April 4, 2009
More than 23,000 children are suffering from diabetes, with obesity responsible for a small but growing number of cases, the first official audit of the condition shows.
The survey has prompted calls for greater support for children with diabetes, particularly within schools.
It confirms that the vast majority (97 per cent) of childhood cases are type 1 diabetes, a chronic condition that requires daily monitoring and injections of insulin.
Britain has the fourth-highest incidence in Europe of type 1 diabetes among children but the lowest proportion of children maintaining good diabetes control. Four out of five are said to have problems monitoring their blood sugar level effectively.
The audit, carried out by the Royal College of Paediatrics and Child Health on behalf of Sir Liam Donaldson, the Chief Medical Officer, also identified at least 328 children under 18 with type 2 diabetes, which can be associated with obesity and usually occurs much later in life.
The report, based on a survey of 607 paediatricians and other doctors in 325 hospitals in England, is regarded as the first officially to recognise the scale of the problem among the young. One recent study estimated a minimum rate of 0.21 type 2 cases per 100,000 under-18s. The new figures suggest a rate of about 3 per 100,000.
Campaigners said that a lack of specialist nurses and support from schools put many child sufferers of diabetes at risk of serious long-term health problems, including complications such as heart disease, strokes and nerve damage that can cause amputations, blindness or kidney failure.
The audit found that the burden of type 1 diabetes among school-age children was particularly high, with doctors reporting seeing 15,361 cases of diabetes among children aged between 5 and 15.
The charities Diabetes UK and the Juvenile Diabetes Research Foundation said that some schools and local authorities had trained nurses and teachers to administer insulin injections and help children with type 1 diabetes to lead normal lives, but such care was far from universal.
Simon O’Neill, director of care, information and advocacy at Diabetes UK, said that about 2,000 new cases of type 1 diabetes were diagnosed in the young each year, with the obesity epidemic meaning that a small number now had type 2.
He said: “Every one of these children must be supported to manage their diabetes and protect their health. Too often young diabetics are denied the school of their choice or have to change their insulin regimen to fit around school timetables regardless of what’s best for their diabetes control.” Some parents were unable to work because they had to administer insulin to their child during the day, Mr O’Neill said.
Julie Edge, a consultant in paediatric diabetes at Oxford Radcliffe Hospitals NHS Trust, said that children with type 1 diabetes needed up to six injections a day to manage their condition, but were too young to adminster them themselves.
“Education authorities need to ensure that they have policies in place so that the children are able to receive this help in school,” she said.
A Private Member’s Bill calling on schools to provide more assistance for pupils with diabetes and other conditions, has been put forward by the Labour MP Jim Cunningham. It is due to have its second reading next month.
Case Study
Sasha Hare, 12, of Brixham, Devon, has type 1 diabetes but receives support from teachers at her grammar school and joins in with sports and dinghy sailing.
It was a different story, however, at primary school. Her mother, Lee, 49, said: “On several occasions she was not allowed to eat, drink or go to the toilet during lessons, which is how her body gets rid of excess sugar. A few weeks later I got a call saying she had fallen over and gashed her head, apparently as the result of a hypo [a hypoglycaemic incident where the blood sugar level falls too low] ... the teachers just told me she was clumsy ... they were afraid to let her play in the main playground so they left her by herself with no supervision.”
Sasha’s parents transferred her to another school, but “when a new headteacher arrived she made clear that she wouldn’t allow me in to give Sasha extra insulin injections".
http://www.timesonline.co.uk/tol/life_and_style/health/child_health/article6031645.ece