SA faces rising diabetes rates: Understanding, managing Type 1 diabetes in children

Published Aug 13, 2024

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In recent years, South Africa has seen a slight drop in overall death rates but there’s a troubling trend that’s hard to ignore: non-communicable diseases like diabetes and cancer are on the rise.

Statistics South Africa reveals a dramatic 58% increase in deaths from these conditions between 1997 and 2018.

With diabetes now the second leading cause of death after tuberculosis and affecting 12% of adults, it’s clear that this silent epidemic is taking a heavy toll on our health and lives.

As we tackle this growing issue, it’s crucial to understand the impact and explore ways to manage and prevent these chronic conditions.

Diabetes is a chronic condition that affects how the body turns food into energy. It’s a lifelong disease with no known cure, but it can be managed.

Type 1 diabetes is one of the most common chronic conditions in children and adolescents, affecting about one in 400 young people under the age of 20.

In Type 1 diabetes, the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. Insulin is a crucial hormone that regulates blood sugar-levels, so without it the body can’t properly use the energy from food.

This can lead to serious health complications if not properly managed.

According to Dr Themba Hadebe, clinical executive at Bonitas Medical Fund, receiving a Type 1 diabetes diagnosis can be overwhelming, especially for children and their families.

Suddenly, they must learn to count carbohydrates, give insulin injections and vigilantly check blood sugar-levels. But with the right support and tools, children with Type 1 diabetes can live full, healthy lives.

For people with Type 1 diabetes, the immune system attacks and destroys the insulin-producing cells in the pancreas. Picture: Nataliya Vaitkevich/Pexels

“Advances in blood sugar-monitoring and insulin-delivery have greatly improved the ability to manage Type 1 diabetes. While it’s a lifelong condition, Type 1 diabetes doesn’t have to hold kids back from doing the things they love,” Hadebe said.

For people with Type 1 diabetes, the immune system attacks and destroys the insulin-producing cells in the pancreas. This leads to two key issues:

∎ Hyperglycemia: High blood sugar-levels, which is the hallmark of diabetes onset and can continue to occur even after starting treatment.

∎ Hypoglycemia: Dangerously low blood sugar-levels, often as a side effect of insulin treatment.

“Type 1 diabetes can come on suddenly or gradually in children and teens, and parents aren’t always aware of the early warning signs, Hadebe said.

Symptoms like increased thirst and urination, unexplained weight loss, fatigue and blurry vision can easily be mistaken for the flu.

However, the sooner Type 1 diabetes is diagnosed, the better. If left untreated, it can lead to a life-threatening condition called diabetic ketoacidosis, where the body begins producing harmful acids called ketones.

This is when blood sugar-levels are very high and the body starts producing ketones. It is a very serious condition that needs immediate hospital treatment, sometimes in the intensive care unit. If not treated right away, there is a risk of a diabetic coma.

A child with a diabetic coma loses consciousness because of brain swelling due to very high blood sugar-levels”

Recognising the signs of hypoglycemia in Type 1 diabetes

Just as high blood sugar-levels can cause troubling symptoms, low blood sugar or hypoglycemia is another major concern for children and teens with Type 1 diabetes.

Hypoglycemia usually occurs as a result of diabetes treatment, especially insulin administration, which lowers blood sugar-levels, explained Hadebe.

“It’s important for parents and children to be able to recognise the signs.”

Some of the most common symptoms of low blood sugar include trembling, sweating, hunger, irritability or moodiness, fatigue, paleness headaches.

Treating Type 1 Diabetes

Managing Type 1 diabetes requires a careful balance of insulin, diet, and lifestyle.

A daily dose of insulin is necessary to keep blood glucose within a healthy range. This can be given through injections or an insulin pump.

In addition to insulin therapy, children with Type 1 diabetes need to carefully plan their meals and snacks to prevent both hyperglycemia and hypoglycemia.

This includes learning to count carbohydrates and time their food intake. Exercise, regular blood testing, and regular urine testing for ketone-levels

Hadebe added: “The diagnosis affects the entire family emotionally, there are various support groups and organisations for children with Type 1 diabetes and their families.

“A younger child may not understand all the life changes, such as glucose-monitoring and insulin injections, which can lead to anxiety and depression.

“They may feel different from their peers, try to treat them as a normal child by managing diabetes as just one aspect of their daily life.

“With the right management plan and access to the latest diabetes technology, children and teens with Type 1 can absolutely live full, active lives,” Hadebe said.

“It takes vigilance but it’s very achievable.”