Growing up with diabetes

2008-11-13 00:00

“Our child was critically ill and we thought we were going to lose him.” Durban mother Renie Pillay can still remember the distress she felt 12 years ago when she took her baby Yoshlin to the doctor with what was initially diagnosed as gastroenteritis.

Today, Yoshlin is a sports-mad teenager who loves hockey, cricket and soccer, but he’s lucky a correct diagnosis of diabetes was eventually made or he could have died.

Diabetes is growing at an alarming rate. Tomorrow is World Diabetes Day — a global awareness day endorsed by the United Nations in an attempt to alert people to the risks, educate them about the symptoms and help them obtain treatment.

This year, the theme is “Diabetes in Children and Adolescents” — a major problem for doctors worldwide as it is growing by around three percent per year. More worrying still, diabetes is growing by five percent per annum among preschoolers. An estimated 70 000 children under 15 develop Type 1 diabetes each year (200 per day). Currently an estimated 440 000 children worldwide live with diabetes.

Diabetes is linked to problems with the production and supply of the hormone insulin which the body needs to use the energy stored in food. There are two types of diabetes. Type 1, where a person either cannot produce or produces too little insulin, cannot be prevented and is usually genetic. Type 2, which occurs when the body cannot use the insulin produced effectively, is a lifestyle disease associated with obesity and lack of exercise. Up until now, Type 2 has been confined to adults, but doctors are now diagnosing children as young as eight.

Warning signs are frequent urination, excessive thirst, increased hunger, weight loss, tiredness, lack of interest and concentration, blurred vision and vomiting, and stomach pain, which are often mistaken for flu. The latter is what happened 12 years ago when a distraught Pillay took baby Yoshlin to her doctor. The diagnosis was as expected — gastroenteritis. The only problem was that all attempts to rehydrate the little boy failed.

Confused, Pillay rushed him back to the doctor, pointing out that despite the fact that he was dehydrated, he was urinating frequently. “We knew something serious was wrong even though we didn’t understand what was going on. We were lucky he didn’t go into a coma or suffer massive organ damage.”

She said that, at the time, she was not even aware that small children could be diabetic, let alone how to cope. However, despite a very lonely and terrifying start, the Pillays have learnt to deal with diabetes positively. “You’ve just got to get used to every single person asking [about your diabetes]. But it gets easier because they [eventually] just accept it and stop. The only time [diabetes] gets in the way is when you see your friends eating an ice cream,” Yoshlin pointed out.

For his mother, this has been “a long and hard road”. When it came to his first day at school, all she could think of was how he would cope. Each year, she has worked closely with teachers, explaining blood glucose tests and how to deal with imbalances.

“We were really blessed. Every teacher was truly remarkable,” she pointed out, but cautioned that not every teacher may be as receptive. Many feel daunted, while others tend to see problems such as constantly having to go to the toilet as an excuse to get out of classes. Yoshlin moves to high school next year with a whole new set of challenges.

The brighter side is that unlike in the earlier days, there are now many more treatment options. Seven years ago, Yoshlin began using an insulin pump which can be adjusted to administer different amounts of insulin at different times of the day, depending on what is being eaten. That means he is allowed the odd treat — usually some pizza — provided that he adjusts his insulin dose accordingly.

As doctors recommend, Yoshlin is an active part of his own treatment plan. As one doctor put it, because children have their own special challenges when it comes to diet restrictions, activity levels and treatment, each youngster needs to be taught and empowered to participate in his or her own insulin routine. This includes knowing what good glucose control means and avoiding hypos (low blood glucose attacks).

Looking back, what is Pillay’s advice? “You can’t avoid your highs and lows, but as long as you know that you are doing the best you can, you should just relax and enjoy your child. He or she will be all right.”

To provide families with invaluable support, the Centre of Paediatric Endocrinology and Diabetes, has sent out an invitation to a family fun day tomorrow at the Japanese Gardens in Durban North from 8.30 am to 4 pm. For further information, contact Racheal or Desiree at 031 265 5377.

what is type 2 diabetes?

Starches, sugars and proteins are broken down by our intestines into glucose, which is a form of sugar. The glucose is then carried via the blood to our cells with the help of insulin which in turn converts the glucose into energy for the muscles to burn. In a Type 2 diabetes sufferer the pancreas either doesn’t produce enough insulin, or the insulin produced is ineffective. Sugar accumulates in our blood, resulting in diabetes.

Risk Factors

You could be at risk from diabetes if you are:

• over 35;

• overweight;

• have a family history of diabetes;

• have given birth to a baby that weighed over 4kg’s at birth, or had gestational diabetes during pregnancy;

• are a member of a high-risk group (in South Africa people of Indian descent are statistically at higher risk than other racial groups);

• have high cholesterol; and/or

• have high blood pressure.

Symptoms:

• excessive thirst;

• unexplained weight loss;

• cuts or bruises that don’t heal or take much longer to heal than normal;

• tiredness;

• frequent urination;

• hands or feet tingling; and/or

• extreme fatigue.

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