India has the dubious distinction of having the largest number of people with diabetes. Unfortunately, the sheer number of adults with diabetes prevents us from noticing large number of youth with diabetes in our midst. Diabetes in youth is neglected by both endocrinologists and paediatricians. This gives rise to a number of misconceptions related to youth diabetes.
Of the numerous medical myths that exist in today’s world, many are related to diabetes. These myths and misconceptions are not only limited to treatment, monitoring and lifestyle management and social aspects of diabetes, but also involves aetiology, epidemiology, clinical features, and prognosis.
Some common myths
Social discrimination is common in diabetes, but potentially dangerous myths and misconceptions occur in young people with diabetes.
Diabetes – a punishment from God
Some of the myths associated with diabetes include diabetes being considered to be a punishment from God, a result of wrong eating habits of the child or a result of eating sugar and ghee by the mother during pregnancy. The truth is: in today’s lifestyle each of us is threatened by diabetes. The fact is that, it is the combination of autoimmune, genetic, and environmental factors which leads to development of diabetes.
Girls do not develop diabetes
In most countries, Type-1 diabetes is more common in girls, but in India more male youth seek medical care and this leads to the myth that girls do not develop diabetes. The fact is that, girls due to social misconceptions are not taken to doctors.
Only obese people get diabetes
Another misconception is that only obese people get diabetes, and because of it lean people are not screened for diabetes. On the other hand, only lean youth are thought to have Type-1 diabetes and obese kids are not screened for Type-1 diabetes. Many common complaints like menstrual disorders, amenorrhea, vulvo-vaginitis or penile skin irritation are never considered a result of diabetes and are treated otherwise.
Treatment of diabetes in the young is the same as that of diabetes in adults
People are often misguided in their notion that treatment of diabetes in the young is the same as that of diabetes in adults. Many children are treated sub-optimally with pre-mixed insulin instead of basal-bolus regime as it is considered to be a treatment for bad diabetes. The benefits of intensive insulin therapy are lost because of these misconceptions and this results in lack of patient motivation. The fact is: intensive insulin therapy not only has long-term good effects but also provides flexibility to the life of youth with diabetes.
Diabetes affects fertility
It is assumed that every boy with diabetes is impotent and every girl is infertile. In case they are lucky enough to have child, it is assumed that there are 100 per cent chances of developing diabetes. The truth is that impotence and infertility are complications of poorly controlled diabetes only over a long period of time. A boy or girl with well-controlled diabetes is as sexually active as anyone without diabetes. The chances of an offspring developing diabetes are less than 15 per cent.
Diabetics don’t live long
People think that youth with diabetes are not going to attain adulthood as it is slow death. But, the fact is that people with diabetes can live a better and successful life, a near normal life with their endocrinologist being their best friend and other referrals like diabetic educators, dieticians, behavioural specialists, podiatrists, ophthalmologists, dentists and physicians from other specialties helping them through various phases of life.
Diabetes monitoring is very expensive
Monitoring is thought to be very expensive and unnecessary. Society assumes that glucose monitoring devices are not accurate, but this is not true. The importance of the HbA1c test is not understood by physicians and patients alike. People are also concerned about sugar levels and do not believe in annual health checkups for early diagnosis of complications. Creating awareness and education among people with diabetes is very important.
Dealing with diabetics
Youth with diabetes suffer from extremes. On one hand, they are neglected by society and their families. They are often put on a near-starvation diet which has been the case since over a century. The absence of urine glucose keeps the family and the patient happy, unfortunately keeps the young person suffering from malnutrition. On the other hand, few kids are fed on a high fat diet by their families trying to increase their weight. People with diabetes need a balanced diet which is tasty, not a boiled bland diet as is thought. Bitter gourd [karela] vegetable well-cooked is used as a treatment for diabetes, forgetting the large quantity of oil which is used to cook it.
Kids with diabetes are either overprotected by the family, not allowing them to go for games or pushed too much for physical exercise as a substitute for insulin. Yoga is good for health, but does not burn calories and is not a substitute for an active lifestyle.
As said by Joslin, the father of Diabetology: A person with diabetes, who knows the most, lives the longest. Let us get together to eradicate myths and misconceptions related to diabetes, improve knowledge among doctors, people with diabetes as well as the society at large and let us change diabetes.
Cord blood to treat Type-1 diabetes
A new research, funded by the Juvenile Diabetes Research Foundation and National Institutes of Health, has indicated that umbilical cord blood can help in safely preserving insulin production among children diagnosed with Type-1 diabetes.
The University of Florida researchers studied the feasibility of using a patient’s own cord blood stem cells in reversing the autoimmune properties developing in the pancreas. The cord blood can help restore the ability to make insulin. Cord blood is rich with cells that help regulate the immune system and is often used after treatments for leukaemia or lymphoma.
This is the first attempt at using cord blood as a potential therapy for Type-1 diabetes according to Dr Michael Haller, an assistant professor of medicine and paediatric endocrinologist at University of Florida. The researchers anticipate success in decreasing the immune system’s attack on the pancreas and possible use of stem cells that can differentiate into insulin-producing cells.
Though this study is relatively small in number of patients, the researchers are confident that it is safe. This confidence is based on the metabolic and immunologic changes observed during the study that indicate positive results. The basic strategy behind this option is utilising the “honeymoon period”, a period of a few months after diagnosis when the insulin is not required in large quantities. Cord blood infusion during this period can intervene and repair early damage. Researchers warn that thinking of using this research as a single-point approach to treat a complicated disease like Type-1 diabetes may be immature. The treatment will have to be multi-disciplinary, similar to approaches to other disease like AIDS or cancer. Most probably multiple drugs would be required to address the various facets of the disease.
– Team CW