<a href="https://www.pexels.com/photo/text-6823763/">Photo by Artem Podrez</a>When people talk about diabetes, they often mean diabetes mellitus, which is a group of related disorders&nbsp;that&nbsp;are characterised by&nbsp;hyperglycaemia or excess sugar in the blood. But&nbsp;that is not the only type of diabetes we have. There is also diabetes insipidus, where the body produces&nbsp;excess urine, causing you to lose too much water. We’ll focus on diabetes&nbsp;mellitus in this article.&nbsp;Diabetes mellitus is a chronic metabolic disorder characterised by high&nbsp;blood glucose levels or hyperglycaemia. It occurs either because the body cannot produce insulin (type 1 diabetes) or because the body cannot use insulin effectively (type 2 diabetes).Diabetes is often seen as a disease of adults and the elderly. However, it is getting more common in children. The International Diabetes Federation (IDF) estimates that there were more than one million children and adolescents under 20 with diabetes in 2019.&nbsp;<h2 style="margin-left:0cm;">Type 1 vs Type 2 diabetes</h2>We mentioned earlier that type 1 diabetes mellitus is the most common type of diabetes in children, but children also have type 2 diabetes. The difference between type 1 and type 2 diabetes is primarily in their origin.Type 1 diabetes&nbsp;occurs when the body’s immune system&nbsp;attacks and destroys the cells that produce insulin&nbsp;in the pancreas.&nbsp;The reason for these attacks on the cells is not clear, but experts suggest that genetic factors and viral infections may cause it.&nbsp;In&nbsp;type&nbsp;2 diabetes, the body either does not produce enough insulin or the organs are not sensitive enough to the present and circulating insulin, leading to&nbsp;excess sugar in the blood.3 out of 100,000 children in Nigeria have type 1 diabetesThe International Diabetes Federation also&nbsp;<a href="https://www.worlddiabetesfoundation.org/news/nigeria-promises-free-treatment-for-children-with-diabetes/#:~:text=The%20recorded%20incidence%20of%20type,)%20and%20Zimbabwe%20(0.8).">estimates</a> that about 3 (2.9) out of 100,000 children between the ages of 0 to 14 in Nigeria have type 1 diabetes mellitus.&nbsp;Children with diabetes have common risk factors, and these include:&nbsp;<ul><li>Family history of diabetes</li><li>Certain genetic mutations</li><li>Environmental factors like exposure to viruses&nbsp;</li><li>Obesity</li><li>Diet</li><li>Level of physical activity</li><li>Steroid therapy</li></ul><h2 style="margin-left:0cm;">How do you know that your child has diabetes?</h2>Diabetes in children has similar symptoms as diabetes in adults, but since children, especially infants and preschool children, can’t explain their symptoms, parents have to pay extra attention.Symptoms to watch out for include:<ul><li>Excessive thirst&nbsp;</li><li>Frequent urination</li><li>Poor cry and weakness</li><li>Increased appetite</li><li>Excess weight gain</li><li>Poor wound healing</li><li>Numbness or tingling in the hands or feet</li></ul>The symptoms are similar for both type 1 and type 2 diabetes, but type 2 symptoms develop later and slower. See a paediatrician immediately if you suspect your child has any of these symptoms.<h2 style="margin-left:0cm;">Diagnosis of diabetes requires expert evaluation</h2><figure class="image"><img src="https://tenbadgers-myhealthvoice.s3.eu-central-1.amazonaws.com/image_27436ce5d6_00f35664ae.webp"></figure><a href="https://www.pexels.com/photo/a-glucometer-over-documents-7653093/">Photo by Pavel Danilyuk</a>Although laboratory tests may show that a child has high glucose levels in their blood, that alone is not sufficient to say that the child is diabetic. Your doctor will take the child’s medical history, evaluate their signs and symptoms, and then order some laboratory tests to confirm the diagnosis.&nbsp;These tests include:<ul><li>Random or fasting blood glucose estimation</li><li>Random or fasting serum glucose estimation</li><li>Oral glucose tolerance test</li><li>HbA1C test</li></ul><h2 style="margin-left:0cm;">Management of diabetes depends on the type</h2><h3 style="margin-left:0cm;">Type 1 diabetes&nbsp;</h3><ul><li>Lifetime insulin therapy</li><li>Regular blood glucose monitoring</li><li>Balanced diet</li><li>Regular exercise</li><li>Mental health support</li><li>Mother and child education</li></ul><h3 style="margin-left:0cm;">Type 2 diabetes&nbsp;</h3><ul><li>Low carbohydrate and fat diet</li><li>Balanced diet&nbsp;</li><li>Regular exercise</li><li>Oral antidiabetic medication</li><li>Insulin therapy</li></ul><h2 style="margin-left:0cm;">Diabetes complications can be life-threatening</h2>Children with diabetes often present late to hospitals, especially after they have developed complications. Some of these complications include:<ul><li>Diabetic ketoacidosis (DKA)</li><li>Hypoglycaemia</li><li>Diabetic retinopathy</li><li>Diabetic nephropathy</li><li>Cardiovascular diseases</li><li>Infections</li></ul>These complications may manifest as:<ul><li>Nausea</li><li>Vomiting</li><li>Abdominal pain</li><li>Fruity breath</li><li>Sudden chest pain</li><li>Blurred vision</li><li>Loss of consciousness</li></ul>Early diagnosis and management, coupled with good blood glucose control, can prevent or delay the onset of these complications.&nbsp;<h2 style="margin-left:0cm;">You can delay or prevent the onset of diabetes</h2>The auto-immune nature of type 1 diabetes makes it challenging to prevent, but you can prevent or delay the onset of type 2 diabetes with some pretty basic steps.<ul><li style="text-align:justify;">Encourage your child to eat healthy diet</li><li style="text-align:justify;">Regular physical activity</li><li>Maintaining a healthy weight</li><li style="text-align:justify;">Limiting screen time</li><li>Regular check-ups</li></ul><h2 style="margin-left:0cm;">What can the government do?</h2>The&nbsp;government&nbsp;is vital in implementing policies and programs that promote diabetes education, prevention, and management.&nbsp;Firstly, the government can allocate funds to support research and development of new treatment methods and technologies for diabetes management in children. This research can help improve the understanding of diabetes, leading to better prevention, diagnosis, and treatment for young patients.Secondly, the government can implement policies that promote healthy lifestyle choices for children. This can include providing nutritious meals in schools, promoting physical activity, and restricting the availability of unhealthy food choices. Such policies can help reduce the risk of diabetes in children and promote healthy living habits.The government can also provide education and awareness programs for parents and caregivers of young children with diabetes. These programs can offer guidance on&nbsp;managing diabetes at home, including monitoring blood glucose levels, administering insulin, and&nbsp;controlling hypoglycaemia.SummaryDiabetes affects children, too, and the number of children it affects is on the rise. The risk factors for diabetes in children include junk diet, obesity, prolonged screen time, little or no physical activity, parents with diabetes, and more. The onset of diabetes can be avoided with dietary and lifestyle adjustments; children with confirmed diabetes must visit a doctor for expert management.&nbsp;Diabetes is a chronic disorder that can be difficult to manage, especially the type 1 variety. Children with the disease may need lifetime management. This can be expensive and discomforting for the child. Parents must watch out for the risk factors and avoid them as much as possible. Please see a doctor if you have any concerns.

Diabetes in Children

Children's Health

Disease prevention and management

Image by<a href="https://pixabay.com/users/erikawittlieb-427626/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=890565%22%3EErikaWittlieb%3C/a%3E%20from%20%3Ca%20href=%22https://pixabay.com//?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=890565">&nbsp;Pixabay</a>Sudden Infant Death Syndrome (SIDS) is the unexplained death of a baby less than one year old. Diagnosis is confirmed if thethe investigation does not reveal a specific cause of death, it may be classified as Sudden Infant Death Syndrome (SIDS).SIDS is a complex and multifactorial condition, and despite ongoing research, the exact cause remains unknown.&nbsp;To confirm a diagnosis of SIDS, an autopsy must be performed, and all other potential causes of death must be ruled out. Only then can we conclude that a child has died of SIDS.<h2 style="margin-left:0cm;text-align:justify;">How common is sudden infant death syndrome?</h2>SIDS accounted for the death of 15,000 infants worldwide in 2013. There is no reliable record of SIDS cases in Nigeria.<h2 style="margin-left:0cm;text-align:justify;">What are the risk factors for sudden infant death syndrome?</h2>There is no&nbsp; concrete evidence as to the cause of SIDS, but several risk factors have been recorded. These risk factors are grouped as follows:<ol style="list-style-type:upper-alpha;"><li style="text-align:justify;">The demographic factors include:<ul style="list-style-type:disc;"><li style="text-align:justify;">Low socioeconomic status</li><li style="text-align:justify;">Maternal young age</li><li style="text-align:justify;">Low maternal education</li><li style="text-align:justify;">Single marital status</li><li style="text-align:justify;">Infants who did not live with their fathers</li><li style="text-align:justify;">Male children are more prone to SIDS.</li></ul></li><li style="text-align:justify;">The factors relevant to pregnancy and birth include<ul style="list-style-type:disc;"><li style="text-align:justify;">Inadequate prenatal care</li><li style="text-align:justify;">Growth retardation in the womb</li><li style="text-align:justify;">Short intervals between pregnancies</li><li style="text-align:justify;">History of multiple pregnancies&nbsp;</li><li style="text-align:justify;">Premature babies and babies with low birth weight</li><li style="text-align:justify;">Substance abuse during pregnancy</li><li style="text-align:justify;">Passive smoking</li></ul></li><li style="text-align:justify;">Sleep environment factors include<ul style="list-style-type:disc;"><li style="text-align:justify;">Bed quality&nbsp;</li><li style="text-align:justify;">Constant changing of baby’s sleeping position&nbsp;</li><li style="text-align:justify;">Use of soft old pillows&nbsp;</li><li style="text-align:justify;">Use heavy comforters&nbsp;</li><li style="text-align:justify;">Covering the baby’s head with thick blankets</li><li style="text-align:justify;">High fever of any cause</li></ul></li><li style="text-align:justify;">Genetic factors&nbsp; such polymorphism of the serotonin transporter gene</li><li style="text-align:justify;">Infections<ul style="list-style-type:disc;"><li style="text-align:justify;">Viral respiratory infections&nbsp;</li><li style="text-align:justify;">Bacterial infections</li></ul></li></ol>There is no warning sign for SIDS. Most babies are healthy when they are put to bed and suddenly die. A lot of care and intentionality is needed on the part of parents and caretakers to avoid any modifiable risk factor actually leading to SIDS.<h2 style="margin-left:0cm;text-align:justify;">Causes of sudden infant death syndrome</h2>By its definition, SIDS does not have any particular cause.&nbsp;<h2 style="margin-left:0cm;text-align:justify;">Prevention of sudden infant death syndrome</h2>Till now, there are no precise causes of SIDS; however, several measures have been established to prevent the occurrence of SIDS. The American Academy of Pediatrics has already established protective measures to decrease the incidence of SIDS. These measures are:<ol><li>Lay the baby on their back</li></ol>It is suggested that the best position for infants is to lay them on their backs in a supine position. Laying a child on their side increases their risk of sudden death, and this is not recommended. Your baby’s risk of SIDS is higher when they sleep on their side or on their stomach.<ol><li>Keep the child warm, not hot</li></ol>An infant needs warmth not heat. Keeping a child in a poorly ventilated room or covering them with excessive clothing can cause hyperthermia, or excess unregulated body temperature. If you’re worried that your child will be exposed to cold then you can dress them in overalls.<ol><li>Keep the baby on a firm surface&nbsp;</li></ol>The baby’s sleeping surface should be preferably hard and firm. Very soft surfaces are a risk factor for suffocation.<ol><li>Stay close to your child&nbsp;</li></ol>The baby’s crib should be in the same room as the parent's, at least in the first year of life. Keeping your baby in the same room as you helps reduce the possibility of SIDS by allowing you to intervene when the child faces any stress.<ol><li>Immunize the child</li></ol>Early and consistent immunization has been associated with a reduction in SIDS.<ol><li>Breastfeed the child</li></ol>Research shows that babies who are well breastfed show less risk for SUDS. It’s advised that you breastfeed your baby for as long as you can.<ol><li>Avoid smoking and alcohol while pregnant</li></ol><h2 style="text-align:justify;">Coping with losing a child to sudden infant death syndrome&nbsp;</h2>SIDS is traumatic, to say the least. It hurts, and a lot of parents blame themselves for sometimes becoming depressed. A few of the ways to overcome this period are outlined below:<ol><li style="text-align:justify;">Lean on family for support</li></ol>Parents who have lost a child to SIDS need encouragement. It is better if you’re open to being comforted by family. It’s usually traumatising to lose a child, and this increases the level of stress and strain on a marriage. It’s worse if there are feelings of guilt or blame involved.Speak to your spouse and seek solace from each other. This is not the time to close up. It's best not to deal with the stress and hurt alone; cry if you need to, but please do not suffer alone. If you need counselling, that’s valid, too, and you may want to go as a couple to sort through your emotions.<ol><li style="text-align:justify;">&nbsp;Going for counseling and receiving psychotherapy</li></ol>For some people, going for counselling or receiving psychotherapy may be the way to heal from the loss of an infant. Social workers, psychologists, psychiatrists, and counsellors all form part of the help team that can offer this help.<ol><li style="text-align:justify;">Let yourself heal</li></ol>As a parent recovering from the trauma of SIDS, give yourself time to heal and not get stuck blaming yourself, but allow yourself to grieve. Forgiving yourself is also very essential.<h2 style="text-align:justify;">Conclusion</h2>Sudden infant death syndrome remains a source of huge concern for parents. The causes are not known, so preventive measures are at best a trail of faith. Evidence suggests that putting children to sleep as safely as possible and ensuring they sleep soundly could help. This includes laying the infants on their backs,&nbsp;keeping them warm and away from beddings that can choke them to death.&nbsp;

Sudden Infant Death Syndrome (SIDS)

Health News and Research

<a href="https://commons.wikimedia.org/wiki/File:A_young_boy_taking_after_an_injection_1.jpg">Kwameghana</a>, <a href="https://creativecommons.org/licenses/by-sa/4.0">CC BY-SA 4.0</a>, via Wikimedia CommonsMeningitis is a serious medical problem that many people often confuse its symptoms with common sicknesses. It can quickly become life-threatening as a result of delayed essential treatment. This article will provide information on meningitis, its common symptoms and what to do in cases of suspected infection.<h2 style="margin-left:0cm;">What is Meningitis?</h2>Meningitis refers to inflammation of the meninges. The meninges contain three layers of protective membranes, the pia mater, dura mater, and arachnoid mater, that cover the brain and spinal cord. These membranes provide support and maintain cerebrospinal fluid circulation.Meningitis in children has similar symptoms to meningitis in adults. Still, the disease is more common in children under the age of one.&nbsp;Neonatal and infant meningitis is often deadlier than in older children due to their immature immune systems and underdeveloped protective barriers. Infants may not exhibit typical symptoms, making diagnosis more challenging.&nbsp;Rapid progression of the disease can also lead to severe complications or death if not treated quickly.<h2>Risk factors of meningitis in children</h2>&nbsp;A couple of factors have been seen to increase the chances that a child develops meningitis, and some of them include:&nbsp;<h3 style="margin-left:0cm;">General Risk Factors:</h3><ol><li>Missed&nbsp;vaccinations:&nbsp;Meningitis is preventable through vaccines. Children who miss their vaccinations are at higher risk of infection.</li><li>Age:&nbsp;Children under 5 are particularly vulnerable, while bacterial meningitis is most common in adults under 20.</li><li>Crowded&nbsp;living environments:&nbsp;Meningitis-causing bacteria spread &nbsp;quickly in crowded&nbsp;rooms and gatherings, increasing infection rates among children.</li><li>Extreme&nbsp;heat and&nbsp;humidity: Viral and bacterial meningitis thrive in hot, humid climates, raising the risk of outbreaks.</li><li>Weak&nbsp;immune&nbsp;system:&nbsp;children&nbsp;who are not breastfed or those on chemotherapy or medications that suppress their immune&nbsp;systems are more susceptible to meningitis-causing organisms.</li></ol><h3 style="margin-left:0cm;">Specific Risk Factors:</h3><ol><li>Infection from Mothers:&nbsp;children born to mothers with infections, such as Group B Streptococcus, are at a greater risk of developing meningitis.</li><li>Neural Tube Defects:&nbsp;The neural tube gives rise to the future spinal cord and offers a direct channel to the brain and the meninges. Children born with neural tube defects, therefore, are at&nbsp;a higher&nbsp;risk of having meningitis.</li></ol><h2 style="margin-left:0cm;">Causes of meningitis&nbsp;</h2>Meningitis is caused by germs,&nbsp;which could either be bacteria or viral.&nbsp;Hence, meningitis is grouped according to the cause. They include;<h3 style="margin-left:0cm;">Bacterial meningitis</h3><ol><li>Escherichia coli</li><li>Streptococcus pneumonia</li><li>Group B&nbsp;Streptococcus</li><li>Listeria monocytogenes</li><li>Neisseria meningitides</li><li>Haemophilus&nbsp;influenza</li></ol><h2 style="margin-left:0cm;">Viral meningitis&nbsp;</h2><ol><li>Polioviruses</li><li>Herpes simplex virus</li><li>Paramyxovirus</li></ol>In addition to bacteria, fungi like&nbsp;Candida,&nbsp;Aspergillus fumigatus, Cryptococcus neoformas, and Borrelia burgdoferi are other important cause of meningitis, even though fungi are not as common as viruses and bacteria.<h2>How is meningitis transmitted</h2>The spread of meningitis is mostly through sneezing, coughing, and kissing. Children acquire the infection when they inhale germs released by an infected person.&nbsp;Once the germ enters the child's nose or throat, it&nbsp;spreads through the bloodstream and then&nbsp;makes its way to the meninges, where it causes inflammation and the accompanying symptoms of inflammation.&nbsp;In low- and middle-income countries where many people live in crowded rooms, leading to overcrowding, it is much easier for these pathogens to be carried, resulting in many children coming down with meningitis.&nbsp;If we take Nigeria as a case study, the country has an estimated population of 193 million people spread across 36 states, making it the most populous country in&nbsp;Africa. This factor has been highlighted by Nigeria being one of the countries&nbsp; considered the “meningitis belt.”&nbsp;According to the&nbsp;<a href="https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON454#:~:text=Situation%20at%20a%20glance,the%20brain%20and%20spinal%20cord.">World Health Organization</a>, between 1 October 2022 and 16 April 2023, Nigeria reported a total of 1686 suspected cases of meningitis, including 124 deaths, for a case fatality ratio (CFR) of 7%.<h2 style="margin-left:0cm;">How do you know that your child has meningitis</h2>Meningitis&nbsp;in children&nbsp;usually starts with headache and fever. These two symptoms are common with&nbsp;many other illnesses, making it&nbsp;difficult to diagnose at this stage. More&nbsp;specific symptoms include:<ul><li>Severe headache</li><li>Pain on bending the neck or neck stiffness</li><li>Sensitivity to light</li></ul>The symptoms also differ depending on the patient's age.&nbsp;In Infants, symptoms&nbsp;may include:<ul><li>Fever</li><li>Being fussy and crying constantly</li><li>Extreme weakness</li><li>High-pitched cry</li><li>Arching backwards</li><li>Bulging fontanelle (a fontanelle is a “soft spot” on the head where the skull have not fused)</li><li>Seizures</li><li>Nausea and vomiting</li></ul>For children older than one year, symptoms to look out for include:<ul><li>Fever</li><li>Neck stiffness</li><li>Poor appetite</li><li>Stupor</li><li>Seizures</li><li>Nausea</li><li>Decreased level of consciousness</li></ul><h2 style="margin-left:0cm;">How is meningitis diagnosed in children?</h2>The tests usually prescribed&nbsp;in a child showing the suspected symptoms of meningitis include:<ol><li>Physical examination&nbsp;</li><li>Blood tests&nbsp;</li><li>Lumbar puncture (spinal tap)&nbsp;</li><li>Imaging tests (CT or MRI scan)&nbsp;</li><li>Polymerase chain reaction (PCR) test&nbsp;</li><li>Cultures of cerebrospinal fluid (CSF)&nbsp;</li><li>Rapid antigen tests&nbsp;</li></ol><h2 style="margin-left:0cm;">Treatment of meningitis in children</h2>Symptoms of viral meningitis usually resolve within 7 to 10 days. In children, viral meningitis typically resolves at home without needing a doctor's visit, although some cases may require hospital treatment.<h3 style="margin-left:0cm;">Treatment includes:</h3><ul><li>Rest</li><li>Fluids</li><li>Over-the-counter pain medications</li><li>Intravenous (IV) antibiotics (for bacterial meningitis)</li><li>IV fluids and electrolytes (to replace lost fluids)</li></ul><h2 style="margin-left:0cm;">What&nbsp; is the outlook for a child with meningitis?</h2>The prognosis of meningitis in a child depends on&nbsp;several factors, such as the cause—bacterial or viral—the severity of the illness, and the child's age.Bacterial&nbsp;meningitis is a medical emergency. However, most children with bacterial meningitis recover completely with no&nbsp;long-term complications.&nbsp;The less common complications include developmental delays or learning disabilities, spastic or&nbsp;paralysed muscles and seizures.&nbsp;Unlike bacterial meningitis, most children with viral meningitis recover with no long term complications. The symptoms of viral meningitis usually&nbsp;improve within a week.<h2 style="margin-left:0cm;">How to prevent meningitis in children</h2>There are several ways to prevent infection with the agents that cause meningitis. The more important ones include:<ul><li style="text-align:justify;">Vaccination</li><li style="text-align:justify;">Good hygiene practices</li><li style="text-align:justify;">Avoiding close contact with sick individuals</li><li style="text-align:justify;">Properly washing hands</li><li style="text-align:justify;">Covering mouth and nose when coughing or sneezing</li><li style="text-align:justify;">Regular health check-ups</li><li style="text-align:justify;">Avoiding crowded places during outbreaks</li></ul>

EZENWA IFUNANYA SANDRA

Diabetes in Children

Sudden Infant Death Syndrome (SIDS)

Meningitis in Children in Low and Middle-Income Countries