Diabetes: An epidemic unfolding amongst young children

Among COVID19s many ripple effects, the worsening of Diabetes burden could have a greater public-health toll. The fact that, Diabetes has not only impacted the adult population, but its rising incidence among children in the age group of 13-15yrs is quite shocking.  A recent finding from ICMR (Indian Council of Medical Research) registry of ‘Youth Onset Diabetes’ has depicted that almost 25% of diabetic patients with onset before the age of 25yrs actually had type 2 Diabetes which is a lifestyle disorder. Most of these patients are brought with symptoms of very high sugars in the form of excess thirst, new onset bedwetting, weight loss, etc. Sedentary lifestyles brought on by lockdowns could be playing a critical role in this rising prevalence. Moreover, children with mildly elevated blood sugars do not come to medical attention and remain undiagnosed. This can have serious implications over long term health of these children.

FACTOR CAUSING DIABETES IN CHILDREN: There has been an exceptional increase in the rates of Diabetes in India in last 30yrs. One of the striking features is increase in the prevalence of type 2 Diabetes among individuals younger than 25yrs of age. Earlier, majority of the cases of Diabetes among children were contributed by type 1 Diabetes which has little relationship with lifestyle. However, in recent times, almost 25 to 30% of cases of Diabetes in individuals younger than 25yrs is contributed by type 2 Diabetes, which a lifestyle related disease. The most important contributing factor for this is enormous change in the lifestyle. Over the period of time, due to globalization of food market and increase in the purchasing power of the people, there has been huge increase in the average daily consumption of calorie-dense food. At the same time, physical activity has declined significantly. As a result, we have seen an epidemic rise in Obesity rates not only in adults but also in paediatric population. The ongoing COVID19 pandemic has made the situation even worse by accelerating the problem of Obesity in children. The screen time, both for educational reasons for online classes as well as for recreational purpose has increased severalfold, further contributing to weight gain. Exposure to environmental chemicals and pollutants is also one of the proposed reasons for rise in Diabetes among children and youth.

Hence, early screening and lifestyle change is recommended. BUT THE QUESTION IS CAN DIABETES BE REVERSABLE AT STAGE? The answer to this simple. If children follow a regimen of intensive lifestyle modification with maintenance of healthy weight, type 2 Diabetes even children like adults can be managed well with diet alone or a basic medication called Metformin along with diet modulation. Moreover, a family centric approach to change the dietary pattern and increase physical activity can be beneficial. Parents should engage in regular monitoring of blood glucose levels for stricter control of Diabetes, as these children are at higher risk of long-term cardiovascular disease.

HERE ARE A FEW THINGS THAT PARENTS CAN DO:

• Engage your child in regular physical activity
• Reduce screen time
• Give them a balanced diet
• Avoid junk food
• Ensure 8 to 9 hours of sleep every night
• Aim to achieve a healthier weight for your child

~ Authored by Dr Sweta Budyal, Sr. Consultant Endocrinologist & Diabetologist, Fortis Hospital, Mulund ~