Apollo Gleneagles Hospital today hosted a discussion on State of the Art Novel therapies in Type I Diabetes Mellitus in Childhood. Speaking on the occasion, Dr.Subrata Dey, Senior Consultant Paediatric Endocrinologist, and Academic Head of Paediatrics, Apollo Gleneagles Hospitals Kolkata highlighted causes clinical presentation and management of Type 1 Diabetes Mellitus, including innovative modern technologies.
Speaking on the occasion, Dr Subrata Dey, Senior Paediatric Endocrinologist, Apollo Gleneagles Hospitals, Kolkata said, “Type 1 Diabetes Mellitus which is mostly seen in children is a deficiency of insulin production. Typical symptoms are excessive thirst, frequent urination and rapid weight loss and if missed child can present in coma. Injectable insulin is the only modality of treatment. There is no role of oral medications. Well managed diabetic children can lead normal productive lives. This condition is on the rise and If blood sugars are not well controlled it can lead to severe complications like retinopathy nephropathy and neuropathy and coronary artery disease in adulthood. Many newer innovative technologies are now available to control blood sugars and give an excellent quality of life to patients with T1DM. ”
Type 1 Diabetes Mellitus (T1) is caused by insulin deficiency because of the inability of the pancreas to produce adequate amounts of insulin. The disease most commonly affects young children and teenagers when the altered body immune-system starts destroying the insulin producing beta-cells in the pancreas. Fasting blood sugar greater than 126 mg/dl or 200 mg/dl 2 hours after food is diagnostic of diabetes mellitus. The incidence of T1 Diabetes in India is on the rise with around 2% increase in West Bengal over the last one year.
Children with T1DM present with excessive thirst frequent urination and unexplained weight loss. A simple blood test and urine test will confirm the diagnosis. If missed child may present with severe breathing difficulty and even coma a life threatening condition called diabetic ketoacidosis. With expert timely modern management, it is possible to revive a T1DM patient from coma to a healthy normal life. “Sharmila a 6 year old girl presented to a district hospital in West Bengal with severe ketoacidosis in coma. Dr Subrata Dey was contacted by the treating Pediatrician and he guided the management of the child through hourly telephonic advice until the child was stable enough to be transported to Apollo Hospital by ambulance after 24 hours. The child was revived blood sugars were controlled and insulin pump therapy was commenced and the child was discharged home within a week with perfectly controlled blood sugars. Now a year later the child is leading a normal healthy life with her insulin pump”
Insulin is the cornerstone of T1 Diabetes management and needs to be administered daily in multiple doses on diabetic children. This can be done using insulin syringes or insulin pens or insulin pumps. With proper insulin therapy, appropriate diet and exercise the blood sugar levels can be well controlled and the child can lead an absolutely healthy life. Blood sugar levels should be routinely monitored at home using a glucometer.
Newer innovative technologies to conquer T1DM like Sensor augmented pump therapy and Flash Glucose Monitoring are now available. Insulin pumps deliver insulin without repeated injections and painless. Flash Glucose Monitoring system which once fixed on the arm can constantly keep a record of blood sugar levels without any prick and helps to guide insulin dosage through the pump. Along with insulin, wellness diet with measured carbohydrate and restricted sugar and physical activities are of great importance in order to treat the insulin deficiency. Artificial pancreas wherein a highly sophisticated pump with the help of sensors and a computer chip will regulate the insulin dosing as per the blood sugars is likely to be available in the next few years.
There is no role of oral medications in the management of the Type 1 form of diabetes. Comprehensive Diabetes Management instituted by paediatric endocrinologists involves a systematic 5 pronged process with a multidisciplinary team that includes Insulin Treatment, Nutritional Management, Physical Activity, Diabetes Education and Psychological Support and can ensure a long and productive life in a patient with Type I Diabetes Mellitus