Children with diabetes mellitus, especially Type 1, have symptoms that are frequently missed until the symptoms worsen. Managing the condition and prevention of significant morbidity can be greatly impacted by early detection and management.

The following seven indicators could mean your child has diabetes or is at risk for the same:
1. Frequent Urination: Your child's inability to control their blood sugar levels may be the cause of their frequent bathroom visits. A baby may need more diaper changes, or a toilet-trained trained child might begin wetting their pants or bed.
2. Abnormal thirst: The child is unusually thirsty
3. Fatigue and Low Energy: Prolonged fatigue may indicate that the body isn't using glucose correctly, which lowers energy levels.
4. Increased appetite
5. Unexplained Weight Loss: Even if hunger is extreme or normal, there is a sudden decrease in the body weight. When the body is unable to acquire glucose, it begins to break down muscle and fat for energy.
6. Recurrent Infections: Recurrent fungal or skin infections could be a sign of an environment where bacteria and fungi thrive due to elevated blood glucose.
7. Slow Wound Healing: High glucose levels can affect blood flow and immunological function, which may be the cause slow healing of wounds.
8. Behavioral Changes: Unstable blood sugar levels can occasionally be indicated by irritability, mood swings or trouble focusing.

Management
To visit pediatric endocrinologist for an appropriate assessment if any of the above symptoms are perceived in the child. Once diagnosed, type 1 diabetes can be managed with a combination of timely insulin, frequent blood sugar monitoring, healthy lifestyle choices and regular checkups. Type 2 diabetes may be managed either with oral pharmacotherapy and / or insulin depending on the glycemic status at presentation, presence / absence of complications and the duration of illness prior to presentation.
For pre clinical stages of type 1 , preventive strategies to modulate the autoimmune process responsible for insulin depletion are presently undergoing clinical trials.
A balanced diet, insulin therapy in type 1, pharmacotherapy in type 2, routine blood sugar testing and structured daily physical activity are all important components of managing childhood diabetes . Limiting processed sweets, promoting nutritious meals and teaching your child to identify symptoms of hypoglycemia are essential. Managing diabetes appropriately enables children to live an active, healthy life.

Authored by: Dr. Abhishek Kulkarni, Consultant- Pediatric Endocrinology , Narayana Health SRCC Children’s hospital

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