Keep Your Eyes: Diabetes On The Rise Among Children

 As part of the International Diabetes Day, which takes place every year in November, Dr. Tenoutasse, head of the diabetology clinic at the Queen Fabiola Children's University Hospital (HUDERF), provides a new update on the increase in cases of diabetes in children. This observation applies to both type 1 and type 2 diabetes, two chronic pathologies treated at the reference center.

90% of diabetes treated is type 1 diabetes

Every year, we observe an unfortunate and regular increase of 3% in cases of type 1 diabetes. Nicknamed "lean" or "juvenile" diabetes, it almost never occurs after the age of 40 and is not linked to excess weight. "We are struggling to understand this increase because the factors that promote the onset of type 1 diabetes remain unknown.

A genetic predisposition and certain environmental factors are in the researchers' sights. We can have a child who has an excellent lifestyle and who is affected by this form of the disease," says Dr. Tenoutasse.

Early diagnosis of type 1 diabetes: warning signs

In Belgium, diabetic children must be monitored by pediatric conventions. This allows for an almost exhaustive inventory of cases. In Belgium, there are approximately 3,300 people under the age of 18 affected by type 1 diabetes.

This chronic disease requires multiple daily insulin injections. It can be treated and currently never cured. Dr. Sylvie Tenoutasse advises going to your pediatrician at the slightest suspicion. The main signs? A child who urinates more than usual, drinks more, loses weight, is very tired... For type 1 and 2 diabetes, rapid medical care can save lives.

Technological advances to improve quality of life

There are technological advances that allow for better regulation of young patients' blood sugar levels. "We want to ensure an optimal quality of life for these children so that they can become fulfilled adults, without complications related to their diabetes," continues the specialist.

Like certain patches that record values ​​continuously. In Belgium, more than 2,500 children have adopted glucose sensors in order to better monitor their blood sugar levels. This sensor system is covered by social security. A greater number of patients have their blood sugar levels under control.

There are also fewer hospitalizations related to glycemic imbalance (from 16% to 4%). More and more children receive insulin via an 'external' pump delivering insulin, without having to give multiple injections during the day.

140 school visits per year

But it is necessary to supervise young patients and their parents, to participate in supporting their teachers. "It is a long-term job," emphasizes Luminita Negoita, a nurse specializing in diabetology. "We also have to follow the developments of new technologies, some patches allow parents with a smartphone to receive an SMS for better care of their child.

Teachers can also be connected to this application, in green classes in particular. We regularly make visits to schools. These are important visits, especially if the child is young. There are more or less 140 per year (excluding the covid period).

Type 2 diabetes: a story of genes and lifestyle

Type 2 diabetes, also called fatty type diabetes, often occurs in individuals who have excess adipose tissue. It is also called maturity-onset diabetes, because it mainly affects older people.

This disease is partly genetic and we will find, among the patient's ancestors, many more diabetics than in an ordinary family. Its appearance is also linked to poor lifestyle: excess weight, lack of physical activity, poor diet, family tendency to obesity, etc.

Increase in type 2 diabetes seen in children too

In recent years, there has been an increase in the number of minors affected by this type 2 diabetes. A few years ago, in the United States, experts indicated that one in two diabetic children was affected by type 2 diabetes. "In Belgium, this is not the case at all.

Among all diabetic children, less than 10% of them have this form, the majority having type 1 diabetes. Two decades ago, however, this percentage fluctuated between one and two percent. But we expect an increase in cases in the years to come," explains Dr. Tenoutasse.

Promoting healthy living and early care at the heart of the multidisciplinary system

Strategies exist to prevent the disease or delay its onset: promoting physical activity, improving the quantity and quality of food or stopping weight gain.

At the Children's Hospital, the teams from the Diabetology, Sports and Junior Weight Clinics work together to enable patients to benefit from activities and follow-ups adapted to their journey. "In terms of type 2 diabetes, our common strategy is to prevent rather than cure.

We also talk about excess weight and healthy living during pediatric consultations, in the emergency room or during hospitalization in order to identify and offer an assessment to children who attract our attention. Attention is also paid, regardless of the pathologies, to integrating sport as soon as the child's condition allows it," explains Dr. Beghin, head physician.

Diabetic patients and patients of the Junior Weight Clinic have the possibility of joining the Sports Clinic program in partnership with the professional coaches of Brussels Football , with whom HUDERF has developed a partnership since 2019.

Diabetes workshops: ask for the program!

Depending on the pathologies, age, needs, interests, the multidisciplinary team offers to participate in group workshops to talk in confidence and help each other, on themes such as emotions, sensations, girls' questions.

Other workshops have an educational aim, such as dietetic workshops to learn in a fun and immersive way the importance of the food pyramid. The workshops are open to all patients of our center.

A personalized empowerment journey to facilitate the transition to adult hospitalization

Once they reach the age of 18 or 20, patients begin a transition program. The challenge? Ensuring continuity of care, ensuring that the patient who has been followed within the team does not lose what they have learned and can manage their illness as independently as possible.

When the time comes to move to "adult" services, the patient must know their illness, understand the decisions relating to their treatment, know how to manage symptoms, be able to monitor and recognize the warning signs that should prompt them to go to the hospital.

In short, they must have become an actor in their own health. "Concretely, we introduce the subject gently and, when the patient feels ready, we offer them an initial joint consultation. We are really keen to adapt to their pace. This transition from pediatrics to "adult" care is synonymous for them with autonomy, more freedom.

On the other hand, other patients may feel abandoned in the wild. Hence the importance of a progressive process, and above all one adapted to each patient,” explains Dr. Tenoutasse.