1. Effects of Early Onset Diabetes in Children
By Omar Padilla Vélez
ABSTRACT
Diabetes is one of the main causes of child death, but it is ignored. New and current
research has shown that early onset diabetes is harmful for anyone. Type1 and Type 2 diabetes
are both hereditary diseases. Experiments with diabetic patients who have diabetic parents show
that diabetes is inherited, especially via paternal lineage. Even though diabetes is a hereditary
disease it is preventable by keeping a healthy lifestyle. Diabetes in children has been
demonstrated to develop serious health problems. Studies have concluded that diabetic children
under 15 have more chances of developing microalbuminaria. This is high levels of protein in the
urine, which can lead to kidney failure. As this disease progresses new treatments are being
developed. The current method for diabetic children consists of multiple daily insulin injections.
This treatment causes a great amount of stress in the children and decreasing their quality of life.
The insulin pump therapy is being introduced as a new method for children. The pump regulates
the glucose levels automatically, releasing the worries and stress of the children and their
parents.
INTRODUCTION
The human body functions using the energy that is consumed daily. In every activity that
is performed, energy is essential. Even when a person sleeps, they still need energy for the
proper function of the body’s systems and processes. The main way that the body gets energy is
by eating. Food is digested in the stomach for the extraction of nutrients which carry energy for
growth and development. Most of the energy comes from glucose, which is a form of sugar in
the blood. This glucose is the main source of fuel for the body. Glucose comes into the
bloodstream and spreads throughout the whole body.
The body’s cells use hormones to complete several processes. To take in the glucose
from the blood into the cells, the body uses insulin. A specific amount of insulin is produced by
the pancreas when food is eaten to move the glucose into the cells. This way, sugar levels in the
bloodstream are lowered and the body gets the energy it needs to work properly. A healthy
pancreas is able to can adjust the amount of insulin needed based on the glucose levels in the
blood.
A person with diabetes has a condition in which the levels of glucose in the blood are too
high. This is an effect of the body cells not responding to the insulin the pancreas produces, not
producing enough insulin or any amount of insulin. Without insulin the glucose does not enter
the cells and no energy for growth and development will be available. This is why diabetes in
considered a metabolism disorder. There are two main types of diabetes, type 1 and type 2.
People who suffer Type 1 diabetes are completely unable to produce insulin. People with Type 2
diabetes can produce insulin, but their cells do not respond to it. In either case, the glucose
cannot move into the cells causing high glucose levels in the blood. Over time, these high

2. glucose levels can cause serious complications in the body like: high blood pressure, high
cholesterol, loss of sight, kidney disease and even nerve damage.
Type 2 diabetes as a hereditary disease
It is believed that people who have offspring. They selected three groups of
family members that have been diagnosed individuals: 1) offspring of fathers with
with type 2 diabetes have a great risk of early onset of diabetes, 2) offspring of
developing it themselves. It is not mothers with early onset of diabetes, and 3)
guaranteed, but a person’s family history offspring, in which neither parent developed
and lifestyle plays an important part in diabetes. Body composition (percentage of
determining they have diabetes. Researchers body fat [%BF]), insulin action (M), and
have tested whether or not paternal and acute insulin response (AIR) were compared
maternal type 2 diabetes may occur in their to formulate conclusions.
offspring and tried to identify it for a better
diagnosis. They specifically examined the Body composition was measured by
metabolic phenotype in three different dual energy X-ray absorptiometry using a
groups of offspring to see distinct paternal total body scanner (DPX-L; Lunar,
versus maternal effects. The offspring Madison, WI). Insulin action was assessed at
phenotype may vary depending on which physiological insulin concentrations during
parent is affected and whether the offspring the hyperinsulinemic-euglycemic clamp
was exposed to diabetes in utero. technique. Blood samples were taken at
specific time to determine the insulin action
Low birth weight (LBW), was by comparing and calculating the glucose
thought to result from in utero maternal infusion with the plasma activity in the
undernutrition. It is one of the phenotypic blood.
features and has been shown to predict the
development of type 2 diabetes. Recent From all the experimentation they
studies with mice demonstrated that concluded that offspring of fathers with
although a LBW phenotype, first generated early-onset diabetes are leaner and have
using maternal undernutrition, confers lower early insulin secretion compared to
impaired glucose tolerance via both individuals who both parents remained
subsequent parental lines, the LBW without diabetes up to 50 years of age.
phenotype is passed on via paternal Insulin action was very similar in all three
inheritance only. As these mice reach groups of offspring. These results indicate
maturity, paternal offspring continue to have an important role of paternal heritability in
lower body weight but similar degrees of body composition. Paternal transmission
impairment in glucose tolerance and patterns for susceptibility to diabetes
impaired insulin secretion. indicate that epigenetic mechanisms are
involved in the predisposition to diabetes.
With this data the researchers made (Penesova et. al 2010).
an experiment to separate parental effects in

3. Health risks on children with diabetes
Type 1 diabetes is the most common screening program, the North Wales
type of diabetes in children today. Usually Diabetic Retinopathy Screening Program,
children under the age of 16 are being hospital departments of chemical pathology,
revealed with the disease. Type 1 diabetes in and general practitioners (GPs). Urine
children is known as an autoimmune disease samples were asked for and patients who did
because the body’s immune system will not attend hospital clinics send their samples
attack one of the body’s own tissues or by postal request. A nephropathy score was
organs. It is believed that the younger the set for each age group from renal outcome
patient suffering Type 1 diabetes the worse and were ranked as: normal, 1;
the outcome. Studies have shown that young macroalbuminuria, 2; established diabetic
onset Type 1 diabetes is associated with an nephropathy, 3; progressive renal failure, 4;
increased incidence of macroalbuminuria, or end-stage renal failure (ESRF), 5.
20 - 200 µg/min albumin proteins in the
urine, and increased incidence of The study resulted that compared
background retinopathy. The aim of this with adult-onset controls, the nephropathy
study was to quantify the influence of age at outcome was worse in childhood-onset
onset on long-term renal and retinal outcome diabetes. The risk of developing
of childhood onset Type 1 diabetes by macroalbuminuria was greater in childhood
comparing the rates at which renal and onset diabetes. The number of patients
retinal pathology occur. developing background retinopathy did not
differ with age at onset but younger onset
patients were more likely to need laser
An ethical committee approval was
treatment. Patients with onset of Type 1
obtained for the study. The data was
diabetes before age 15 had worse renal
provided by three hospital units and all 74
outcome and require more treatment than
general practices serving the area. The
adult-onset patients. Differences between
patients were 98% Type 1 diabetic patients
those with onset before age 5, onset at 5–9
with onset before age 15. They divided
and 10–14 years are small compared with
patients who developed Type 1 diabetes in
the difference between childhood onset and
groups by age: before age 5 (group 1), from
adult onset. Kidney disease and diabetes will
age 5 to 9 (group 2) and from age 10 to 14
progress and the child will not be able to get
years (group 3), and a reference group
rid of the waste that is their blood. This
comprising all patients diagnosed with Type
waste will build up and become toxic to the
1 diabetes between ages 21 and 25 years
body turning into uremia. Developing
(group 4).
diabetes in the teenage years appears to have
a major effect on the risk of developing
The data on these patients was
long-term micro vascular complications.
obtained from the diabetes register, patients’
(Harvey and Allagoa 2003).
case notes, the local microalbuminuria
Insulin pump therapy

4. As technology is developed in quality of life and it decreases parental stress
medicine, it is important that new treatments because the glucose levels are maintained
are efficient and harmful for the patients. In and the children do not argue that much. A
the U.S., 186,300 children have been research was conducted using sixty-two
diagnosed with type 1 diabetes and each middle and high school children (ages 12–
year 15,000 more are diagnosed. Type 1 17) with type 1 diabetes, and the parents in
diabetes can result and develop in serious charge of them. Twenty-six (42%) of the
like cardiovascular disease, blindness, nerve children were using the pumps at the time of
damage and kidney damage. Researchers are the study and 36 (58%) were using MDI. A
focusing on establishing effective methods written informed consent was obtained from
to control blood glucose levels. Currently, the parents. The data collected was:
insulin levels are managed via multiple daily children’s age, date of diabetes diagnosis,
injections (MDI), but an increasing number and most recent blood glucose levels. Also,
of children are using insulin pumps. Insulin the parents completed a measure of
pumps deliver insulin 24 hours a day parenting stress and the children completed
through a catheter. This allows more a measure of quality of life.
flexibility nutrition choices and may lead to
more stable glucose levels. These insulin The outcome of the study indicated
pumps better mimic pancreatic insulin that children on insulin pump therapy are
delivery and provide a more predictable not very different from children receiving
insulin effect on blood glucose levels than MDI in terms of metabolic control, quality
injections. of life and parenting stress. These results are
similar to previous studies. The similar
The insulin pumps have three results may be associated with advances in
advantages over MDI. The children achieve MDI therapy. (Yelena et al. 2010).
better metabolic control, they have a higher
CONCLUSION
Studies have shown that diabetes is a hereditary disease. By following the condition’s
metabolic phenotypes in offspring, researchers demonstrated that the disease is inherited from
parent to child. Symptoms and conditions that lead to diabetes such as low birth weight and
insulin secretion are seen in children with parents with who suffer the same conditions. Even
though diabetes is hereditary, it is preventable.
Children with diabetic family history and who do not keep a healthy life style are at great
risk of developing the disease. Diabetes in children is very serious because it leads to big health
issues at an early age. A study with children under and over 15 year of age showed that children
fewer than 15 diagnosed with diabetes have more renal problems. This is caused by
microalbuminaria, high levels of protein in the urine. This can lead to kidney problems and even
kidney failure. It is important to develop an effective treatment for children because they are not
capable on understanding the risk of diabetes. Children care for having a good time, which is
why the new insulin pump therapy is ideal for them. The pump regulates the glucose levels in the

5. blood automatically. This releases the kid’s worries and let’s them have a good quality of life
while at the same time having a better control over their condition.
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