Dear doctor; Is it true that children with type 1 diabetes do not live long? And how could one help a child with diabetes? Noeline, 24. Dear Noeline, Children with type 1 diabetes are different from other children due to the fact that they need life long insulin therapy and some diet restrictions. But in no way their life span is short. They do live as long as anyone. Type 1 diabetes usually occurs due to absolute deficiency of insulin in the body in contrast to type 2 diabetes where insulin is present in body but body cells are resistant to it. Insulin is a hormone produced by cells of pancreas that helps to maintain the glucose metabolism in the body. Deficiency of insulin leads to high blood glucose levels as body fails to neutralise and utilise glucose produced by liver. This leads to increased frequency of urination and subsequent thirst and weight loss in spite of increased appetite. Persistence of high blood glucose levels leads to severe infections which do not resolve soon like non healing ulcers and wounds. Long standing high blood glucose levels damage the kidneys, eyes, heart, nerves and blood vessels and increase risk of heart attacks and strokes. These damaging effects occur more severely with type 1 diabetes and since there is lack of insulin in the body, it needs treatment only by insulin. Diagnosis is simply done by testing blood glucose levels which are high both in fasting and meal states. Young children and adults always have diabetes type 1, whereas type 2 diabetes occurs in older people. Since one usually does not suspect diabetes at a young age, mostly it is detected late, when the individual already has severe symptoms. But in no way is the longevity of life affected due to diabetes. Regarding quality of life, with regular treatment and dietary restrictions (low calorie sugar-free diet), any youngster with diabetes can have a good quality of life. Only they have to be vigilant about good personal hygiene and avoiding infections. As soon as possible, the child should be taught to take insulin injections so that in no way his dose is ever missed wherever he is. He should learn to take correct dose of insulin with proper aseptic precautions. He should also be educated about symptoms of low blood glucose and the importance of taking food along with insulin. With easy availability of artificial sweeteners, one can use them for a sweet flavour whenever needed. If one can procure a glucometer and monitor blood glucose levels at home, he can also indulge in foods of his choice, including desserts and cakes and adjust the doses of insulin accordingly. But much dietary indiscretion will always be wrong. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital
