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Diabetes is a chronic disorder where a person has high blood glucose levels. It is commonly referred to as diabetes mellitus. Insulin is the hormone responsible for regulating blood glucose levels. It is produced by the Islets of Langerhans, which is located in the pancreas; its production depends on the concentration of glucose in the blood. Insulin helps the body cells to utilize glucose which is the main a source of energy. Diabetes occurs when the pancreas produces little insulin or none at all and when body cells do not respond to the produced insulin. It can be broadly classified into two main groups; type 1 and type 2 diabetes. The most regular indicators of diabetes are recurrent passing of urine (polyuria), vision problems, feeling excessively thirsty (polydipsia) and increased episodes of hunger (Cooke & Plotnick, 2008).Type 1 diabetes is also referred to as juvenile diabetes or insulin dependent diabetes mellitus (IDDM).

It is the most common diabetes in children and young adults. It occurs when there is little or no production of insulin due to immunological damage of beta cells of the pancreas; the cells responsible for insulin production (Louise, 2007). Thus, the body cells cannot utilize glucose and this result in elevated glucose levels in blood, and subsequent excretion in urine (glycosuria). Apart from the common symptoms, others signs associated with this condition are weight loss, tiredness and excessive sweating especially at night (Cooke & Plotnick, 2008). Type 1 diabetes is incurable and often fatal if not treated. Its management is life-long and involves insulin administration through injections; inhalants are also available. The dose and frequency of the injections vary with individual and will be determined by the doctor based on the severity of the disease. Organ transplant involving the islets and pancreas is still being explored as a possible method of treating diabetes. However, this is still in experimental stages.

Type 2 diabetes is also referred to as non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Often, this occurs in adulthood (more than 40 years); however, lately, there has been an alarming increase in its occurrence in overweight children and adolescents. It occurs primarily due to insulin resistance and sometimes this is coupled to relative insulin insufficiency (Riserus, Willett, & Hu, 2009). Apart from the genetic predisposition, sedentary lifestyle is also a main factor contributing to the development of type 2 diabetes. Minimal physical activities, unhealthy diet, and being overweight considerably raise the risk of type 2 diabetes (Rosenbloom & Silverstein, 2003) The treatment involves changes in lifestyle, diet modification and increasing physical exercises. However, medication may be required to complement the treatment.

In children, diabetes has been on the rise because of a combination of factors. In families that have a known history of the disease, genetics, and inheritance are the main factors contributing to the prevalence of diabetes. Many studies have conclusively illustrated a recessive gene is responsible for the risk of inheriting, and later developing diabetes. Over the years, changes in lifestyle have led to the rise in prevalence among children. Physical inactivity, smoking, alcohol abuse and consuming unhealthy diet accounts for this increase; reports from the Centers for Disease Control (CDC) indicate that increased intake of saturated fats has contributed significantly to obesity. Obesity accounts for more than half of type 2 diabetes cases. The rise in the number of overweight children, over the years, is understood to be responsible for the gradual rise of diabetes in children and adolescents (Rosenbloom & Silverstein, 2003). Sedentary activities such as, watching television for long hours, playing video games, surfing internet, lack of participation in sports and poor diet are among the factors leading to overweight in children and adolescents. This predisposes them to a higher risk of developing diabetes.

Early detection of diabetes is valuable in its management. Untreated diabetes can lead to grave complications such as kidney problems, eye cataracts, limbs and skin problems and heart disease. Diagnosis should be done by taking a blood glucose test commonly referred to as oral glucose tolerance test. According to Rosenbloom & Silverstein (2003), a fasting blood glucose level greater than 7.0 mmol/L (126 mg/dL) or random blood glucose greater than 11.1 mmol/L (200 mg/dL) in oral glucose tolerance test is indicative of diabetes. It helps to classify diabetes and the best treatment to manage it. Close monitoring and controlling of the blood glucose levels is essential in the treatment. It helps to determine the frequency and dosage of the insulin injection. The parent should be keen to detect the symptoms on time and consult a qualified medical practitioner if any will be detected.

Diet management forms a vital component of the diabetes management plan. The diet is dependent on the body mass index and age of the child; this should be determined by the parent and a diet specialist. An ideal diet plan should consist of three balanced meals with snacks in between them. The parent should ensure that the child adheres to the diet plan and should be well acquainted with the signs of high and low blood sugar levels. The diet plan should be composed of such foods that help to reduce and control weight especially in obese children. The parents should encourage their children to increase physical activities. These activities help to control the weight and reduce the amount of insulin to be injected by using up some glucose in the blood. However, parents should ensure this is controlled to avoid the risk of low-blood sugar. The child should have additional carbohydrates before undertaking physical exercises. Examples of physical activities include walking, cleaning the house, gardening, playing with pets and aerobic training.

The parents and children should ensure they are well informed about the insulin therapy. They should be familiar with the dosage, method and schedule of administration. These injections are usually administered subcutaneously on the thighs or the hypochondriac region. If the children are old enough, they should be trained on how to self-inject the medication. They should also learn how to take the blood glucose test and be knowledgeable on what the test results means. Nevertheless, it is recommended that the patient visits a doctor regularly for reviews because sometimes there may be a need to change the treatment plan. These reviews also help in early detection of any secondary conditions that may arise due to diabetes and their early treatment will be initiated.

Diabetes is a persistent disorder that once diagnosed requires careful management and constant monitoring. Data from the Centers for Disease Control indicates an alarming rise in the number of people diagnosed with diabetes. Diabetes was initially viewed as a disease of adults; but lately, it is significantly being diagnosed in children. This can be attributed to the rise in the number of overweight children due to changes in lifestyles and diet during childhood. It is proven that positive lifestyle modification, regular physical exercises and a proper diet can help reduce the risk of developing diabetes. Some drugs can be combined with the above measures to help decrease the incidences of diabetes.

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