CHILDHOOD DIABETES

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Childhood diabetes includes both type 1 (autoimmune insulin deficiency, most common in children) and type 2 (insulin resistance often linked with overweight/obesity). Both need medical care.

Cases of diabetes in children are rising worldwide; early recognition and treatment prevent life-threatening diabetic ketoacidosis (DKA) and long-term complications.

Type 1 requires insulin from diagnosis; type 2 may sometimes be managed initially with lifestyle changes and/or medicines but still needs close monitoring.

CHILDHOOD DIABETES IN SOUTH AFRICA

Globally, childhood diabetes cases have increased substantially over recent decades – along with the obesity epidemic. Large analyses show a near 40% rise in childhood diabetes since 1990.

South Africa carries a high national diabetes burden overall, and the growing prevalence of obesity and metabolic risk factors among youth means type 2 diabetes in children is increasingly being seen in clinics.

Even though childhood diabetes remains less common than adult diabetes, both types occur and are being diagnosed more frequently — so awareness and timely testing matter.

HOW DO I KNOW IF MY CHILD HAS DIABETES?

Type 1 — typical symptoms come on over days to weeks:
Increased thirst and drinking a lot (polydipsia)

Passing a lot of urine (polyuria) — nappies or underwear may be wet, toilet visits increase at night

Weight loss or failure to gain weight despite good appetite

Tiredness, irritability, abdominal pain, vomiting (worrying sign)

Symptoms may be difficult to recognise in very young children

If untreated, type 1 can progress quickly to diabetic ketoacidosis (DKA) — a dangerous emergency with vomiting, rapid breathing, dehydration and reduced consciousness. DKA needs urgent hospital care.
Type 2 — symptoms may be more subtle or slow to appear:
Some children have increased thirst and urination, tiredness and poor concentration.

Many children with type 2 are overweight; there may be signs of insulin resistance such as dark creases at the back of the neck (acanthosis nigricans).

Because type 2 can be gradual, it’s often detected during routine checks or when screening high-risk children (family history, overweight, puberty).

If your child has symptoms (thirst, frequent wetting, weight loss or vomiting), get immediate testing. Don’t wait — early diagnosis avoids DKA.
Emergency: Diabetic ketoacidosis (DKA)

DKA is the most serious immediate complication of T1D and can be the first sign of diabetes in children. Symptoms: vomiting, belly pain, very fast/deep breathing, drowsiness, fruity breath, severe dehydration.

DKA requires urgent hospital treatment (IV fluids, insulin infusion, electrolyte monitoring). Delays in recognising DKA are a major source of preventable harm and death. Know the red flags and get emergency care fast.

TREATING AND MANAGING YOUR CHILD’S DIABETES

Type 1 diabetes
Insulin from diagnosis. That may be multiple daily injections (short-acting at meals + long-acting background insulin) or an insulin pump where available. Insulin is essential — without it the child will become dangerously unwell.

Blood glucose monitoring — finger-prick glucose checks several times daily, or continuous/glucose-sensor devices where available.

Carbohydrate counting and meal planning — caregivers are taught how to match insulin to food and activity.

Education and psychosocial support — for the whole family: recognising low blood sugar (hypoglycaemia), sick-day rules, school care plans and the emotional challenges of chronic illness. Local groups and guidebooks help families adapt to daily routines.

Newly diagnosed diabetics often have a “honeymoon” period during which it appears they are fully recovered. Unfortunately, this is just a phase, and parents need to be on the lookout for a resurgence of symptoms.
Type 2 diabetes
Lifestyle first: healthy eating, increased physical activity, weight management. For children, this involves family-centred changes, not blame.

Medication: metformin is commonly used; some children eventually need insulin if blood sugars are high or during illness. Regular monitoring for complications and progression is needed.
Practical advice for schools and caregivers
Have a written Diabetes Care Plan: when to test, how to treat low blood sugar, who gives insulin, emergency contacts.

Keep quick-acting sugar (juice, glucose tablets) for hypoglycaemia and teach school staff how to use them.

Train one or two staff members in recognising emergencies and performing basic testing or calling for help.

Encourage normal participation in PE and social activities; with planning, diabetes does not need to limit a child’s school life.

LONG-TERM COMPLICATIONS OF CHILDHOOD DIABETES

With good control, children can grow and develop normally, but all children with diabetes need long-term follow-up for:

Growth and pubertal development (glucose control often becomes difficult at this time)
Eye checks (retinopathy screening in older adolescents)
Kidney tests (urine for protein)
Foot care and education
Mental health support (diabetes is psychologically demanding for children and families). Care plans should be age-appropriate and transition planning is essential as teens move into adult services.

PREVENTING TYPE 2 DIABETES IN SOUTH AFRICA

Because type 2 is linked to overweight and metabolic risk:

The family diet is critical. Parents have to lead by example.
Promote healthy first foods and activity from infancy. Limit sugar-sweetened drinks and ultra-processed snacks.
Encourage regular physical activity (play, sports, active transport).
Support healthy sleep and reduce excessive screen time.
Family-wide changes work best — children need parents and caregivers as role models.

CHILDHOOD DIABETES

CHILDHOOD DIABETES

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

CHILDHOOD DIABETES IN SOUTH AFRICA

HOW DO I KNOW IF MY CHILD HAS DIABETES?

TREATING AND MANAGING YOUR CHILD’S DIABETES

LONG-TERM COMPLICATIONS OF CHILDHOOD DIABETES

PREVENTING TYPE 2 DIABETES IN SOUTH AFRICA

FURTHER READING