The world is going through a ‘diabetic stage’ where the alarming rise of type 1 diabetes is penetrating fast in the adult population, especially people who are on the wrong side of the 60s. Diabetes in children is not a new phenomenon, but it has threatened recently a large section of society. Most of the children suffer from type 1 diabetes, but type 2 diabetic children are also in the rise, particularly in the U.S.
Dietary Management For Diabetic Children
The controversy over the best approach to treatment applies particularly to the younger age group of patients. Clinicians who advocate the “free” diet or diet-for-age without added sugar feel that it promotes a more a positive attitude in the family and a more normal psychosocial development in the child. To avoid wide daily variations in blood glucose levels, however, the nutrition counselor is called on to assist the mother with meal planning so that there is a consistent daily intake of energy and nutrients. For example, a four-year-old child cannot consume 1000 calories today and 1600 calories tomorrow and still maintain reasonable control. At the same time, food intake must be spaced throughout the day as with any patient using intermediate-acting insulin to avoid hyper or hypoglycemic episodes.
Treatment of Diabetes in Children
Diabetes in children is not a common disease but it’s specialized nature need to treat in hospital rather by GP. Most children who suffer from diabetes need insulin treatment, a proper insulin routine can control the blood glucose level.
• Critical patients need frequent dosages of fast-acting insulin in the day, and slow-acting insulin in the night.
• Very small children generally don’t need an injection at night, but as they grow older, it might be necessary.
• Insulin pumps are now becoming popular for older children.
In the first year of diagnosis, children need a small dosage of insulin referred to as ‘honeymoon period’. Insulin treatment must be regular, take care of diet and avoidance of ‘hypos’ (low blood glucose attacks) are important factors.
Emotional Adjustment in Children
Coping with a chronic disease in childhood such as diabetes mellitus presents a major challenge to both the family and the child. A number of studies show that there is an increased incidence of emotional stress in children with diabetes compared with normal children. They tend to be dependent, anxious, and hostile and have impaired self-images. Acute emotional stress adversely affects diabetic control and can cause ketoacidosis. Rage and extreme anxiety can trigger epinephrine release from the adrenal medulla. Epinephrine stimulus gluconeogenesis which can result in hyperglycemia. Also, emotional stress may lead to episodes of food gorging or missing insulin injections entirely. The child with diabetes, who experiences episodes of ketoacidosis due to emotional stress, and his family may need the help of a psychiatrist or psychologist to establish an environment within the family that will promote the stabilization of the child’s diabetes mellitus.