Whenever a child is diagnosed with diabetes for the first time, parents often react with shock and disbelief. In reality, diabetes is one of the commonest chronic conditions that affects children. About 95 per cent of diabetic children have type 1 diabetes mellitus (T1DM).

Over the last 15 years, there has been an increase in childhood T1DM around the world, including Malta, which has one of the highest incidence rates in the EU. The commonest age at initial diagnosis is in the five to nine years’ range, followed by those even younger than five years.

Glucose is the body’s main metabolic fuel, and provides us with energy to remain alive and go about our daily activities. Most of the glucose is derived from food, while the remainder is manufactured by the body itself. In T1DM, there is an autoimmune attack on the specialised beta cells in the pancreas that produce insulin, a chemical that normally regulates how glucose is used by the body. As a result of this process, the body stops producing insulin and loses its ability to use glucose for energy production.

Accumulation of unutilised glucose in the circulation leads to an increase in the blood glucose level, that can lead to serious disease later on in life unless it is adequately controlled by medication.

This includes reduced vision, kidney failure, nerve damage and circulatory problems.

Certain symptoms in a child should prompt the parents about the possibility of T1DM, ­including:

• Starting to pass more urine than usual during both day and night. Some older ­children may even start wetting their beds again at night;

• Increased thirst, making the child want to drink much more than usual;

• Weight loss that is often obvious over a matter of just days or weeks.

If parents notice any of these symptoms, they should take the child to their family doctor without delay to check the blood glucose level rapidly with a glucose meter. If diabetes is confirmed, these children should be taken urgently to hospital for treatment because their condition may deteriorate rapidly. Delays in diagnosis and/or treatment can result in an acute complication called diabetic ketoacidosis (DKA). At this stage, affected children may have become extremely unwell and will need urgent, intensive treatment in hospital. Severe DKA can even be fatal.

Although there is, as yet, no permanent cure for T1DM, diabetic individuals are able to live happy, fulfilling and healthy lives if they are careful. The central problem in T1DM is lack of insulin, so affected children are obliged to take insulin injections every day. A healthy meal plan, regular aerobic physical activity and regular blood glucose checks with a portable glucose meter are essential complements to insulin replacement therapy.

Scientific research into T1DM has gathered pace over the last decade. The likelihood that a lasting cure for T1DM may be discovered within a few years’ time appears to be ever more probable.

John Torpaino is a consultant paediatric endocrinologist at Mater Dei Hospital.