Dr Tariq Jagnarine
Family Medicine, Endocrinology and Diabetes

Each year, World Diabetes Day is commemorated on the 14th November, to raise awareness about the disease, the impact on people’s health and wellbeing and the effective strategies that can be used to prevent and control it. This year is a unique one with the COVID-19 pandemic, which has caused many challenges, including for people living with diabetes and for their health care providers. The World Diabetes Day 2020 theme is “Diabetes: Nurses make the difference” to highlight the crucial role that nurses play in supporting people living with diabetes

Diabetes rates are rising in young people. Early detection and treatment in children and teenagers can improve their health and wellness throughout life. According to the International Diabetes federation (IDF) 2020, there are over 50,400 persons living with Diabetes in Guyana with a prevalence of 10.5%.
• A rise in prevalence of Type 2 Diabetes is occurring worldwide in parallel with an increasing prevalence of obesity in children.
• Type 1 diabetes is much more common in young people than type 2 diabetes. However, the rates of both types in young people are increasing.
• In 2014–2015, doctors diagnosed type 1 diabetes in around 18,291 young people aged 10–19 years and type 2 diabetes in around 5,758 young people.
• The National Institutes of Health (NIH) report that, each year, rates of type 1 diabetes are rising by 1.8%, and rates of type 2 diabetes are rising by 4.8%.
• Young people who develop diabetes have a higher risk of health challenges throughout their life.
Type 1 and type 2 diabetes are different conditions, but they both affect the body’s use of insulin. Although type 1 is more common in young people, both types can affect children and teenagers.

Type 1 diabetes in children, previously called juvenile diabetes, occurs when the pancreas is unable to produce insulin. Without insulin, sugar cannot travel from the blood into the cells, and high blood sugar levels can occur.
People can develop type 1 diabetes at any age, from early childhood to adulthood, but the average age at diagnosis is 13 years. An estimated 85% of all type 1 diagnosis take place in people aged under 20 years. Treatment involves lifelong insulin use and blood sugar monitoring, as well as diet and exercise management, to help keep blood sugar levels within the target range.
Type 2 diabetes is less common in young children, but it can occur when insulin is not working correctly. Without enough insulin, glucose can accumulate in the bloodstream. The chance of developing type 2 diabetes increases, as people get older, but children can also develop it. The rates of type 2 diabetes are increasing along with increases in childhood obesity. Over 75% of children with type 2 diabetes have a close relative who has it, either due to genetics or shared lifestyle habits. Having a parent or sibling with type 2 diabetes is linked with an increased risk. Sometimes, persons will need medication. However, people can often manage type 2 diabetes by:
• Changing the diet- less carbs, more fruits, and proteins
• Getting more exercise
• Maintaining a moderate weight

●Positive family history
●Specific racial and ethnic groups
●Female sex
●Conditions associated with insulin resistance

The symptoms of diabetes are similar in children, teenagers, and adults. Some symptoms are common in both types of diabetes, but there are some differences to help tell them apart.
The symptoms of type 1 diabetes in children tend to develop rapidly over a few weeks. Type 2 diabetes symptoms develop more slowly. It may take months or years to receive a diagnosis.
The main symptoms of type 1 diabetes in children and adolescents include:
• Increased thirst and urination
• Hunger
• Weight loss
• Fatigue
• Irritability
• Fruity smell on the
• Blurred vision
• Yeast infections in females can also be a symptom of diabetes.
• Diabetic ketoacidosis (DKA) at the time of diagnosis. This occurs when the body begins to burn fat for energy due to a lack of insulin. This is a serious condition that requires treatment.
People may be able to get a diagnosis before DKA develops by recognizing the four main symptoms of type 1 diabetes.
Diabetes U.K. urge people to be aware of the “4 Ts” in children:
• Toilet: The child might be using the bathroom frequently, infants may be having heavier diapers, or bedwetting may be occurring after being dry for some time.
• Thirsty: The child may be drinking more fluids than usual but feeling unable to quench their thirst.
• Tired: The child may be feeling more tired than usual.
• Thinner: The child may be losing weight.

See Monday, November 16 Edition for the
continuation of this article