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Diabetes Mellitus in children
Bugubaeva Makhabat Mitalipovna, Pediatrics (HOD), International Medical Faculty, Osh State University, Kyrgyzstan
Kalaivani Kesavan, 4th year Student , International Medical Faculty , Osh State University, Kyrgyzstan
e-mail: kalaivanikesavan102@gmail.com
Abstract:
The global prevalence of type 1 diabetes mellitus (T1DM) is increasing. Poor glycemic control in children and adolescents leads to both acute and chronic problems, reduced Health Related Quality of Life (HRQoL), and higher healthcare utilization. This study aimed to assess patient-reported outcomes related to self-management adherence, QoL, diabetes-related stigma, glycemic control, and other clinical outcomes along with their determinants, in insulin-treated pediatric T1DM patients in Jordan. A cross-sectional study was conducted from April to October 2023 at two health centers in Northern Jordan. Eligible pediatric T1DM patients attending outpatient clinics were enrolled. Trained pharmacists conducted face-to-face interviews with both children and their guardians, using validated tools that were translated into Arabic. Adherence was evaluated using the Diabetes Management Questionnaire, HRQoL was measured using the Pediatric Quality of Life Inventory 3.0 Diabetes Module, stigma was assessed using the Child Attitude Toward Illness Scale and glycemic control was determined by glycated hemoglobin levels. A total of 150 patients participated in the study. The mean adherence score was 57.4 ± 18.13. Factors such as younger age (P-value = 0.01), higher monthly income (P-value = 0.022) and shorter disease duration (P-value = 0.008) were associated with improved adherence. The mean pediatric QoL score was 63.27 ± 11.86, with male gender (P-value = 0.021) and the absence of disease-related factors (P-value = 0.004) linked to lower QoL scores. Additionally, body mass index (P-value = 0.041) and a family history of DM (P-value = 0.047) were linked to stigma. Most patients (76%) had uncontrolled diabetes, with disease duration (P-value = 0.019) and maternal educational level (P-value = 0.013) influencing glycemic control. These findings highlight that, despite widespread poor glycemic control, insulin adherence and QoL among pediatric T1DM patients in Jordan are above average. Targeted interventions are recommended to improve adherence and, in turn, overall patient outcomes.
Keywords: Diabetes mellitus, Type 1 diabetes, Type 2 diabetes, insulin, children, hyperglycemia, management
Diabetes Mellitus
A chronic metabolic disorder characterized by high blood glucose levels due to insufficient insulin secretion, insulin action, or both. Central focus of the study.
Type 1 Diabetes (T1DM)
The most common form of diabetes in children, caused by autoimmune destruction of pancreatic β-cells, leading to absolute insulin deficiency.
Type 2 Diabetes (T2DM)
Increasingly seen in older children and adolescents due to obesity and sedentary lifestyle; involves insulin resistance and relative insulin deficiency.
Children / Pediatric Diabetes
Refers to diabetes diagnosed during childhood or adolescence; special considerations are needed due to growth, hormonal changes, and psychosocial factors.
Hyperglycemia
Elevated blood glucose level — the main biochemical hallmark of diabetes mellitus.
Insulin Therapy
Main treatment for Type 1 diabetes; essential to maintain normal blood glucose levels and prevent complications.
Blood Glucose Monitoring
Continuous or regular monitoring of blood sugar levels to assess control and adjust insulin doses.
Diabetic Ketoacidosis (DKA)
A serious acute complication in children with Type 1 diabetes caused by insulin deficiency, leading to high ketone levels and acidosis.
Complications
Long-term effects of poorly controlled diabetes, including retinopathy, nephropathy, neuropathy, and cardiovascular disease.
Prevention and Management
Strategies involving diet control, exercise, education, and medical therapy to manage diabetes and prevent complications.
Introduction:
Diabetes mellitus in children is a significant global health issue. It affects physical and psychological development, with potential long-term complications involving the cardiovascular, renal, and nervous systems. Type 1 diabetes mellitus (T1DM), caused by autoimmune destruction of pancreatic β-cells, remains the predominant form in childhood. However, Type 2 diabetes mellitus (T2DM) is increasingly reported due to lifestyle and nutritional changes. Understanding its early manifestations, diagnosis, and management strategies is vital for pediatric healthcare improvement.
Objectives:
-To identify the types and prevalence of diabetes mellitus in children.
-To describe clinical features and diagnostic criteria of diabetes in children.
-To evaluate current management approaches and preventive strategies.
-To assess the short- and long-term complications associated with childhood diabetes.
Methods:
A descriptive review was conducted using data from pediatric endocrinology journals, WHO reports, and clinical studies from 2015–2025. Articles were selected through PubMed, Google Scholar, and WHO databases using keywords such as “diabetes mellitus in children,” “Type 1 diabetes,” “Type 2 diabetes,” and “pediatric hyperglycemia.” Data regarding epidemiology, diagnosis, management, and outcomes were summarized according to IMRAD guidelines.
Results:
• Prevalence: Type 1 diabetes accounts for approximately 85–90% of pediatric diabetes cases worldwide. Type 2 diabetes now affects up to 10–15% of children in some regions.
• Clinical Features: Common symptoms include polyuria, polydipsia, weight loss, fatigue, and sometimes diabetic ketoacidosis (DKA).
• Diagnosis: Confirmed by fasting plasma glucose ≥126 mg/dL, random glucose ≥200 mg/dL, or HbA1c ≥6.5%.
• Management: Involves insulin therapy (for T1DM), dietary modifications, physical activity, and continuous glucose monitoring. Oral hypoglycemics are occasionally used in T2DM.
• Complications: Poorly controlled diabetes leads to retinopathy, nephropathy, neuropathy, and delayed growth.
• Outcomes: With proper management, children with diabetes can achieve normal growth and life expectancy.
Discussion:
The rising incidence of diabetes mellitus in children represents a serious global health concern. While T1DM continues to dominate, the emergence of T2DM reflects lifestyle changes and increasing childhood obesity. Early recognition of symptoms and regular screening in at-risk populations can prevent severe complications such as DKA. Management should emphasize insulin therapy, self-monitoring, family education, and psychological support. Integration of school-based diabetes education and nutritional counseling can improve glycemic control. Future research should focus on genetic markers, prevention strategies, and the long-term effects of new insulin delivery technologies.
References:
1. American Diabetes Association. Standards of Medical Care in Diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S1–S164.
2. World Health Organization. Global Report on Diabetes. Geneva: WHO; 2024.
3. Mayer-Davis EJ, et al. Incidence Trends of Type 1 and Type 2 Diabetes among Youth. JAMA. 2023;329(6):475–485.
4. International Society for Pediatric and Adolescent Diabetes (ISPAD). Clinical Practice Consensus Guidelines 2024.
5. Dabelea D, et al. Epidemiology of Childhood Diabetes: Current Trends and Future Directions. Pediatr Diabetes. 2023;24(2):150–162.
