The number of children with diabetes mellitus (DM) is increasing worldwide in industrial and developing countries. Type 1 diabetes in children is a condition in which the child's body no longer produces an important hormone (insulin). Children need insulin to survive, so the insulin that is lost needs to be replaced by injections or by an insulin pump,

Type 1 diabetes in children is known as juvenile diabetes or insulin-dependent diabetes. Type 1 DM (T1DM) is the most common type of DM in children. Most prepubertal children with diabetes are classified as T1DM, although some children with T2DM present before puberty especially those who are overweight, obese, or insulin resistant.

The exact cause of type 1 diabetes is unknown. But in most people with type 1 diabetes, the immune system, which normally fights harmful bacteria and viruses, mistakenly destroys the insulin-producing cells in the pancreas. After the cells in the pancreas are destroyed, there is little or no insulin production. Insulin does the important job of moving sugar (glucose) from the bloodstream to the body's cells. Sugar enters the bloodstream when food is digested. Without enough insulin, sugar builds up in the bloodstream, which can lead to life-threatening complications if left untreated.

Risk factors for type 1 diabetes in children include family history, genetics, race. In the United States, type 1 diabetes is more common among white children than among children of other races. Certain viruses, exposure to various viruses can trigger autoimmune destruction of pancreatic cells.

Complications of type 1 diabetes can affect major organs in the body. Complications can include: heart and blood vessel disease, narrowing of the arteries, high blood pressure, heart disease, and stroke later in life. Nerve damage. Excess sugar can injure the walls of small blood vessels. This can cause tingling, numbness, burning or pain, kidney damage, eye damage, diabetes can damage the retinal blood vessels, which can cause vision problems, diabetes osteoporosis can cause lower than normal bone mineral density, increasing the risk of osteoporosis in children when they are young. mature.

Diagnosis There are several blood tests for type 1 diabetes in children, The randomized blood sugar test is the main screening test for type 1 diabetes. Blood samples were taken randomly. Glycated hemoglobin (A1C) test. This test shows a child's average blood sugar level over the past three months. Fasting blood sugar test., Blood samples are taken after the child has fasted overnight. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 1 diabetes.

Additional tests. If the blood sugar test shows diabetes, your doctor will likely recommend additional tests to differentiate between type 1 diabetes and type 2 diabetes because treatment strategies differ by type. These additional tests include, Blood tests to check for antibodies which are common in type 1 diabetes. Urine or blood tests to check for the presence of ketones, which also indicate type 1 rather than type 2 diabetes.

Prevention Currently there is no known way to prevent type 1 diabetes but as parents we can help children prevent its complications by helping children maintain good blood sugar control as much as possible, teach children the importance of eating a healthy diet and participating in regular physical activity, schedule regular visits with a pediatric diabetes doctor and annual eye exams starting no later than five years after the initial diabetes diagnosis or at age 10.

Treatments that can be done by parents for type 1 diabetes include taking insulin, counting carbohydrates, monitoring blood sugar frequently, eating healthy foods, exercising regularly or moving a lot for the child.

Source : Aman B Pulungan. Type 1 diabetes mellitus in children: experience in Indonesia. Clin Pediatr Endocrinol. 2021. Vol.30 / No.1. pp 11–18.

MayoClinics. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-2035301. ( 4 Oktober 2021).

MayoClinics. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017. ( 4 Oktober 2021).

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