Paediatric Registrar with an interest in Diabetes DIABETES in CHILDREN 20/07/2016 Anita Demetriou Paediatric Registrar with an interest in Diabetes

Type 1 Diabetes 95% cases of diabetes in under 16 year olds 17 per 100, 000 Tripled in the last 30 years Cause: - not lifestyle Antibodies directed against cells in pancreas Lack of insulin Inability to take up glucose into body cells

Type 1 Diabetes How does it start? Who is more at risk? Drinking more Passing urine more Weight loss Lethargic/tired Thrush/skin infections Acutely unwell; vomiting, drowsy, breathless Who is more at risk? Family history of diabetes or thyroid disease or coeliac disease

Type 1 Diabetes What does it mean for families? Huge life-changing event Several days in hospital having intensive education Lifelong fingerpricks to check blood sugars Lifelong 4 injections per day (or more) 1 year after diagnosis some mothers are showing signs very similar to post-traumatic stress disorder Adolescent period very challenging

Type 1 Diabetes What does it mean for families Balance between maintaining normal life and activities and achieving good control of blood sugars Night-time insulin and meal-time insulin Normal healthy diet Nothing strictly “off-limits” Training in school, school trips etc

Support for Families Support mainly comes from Hospital Diabetes team Specialist nurses Doctors Dieticians Psychologist 24 hour contact As required Social work GP Family network

Type 2 Diabetes Much less common in children On the rise! The body does make insulin Not enough OR it can’t work properly Being overweight makes you resistant to insulin

Type 2 Diabetes in BME communities Significantly higher risk in these communities Lifetime risk is approx 50% Compared with 20% Rising in Children (epidemic) Rise in obesity Rise in gestational diabetes Sedentary lifestyle High sugar diets

Type 2 Diabetes How does it start? Sometimes no symptoms at all Thirst, passing more urine, tiredness, lethargy Sometimes picked up by a healthcare professional by chance or where there is a strong family history

Type 2 Diabetes- how can we prevent it? WEIGHT MANAGEMENT EXERCISE DIET

Prevention Even a small amount of weight loss or increase in activity can delay or prevent the onset of Type 2 Diabetes Exposure in the womb to diabetes in pregnancy (gestational diabetes) Increased amount of body fat in children Increased risk of Type 2 Diabetes

Any Questions??