Prof (Dr) Balram Bhargava, director general of ICMR released guidelines for management of type 1 diabetes providing advice on care of diabetes in children, adolescents and adults.
Type-1 diabetes is an autoimmune disease characterized by insulin deficiency and hyperglycemia in people with underlying genetic susceptibility. Notably, type-2 diabetes is emerging as a new childhood disease in India due to an increase in obesity. However, it can be controlled with lifestyle changes and a healthy diet.
Dr Nikhil Tandon, head, department of endocrinology and metabolism, AIIMS, said, “In this disease, due to the absence of insulin, blood sugar levels rises. At the same time, there will be utilization of other sources of energy like fat and protein which eventually changes body metabolism and causes acid production inside the body. Unless you recognize and treat these individuals with insulin, there can be an acute metabolism complication leading to death."
“Children and adolescents are mainly affected with this. Because, we don’t really think of children suffering with type-1 diabetes, our mental picture of diabetes is for those who are old age and overweight. But when children and young adolescents are unwell and nobody thinks in this direction that it could be type-1 diabetes. So, there are chances that diagnoses get missed out and treatment does not start which turns into a life-threatening condition," said Dr Tandon, who prepared the guidelines.
Doctors also warned against non-injectable therapy. “In the absence of injectable insulin, this invariably will end up with the child’s condition deteriorating, increasing the risk of fatality. If there is a suspicion of type-1 diabetes, insulin is the only treatment of choice," said the AIIMS doctor. He added that not a single dose of insulin should be missed and sugar levels should be monitored.
Dr. V Mohan, Director, Madras Diabetes Research Foundation (MDRF), Chennai said: “For the first time, we have brought out the comprehensive guidelines for the treatment of children suffering with type-1 diabetes. It talks about this medical condition, how to diagnose, how a child needs to be treated, what kind of insulins, how to give the insulin and how and when to give the insulin, how to prevent complication in children if any. So, the total prevalence of type-1 diabetes in India is over 2.5 lakh in all age groups, out of which there are one lakh children below the age of 14 years, said Dr Mohan, another author of the report."
“ICMR is in the process of developing a revamped version of young diabetic registry as a database for those suffering with T1DM across the country," he said. These guidelines will help doctors to give appropriate treatment to children with type-1 diabetes. It will be disseminated to all doctors for providing uniform treatment to such patients."
