Diabetes develops when the pancreas produces little to no insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar levels and moves sugar (glucose) from the bloodstream to the body’s cells for energy. So, diabetes results in high levels of sugar in the blood.
Causes of the disease are relatively unknown, however Diabetes expert and adviser for the Sweetlife organization – South Africa’s largest online diabetes community – Dr Claudine Lee points to a number of factors.
“Factors that are involved but not directly causative include: genetics, environment, stress, viral exposure or the gut biome,” she says. Diabetes leads to complications in the heart, kidneys, eyes, nerves and blood vessels.
There are two main types:
Type 1 diabetes
Type 1 diabetes most often occurs in childhood or early adulthood as an auto-immune condition where the body no longer produces insulin. According to Mayo Clinic this is due to environmental and genetic factors where the body’s immune system mistakenly destroys insulin-making (islet) cells.
Common symptoms which usually develop quickly in children include: excessive thirst, frequent urination (which could lead to possible bed-wetting in a potty-trained child), extreme hunger, weight loss, exhaustion and blurred vision. Mayo Clinic adds irritability or behavioural changes as well as fruity-smelling breath to the list.
Dr Lee says insulin in variable forms is the only treatment. “All type 1 children should have access to all and any technology. This includes the insulin pump and the continuous glucose monitor (CGM),” she says.
“With type 1 diabetes at least four injections a day are required. It’s either a long-acting injection once daily and a short acting with every meal working out the dosage according to sugar value and carbohydrates consumed. Pump therapy is so much easier. With the pump you change the infusion set every three days and have an AI algorithm help with all the maths. The pump gets way better sugar control, it’s easier to use and keeps kids out of hospital,” says Dr Lee. 
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Type 2 diabetes
Type 2 diabetes is more common in adults. But due to the global increase in childhood obesity, there are more reported cases of type 2 diabetes in children and adolescents. Symptoms may take a while to show and sometimes they are unnoticed.
Some children may present with the common increased thirst, frequent urination, extreme hunger, fatigue and blurry vision if they have too much sugar in the bloodstream, according to Mayo Clinic. As well as frequent infections and darkened areas of skin especially around the neck, armpits or groin.
“Type 2 diabetes is a silent killer as often times there really are very few symptoms for about 10 years, all the while the high sugars damage the organs. This is why screening is very important, even a random finger prick glucose reading,” Dr Lee says.
It can be reversed. If not, it can be managed. Sweetlife sums this up as TEEL:
Take your medication (oral medication or insulin);
Eat healthy food;
Exercise a little each day;
Lose weight if you need to.
Type 2 diabetes occurs when the body does not use the insulin it produces as well as it should. This is insulin resistance.
Understanding insulin resistance
Insulin resistance is a sign that someone is at risk of developing type 2 diabetes. When you’re insulin resistant it means the insulin in your body is blocked and cannot pass easily from the bloodstream into the cells, resulting in high blood glucose.
“Insulin resistance happens a lot in adults, overweight teenagers and folks in general who eat too much and exercise too little,” Dr Lee says.
This too is a silent condition with no initial visible symptoms. Consider your child lucky if they’re diagnosed before it has turned into type 2 diabetes –and make some urgent lifestyle changes.
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