What is so different about diabetes in children

The specific needs of children with diabetes are often overlooked. Type 1 diabetes is growing, and 70,000 new cases are reported each year in children worldwide.

While there have been many improvements in diabetes management, many challenges remain in treating youth diabetes. While their insulin and nutritional needs are the same as those of adults, there are major physiological, medical, psychosocial and emotional differences. Like adults, young people with diabetes are at risk of developing life-threatening complications. Studies confirm higher mortality rates in children with diabetes, and 12 years after diagnosis, more than 50% of children with diabetes develop complications or co-morbidities.

Changing needs of children
The needs of children with diabetes change as they grow and develop. Checking blood glucose levels, dealing with medication, balancing activity and food choices are all factors that impact the lives of young children. In addition to longer sleep patterns, unpredictable behaviour and eating habits, children also have a higher sensitivity to insulin, and frequent infectious diseases.

Pre-school children
A child’s diagnosis of diabetes also impacts the family. Small children cannot understand or manage their condition, and the burden of care must be shared among adults. Families need help to cope with the condition, while learning about diabetes and its management. Support must be ongoing, age-appropriate and evolve with the needs of the growing child.

The impact of puberty
Puberty has a major impact on coping with diabetes. Some studies suggest that teens with diabetes are less satisfied with life and have more negative perceptions of their health than peers without the condition. However, a worldwide collaborative study showed that better treatment results were associated with fewer worries, better quality of life and a decreased perception of the burden of diabetes on the family. This emphasizes the importance of optimal physical and psychological care for young people living with diabetes.
More reference centres for paediatric diabetes

The multidisciplinary team
Ideally, children with diabetes should have access to a specialized multidisciplinary team of diabetes healthcare professionals which includes a physician, a diabetes nurse educator and dietitian, as well as additional access to a psychologist, social worker, ophthalmologist and other specialists. The diabetes healthcare team may also require special skills to effectively deal with differences in age, levels of comprehension and education between children and families. Varying language and cultural needs may also represent a further challenge to healthcare providers.

It is hoped that initiatives highlighting the special needs of children and young people with diabetes will lead to the establishment of more reference centres for paediatric diabetes where families have access to the medical, psychosocial, economic and emotional support they deserve.

Thomas Danne and Olga Kordonouri