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Wrong diabetes message hurts children

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Diabetes Awareness Week 23-29 Nov 04
Wrong message hurts children

The rising numbers of Type 2 diabetes in adults, and now also in children, is alarming and Diabetes Youth NZ applauds Diabetes New Zealand’s aim to reduce the incidence of this condition which is reaching epidemic levels. But this important campaign to help identify those at risk of developing Type 2 diabetes and help them to “Nip it in the Bud” can harm children with Type 1 diabetes if the wider community misinterprets the message, says president of Diabetes Youth NZ, Crystal Beavis.

There is a growing perception in parts of the community that only “couch potatoes” - fat, lazy people - get diabetes and that all diabetes is preventable. This is not true. This misconception has caused considerable anguish for children with Type 1 diabetes and their parents, and has also put funding at risk for the very important work that Diabetes Youth NZ undertakes.

Type 1 is the most common form of diabetes diagnosed in children. It cannot be prevented, is not associated with being overweight, and is a distinctly different disease from Type 2 diabetes, the most common form diagnosed in adults. And while by far the majority of diabetes in NZ is Type 1 and Type 2, there are as many as 9 other categories of diabetes mellitus, reflecting a wide range of underlying conditions that can compromise the body’s natural insulin production and ability to turn food into energy.

Many parents now tell me they wish Type 1 diabetes had a different name so that there was less confusion, says Crystal. Parents and children not only have to manage a life-threatening condition, but are now also having to counter some extremely ignorant attitudes that blame them for it.

Our estimates indicate there are about 1500 school-age and pre-school children with type 1 diabetes in New Zealand compared with considerably less than 100 so far diagnosed with Type 2. So it is extremely important that the community learns more about diabetes – and that it learns the right things.

The onset of Type 2 diabetes can be delayed, and may be prevented, if people at risk adopt and maintain healthy eating and exercise habits. This is a sensible message to counter a disease that is becoming epidemic as lifestyles become more sedentary.

Type 1 diabetes, however, is an autoimmune condition that has a genetic basis and it cannot be prevented. What triggers the immune system to attack and kill the body’s insulin-producing cells is still unknown, but there is no known association with weight, eating habits or “lifestyle”. It is a disease that has been documented for centuries, and it can occur in babies as young as six weeks old and in young adults in their 20s or even later, although the most common age of diagnosis school-age children.

The onset of Type 1 diabetes is rapid and – until the discovery of insulin – was fatal. Ironically, the insulin injections that keep these children alive can also be fatal if the wrong dose is given. Insulin injections must be given at least twice to four times daily, and the dose calculated each time on the basis of the child’s blood sugar levels, appetite and expected level of exercise. Blood tests must be undertaken up to six or more times per day to manage the condition properly so the child remains healthy. Managing type 1 diabetes is stressful and relentless.

Children with Type 1 diabetes grow up learning to take remarkable responsibility for their health and well-being, but they need the support of their families, schools and wider community around them says Crystal, so let’s get the message about diabetes right. The community needs a better understanding of this whole group of conditions.

Note:

Criteria recently established by Auckland’s Starship children’s diabetes services for screening children for Type 2 diabetes include:

OBESE children WITH acanthosis nigricans (areas of darkened skin around the neck)
AND aged more than 10 years
AND ONE of the following…
- Ethnic groups: Maori, Pacific Island or Asian
- First degree relative with type 2 Diabetes
- Mother had gestational diabetes
- Polycystic ovarian syndrome (PCOS) present
- Hypertensive or dyslipidaemic

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