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Home > Patients & Visitors > Diseases & Conditions > Metabolic diseases > Diabetes Mellitus (DM)

Diabetes Mellitus (DM)

 


Signs & Symptoms

  • Always feeling thirsty
  • Passes a lot of urine
  • Ants attracted to urine (toilet bowl)
  • Eating a lot but losing weight (more applicable to type 1 DM)

Prediabetes is usually asymptomatic.

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What causes it

Both type 1 and 2 diabetes have a hereditary component and lifestyle component, but the contribution varies.


For type 2 diabetes, though there is a strong genetic (hereditary) component, a sedentary lifestyle with poor eating habits and excessive weight gain is a very strong predisposing / contributing factor. It is estimated that up to 80% of children with Type 2 Diabetes Mellitus (DM) has a relative with Type 2 DM too.


For type 1 diabetes, the dominant predisposing factor is genetic. The hypothesis is that these children with type 1 diabetes are genetically predisposed to Type 1 DM, and they encounter an environmental factor which triggers the process which progressively destroys the organ which produces insulin, and eventually develop diabetes when a critical level of damage is reached. It is estimated that only 15% of Type 1 DM children has a first degree relative (parent or sibling) with type 1 diabetes also. The trigger in the environment is unknown at the moment, though some postulate certain viruses or chemicals.

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About the condition

Both children and adolescents are susceptible to type 1 and type 2 diabetes. However, type 2 diabetes usually affect older children especially those entering or in puberty, and also more likely if these children and adolescents are overweight and has a family history of type 2 diabetes in parents/siblings.

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Diagnosis and Treatment Options

For Type 1 Diabetes Mellitus (DM), children and adults alike will need to use insulin injections. However, children generally have a fairly steady routine meal times, and meal volume/types, so it is possible to use twice or three injections a day if the child and family desire. Due to the hectic work or school schedules and variable meal patterns of adults and teenagers, multiple insulin injections using a combination or ultrafast insulin before meals and a long acting insulin injection may be better (of course, younger children can also adopt this regimen too). Insulin pump therapy can be used for all age groups, though constant supervision by a trained caregiver is required if used in a young child.


For Type 2 Diabetes Mellitus (DM), some of the common oral diabetes medications can be used for all age groups. For more serious Type 2 DM with poor control, insulin may be need too, just like Type 1 DM.

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Care Tips

  • Take your medication and injections regularly
  • Watch your diet
  • Eat regular meals as instructed
  • Exercise regularly
  • Lose weight (for type 2 DM)

 

For the children and teenagers with diabetes, control can be more difficult some times because of compliance issues. Teenagers, especially, undergo a lot of changes both physically, emotionally, and in their social circles. They tend to seek more independence, and have a need to identify with their peers, and may develop priorities in life other then their diabetes. They may also have more risk-taking behaviour and may omit insulin injections, medications, or forgo their dietary control.  Physically, there are surges of sex hormones and growth hormone during puberty which can affect their diabetes control too. 

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