabetes.

Type 1 Diabetes

 
Type 1 diabetes is an autoimmune disease caused by the destruction of insulin-producing cells by the body’s own immune system. It is a life-long-disease that occurs when the pancreas stops producing insulin and blood sugar levels arise as a result. Over 90% of children with diabetes have type 1 diabetes.
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Over 90% of children with diabetes have type 1 diabetes.  

Every year 65,000 children under 15 develop type 1 diabetes worldwide.

Type 1 diabetes is growing by 5 % among pre-school children and by 3% in older children and adolescents each year.

 
Patients with type 1 diabetes need daily insulin treatment to survive. Insulin can be delivered                                               
     
             

via multiple injections with syringes or insulin pens.

via a pump, which allows continuous infusion of insulin and the option of adding extra dosage as needed.
                                             
Patients should measure their blood sugar levels often to control and improve the management of their diabetes. The blood sugar levels can be monitored by:
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Self monitoring with finger-sticks meter reading at least before and after meals as well as at bedtime.

Continuous glucose monitoring (CGM) with a sensor placed onto the patient’s abdomen providing continuously sugar levels readings.

HbA1c measurement, a blood sugar test performed by a healthcare professional, which indicates the average blood sugar levels over 2-3 months.

         
Poor blood sugar level control can lead to

                          

hypoglycemia (low blood sugar) with serious complications including loss of consciousness and seizures and eventually coma or death if unmanaged.

hyperglycemia (high blood sugar) which contributes to long-term complications, such as blindness, kidney failure, cardiovascular disease and limb amputation if untreated.

diabetic ketoacidosis (DKA), which is a state of inadequate insulin levels resulting in high blood sugar and accumulation of organic acids and ketones in the blood and is the leading cause of morbidity and mortality in children with type 1 diabetes.

Type 1 diabetes can not be prevented so far.

 


Type 2 Diabetes  
Type 2 diabetes is a polymorphic chronic disease characterized by dysfunction of insulin secretion or missing effectiveness of insulin. That means, that the disease results from the body’s inability to produce enough or properly use insulin.
Type 2 diabetes is often linked to obesity. With the obesity epidemic also in young people more and more adolescents are affected of type 2 diabetes. In Europe 5% of children and adolescents with diabetes have type 2 diabetes. 
The aim of type 2 diabetes treatment is normalization of blood sugar levels, the reduction of risks of comorbidity and of long-term complications using tablets and/ or insulininjektions at later demands. 
The management of type 2 diabetes should also include lifestyle modification with a focus on
 
a low –carbohydrate  and low glycemic load diets
increase of daily physical activities
Even if children and adolescents with type 2 diabetes have to face an encumbered psychological situation, anxiety or depression occurs in already 70% of obese adolescents and 17% are affected by eating disorder.
There are sufficient intervention programs for children and their families including lifestye changes such as healthier diet and increased physical exercise which can be added to primary prevention of type 2 diabetes in children and adolescents.