Every Child Matters - Children with Diabetes

Introduction1.1 What is diabetes?Type 1 diabetes is an autoimmune disease; it is not caused by overeating, poorlifestyle or self-induced, but by a combination of genetic and environmentaltriggers. The body destroys insulin producing beta cells in the pancreas.Insulin is required by the body to metabolise glucose. Without insulin thebody literally starves to death. Before the discovery of insulin, people withdiabetes died within a very short time, it was a distressing slow death. Type 1diabetes is not preventable and there is nothing that a child, or their parentscould have done to prevent type 1 diabetes from developing. 80 – 90% ofchildren with diabetes have type 1 diabetes. Type 2 diabetes, a very differentform of the condition, which requires totally different management. In type 2diabetes there is usually a problem with insulin resistance and in geneticallysusceptible people, obesity can trigger the condition. Many things besidesinsulin affect the blood glucose levels, carbohydrate intake, exercise, illness,growth hormones and emotions. Stress can increase OR decrease bloodglucose levels. This is one of the reasons why blood glucose levels can beunpredictable and hard to control.A child can develop type 1 diabetes at anytime between birth and aged 18years, but statistics are showing that more children are developing diabetes ata much younger age than previously. Diabetes is now occurring in muchyounger children, often preschool aged children ( 1 ). There is a 6.3% annualincrease in the numbers of under 5’s being diagnosed, compared to an overallincrease of 3.4% in all age groups ( 2 ). The incidence of diabetes in thepopulation shows a geographical variation, the incidence in Aberdeen being24 children per 100,000 and in Oxford 17.8 per 100,000. Diabetes affectsboth males and females, with a very slight male preponderance, depending onage and season of diagnosis( 3 ).The National Institute for Health and Clinical Excellence (NICE2004 4 ) Type 1 diabetes is one of the most frequent chronic diseases inchildhood. Children and young people with type 1 diabetes and their familieshave particular needs, which differ from those of adults with type 1 diabetes.Type 1 diabetes is a continuing hormonal deficiency disorder that hassignificant short-term impacts on health and lifestyle and is associated withmajor long-term complications and reduced life expectancy. People with type1 diabetes require insulin-replacement therapy from diagnosis.A recent survey showed that about 16,000 children and young people aged 0-16 years attended paediatric diabetes centres in England. Of these, 95% hadtype 1 diabetes and 1% had non-type 1 diabetes. (type not specified)Keeping the blood glucose concentrations as close as possible to the normalrange for people without diabetes is known to prevent or to delay the longtermvascular complications of diabetes. Systems of surveillance for the earlydetection of complications are important, as is the effective management ofcomplications when they occur.1 Hanas,R. 2006 Type 1 diabetes in children, adolescents and young adults2 Williams & Pickup 2004 Handbook of diabetes3 Court & Lamb1997Childhood and adolescent diabetes4 Type 1 diabetes in children and young people3