Type 1 and Type 2 Diabetes Mellitus (Children)

Diabetes Mellitus is a chronic condition characterised by elevated blood sugar levels. It occurs in two forms: Type 1 and Type 2. Insulin, a hormone produced by the pancreas, helps glucose from the bloodstream enter body cells to be used for energy.

In Type 1 Diabetes Mellitus, the body produces insufficient insulin. In Type 2 Diabetes Mellitus, the does not utilise the insulin effectively, known as insulin resistance. As a result, glucose remains in the bloodstream.

While Type 1 Diabetes Mellitus is more common among children in Singapore ^[1], the incidence of Type 2 Diabetes Mellitus is rising, partly due to a increased childhood obesity ^[1].

Source ^[1] PubMed

Type 1 Diabetes Mellitus

This autoimmune condition results in the destruction of pancreatic beta cells by the body's immune system. It can occur at any age but is more common in children and young adults. Its exact cause is unknown but likely involves genetic and environmental factors, including viruses.

Type 2 Diabetes Mellitus

Often linked to obesity, Type 2 Diabetes Mellitus can also be caused by certain medications. Affected children frequently have family members with the same condition.

Symptoms of Type 1 Diabetes Mellitus

• Excessive thirst or hunger
• Frequent unration, including at night
• Unexplained weight loss
• Fatigue
• Abdominal pain
• Dry mouth
• Blurred vision
• Bed-wetting

Symptoms of Type 2 Diabetes Mellitus

• Excessive thirst or hunger
• Frequent unration, including at night
• Darkened skin on the back of the neck or armpits (Acanthosis Nigricans)
• Symptoms may be absent or develop gradually, often discovered during health screenings

Type 1 Diabetes Mellitus

• Treatment involves insulin injections. Various delivery methods and insulin types (ultra-short-acting, short-acting, intermediate-acting, long-acting) are available.
• The insulin regimen is tailored to the child's lifestyle and dietary habits.

Type 2 Diabetes Mellitus

• Diagnosed using an Oral Glucose Tolerance Test (OGTT).
• Treatment includes diet control, oral medications, and maintaining a healthy lifestyle. Some cases may require insulin injections.

Proper management allows children with Diabetes Mellitus to lead healthy, active lives. Support from family, friends, schools and healthcare professionals is crucial for motivation and effective diabetes control.

Our Child and Adolescent Diabetes Support Group offers an annual camp, motivational courses and parent support groups. For more information, please click here.

Continued clinical research is essential for advancing paediatric healthcare. Our doctors are committed to contributing to the future of child health and medicine through both clinical practice and research.

1. Tan ML, Khoo EY, Griva K, Lee YS, Amir M, Zuniga YL, . . . Wee HL (2016).
   Diabetes Health Profile-18 is Reliable, Valid and Sensitive in Singapore.
   Annals of the Academy of Medicine, Singapore, 45(9):383-393.
2. Venkataraman K, Tan LS, Bautista DC, Griva K, Zuniga YL, Lee YS, . . . Wee HL (2015).
   Psychometric Properties of the Problem Areas in Diabetes (PAID) Instrument in Singapore.
   PLoS One, 10(9):e0136759. doi: 10.1371/journal.pone.0136759
3. Tan VM, Ooi DS, Kapur J, Wu T, Chan YH, Henry CJ, Lee YS (2015).
   The role of digestive factors in determining glycemic response in a multiethnic Asian population.
   European Journal of Nutrition, 55(4):1573-81. doi: 10.1007/s00394-015-0976-0
4. Tan VM, Lee YS, Venkataraman K, Khoo EY, Tai ES, Chong YS, . . . Khoo CM (2015).
   Ethnic differences in insulin sensitivity and beta-cell function among Asian men.
   Nutrition & Diabetes, 5:e173. doi: 10.1038/nutd.2015.24
5. Lim YY, Loke KY, Ho CW, Kimpo MS, Lee YS (2015).
   Ovarian germinoma accelerating the presentation of diabetes mellitus.
   Journal of Pediatric Hematology/Oncology, 37(1):e55-6. doi: 10.1097/MPH.0000000000000238
6. Tan LSM, Khoo YHE, Tan CS, Griva K, Mohamed A, Lee YS, . . . Wee HL (2015).
   Sensitivity of three widely used questionnaires for measuring psychological distress among patients with type 2 diabetes mellitus.
   Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 24(1):153-62. doi: 10.1007/s11136-014-0747-z
7. Tan VM, Wu T, Henry CJ, Lee YS (2015).
   Glycaemic and insulin responses, glycaemic index and insulinaemic index values of rice between three Asian ethnic groups.
   The British Journal of Nutrition, 113(8):1228-36. doi: 10.1017/S0007114515000586
8. Co MA, Tan LS, Tai ES, Griva K, Amir M, Lee YS, . . . Wee HL (2015).
   Factors associated with psychological distress, behavioral impact and health-related quality of life among patients with type 2 diabetes mellitus.
   Journal of Diabetes and its Complications, 29(3):378-83. doi: 10.1016/j.jdiacomp.2015.01.009
9. Tan LSM, Dianne CTB, Khoo YHE, Griva K, New M, Lee YS, . . . Wee HL (2014).
   WHOQOL-BREF among Singaporean Patients with Type II Diabetes Mellitus: What Does It Measure?
   British Journal of Medicine and Medical Research, 4(17): 3293-316. doi: 10.9734/BJMMR/2014/9054
10. Venkataraman K, Khoo CM, Leow MK, Khoo EY, Isaac AV, Zagorodnov V, . . . Lee YS (2013).
    New measure of insulin sensitivity predicts cardiovascular disease better than HOMA estimated insulin resistance.
    PLoS One, 8(9):e74410. doi: 10.1371/journal.pone.0074410
11. Todd AL, Ng WY, Lee YS, Loke KY, Thai AC (2002).
    Evidence of autoantibodies to glutamic acid decarboxylase in oral fluid of type 1 diabetic patients.
    Diabetes Research and Clinical Practice, 57(3):171-7.
12. Ng WY, Lee YS, Todd A L, Lui KF, Loke KY, Thai AC (2002).
    Tyrosine phosphatase-like protein (IA-2) and glutamic acid decarboxylase (GAD65) autoantibodies: a study of Chinese patients with diabetes mellitus. Autoimmunity, 35(2):119-24.
13. Lee YS, Ng WY, Thai AC, Lui KF, Loke KY (2001).
    Prevalence of ICA and GAD antibodies at initial presentation of type 1 diabetes mellitus in Singapore children.
    Journal of Pediatric Endocrinology & Metabolism : JPEM, 14(6):767-72.