Diabetes: the system lets down our children

A new report has revealed that up to three quarters of children who have diabetes are not getting all their regular health checks – and are therefore at risk of developing complications sooner than necessary.

Nearly three quarters of children who have diabetes have Type 1 diabetes – which develops when their pancreas stops producing insulin and is not related to lifestyle factors. Insulin is needed for the body to take energy from food. In Type 1 diabetes, it has to be replaced by animal or artificial insulin being injected. This type of the condition usually develops during the teenage years, but can come on earlier or later. It is sometimes called juvenile or early onset diabetes.

Type 2 diabetes develops when a person is overweight and/or takes little or no exercise and their pancreas stops working properly and/or their insulin stops being fully effective. In these cases, treatment is usually by medication to begin with, although injections of insulin may become necessary as the condition goes on. In some cases, if the patient loses weight and begins taking exercise, the condition can go away and the person can return to full health.

Both kinds of diabetes carry side effects. The presence of extra sugar in the blood (not used up by insulin, as it would be in a healthy person) can damage the parts of the body where the capilliaries carrying the blood are at their thinnest: the feet, the eyes, and the kidneys. Because of this, everyone with diabetes, of whichever kind, should have regular checks on their blood sugar (to check that their diabetes treatment is working) and on their kidney function, eyes and feet so that any deterioration can be picked up quickly and treated. Now the report, from the Royal College of Paediatrics and Child Health, has shown that very many children are missing out on these checks. They are therefore running the risk that the secondary damage caused by diabetes will not be picked up early and treated – so the damage will be worse. As the diabetic children of today can expect to live long lives with the condition, the chance of them developing secondary damage during their lifetime is high.

It’s not all bad news. Researchers found that children’s blood glucose levels have come down for the fifth year running. This is a sign that either more children are controlling their diabetes better, or that there is slightly better control across the board. Better control means less chance of developing side effects. However, only 23.5% of children were judged as achieving “excellent” control: that’s up from 15.8% three years ago, but still lower than desirable.

Further good news came with the finding that nearly all – 98.7% – of young people with diabetes are having their blood glucose levels measured at least once a year. However, less than two thirds (64.9%) of youngsters at risk were having their eyes tested at recommended frequencies and only just over half (52.4%) were having their kidney function tested.

Representatives of the Royal College called on the NHS to do more to ensure recommendations were implemented.

In the meantime, parents of young children with diabetes and young people with diabetes themselves can help. Those with the condition should have seven checks per year: HbA1C levels (blood glucose), growth, blood pressure, kidney function, cholesterol level, eye screening, foot examination. In addition, those with the condition should be screened for thyroid and coeliac disease and should have a psychological review. This is all set out in NICe guidelines. If you or your child is not having these checks, discuss this with your GP. You should also make sure that your GP tells you the result of any checks that you have had, what the acceptable range of results is and whether you need any further treatment arising out of your results.

[Adverts]