Rising type 1 diabetes in Indian children sparks urgent health concerns

INDIArsquoS TYPE 1 DIABETES CRISISIndia is witnessing a silent but worrying rise in Type 1 diabetes among children and adolescents According to diabetologists and paediatricians cases are increasing steadily and India now has the highest number of children with Type 1 diabetes worldwide as per the International Diabetes Federation IDF With November marked as National Diabetes Awareness Month the data underlines the urgent need for research early detection affordable insulin and longterm care for young patientsWHAT IS TYPE 1 DIABETESgtgt Type 1 diabetes is different from the more common Type 2 It occurs when the immune system destroys the pancreasrsquo insulinproducing cells leading to high blood sugargtgt Patients need lifelong insulin regular glucose monitoring and dietary planninggtgt ldquoUnlike adultonset diabetes children with Type 1 diabetes need wholesome nutrition The key is calculating carbohydrate content and adjusting insulin for any food The idea is not to lsquoavoid sweetsrsquo but to guide the whole family towards healthy eatingrdquo said Dr Meenakshi Girish HOD Paediatrics AIIMS Nagpur the only institute with a dedicated noncommunicable diseases wardgtgt Early diagnosis and correct treatment prevent lifethreatening complications such as diabetic ketoacidosis DKALIVING WITH TYPE 1 DIABETESNupur Lalvani who has been living with Type 1 diabetes for over 30 years told midday ldquoIt is a difficult disease It keeps you on the edge throughout your life But if you have access to the right medication a knowledgeable doctor who understands type 1 diabetes and support from family and friends you can live a wonderful life If you donrsquot miss your checkups insulin shots and glucose monitoring the condition can be managed and life can feel almost normalUnfortunately these are also the reasons why many people with type 1 diabetes die young With limited access to affordable medication lack of awareness and tough lifestyle demands the fatality rate rises I have to take an insulin shot every single time before I eat mdash and that is not easy mentally or financiallyrdquoA Survey of 898 type 1 diabetes Patients Nov 2024105deaths reported 11637Of these 105 deaths4337 in children aged 15 or below2437 within 2 years of diagnosis5337 within 3 years of diagnosisB Global numbers Age 0ndash19 yearsgtgt 12 million children adolescents living with type 1 diabetesgtgt Highest number reported in IndiaSource International Diabetes FederationCHALLENGES FACED BY PATIENTSgtgt Basic treatment using insulin pens and frequent glucose checks costs at least Rs 5000 per monthgtgt Financial strain makes longterm care difficult for middleclass familiesgtgt Emotional stress at diagnosis lifelong dependence on injections or pumpsgtgt Frequent fingerprick tests and rigid daily routines for childrengtgt Difficulty calculating carbohydrate content in Indian food lack of free appsgtgt Most schools lack facilities for children with Type 1 diabetesgtgt Fear of hypoglycemia causes anxiety among parentsgtgt Stigma and psychological pressure on familiesSYMPTOMS OF TYPE 1 DIABETESgtgt Sudden return of bedwetting in a toilettrained childgtgt Weight loss despite extreme hungergtgt Excessive thirst and frequent urinationgtgt Fatigue lethargygtgt Fruity breath abdominal pain possible DKA ndash medical emergencygtgt Fungal infections in the genital areaSource Dr Meenakshi GirishTHE COST BURDENgtgt A 10 ml vial of analogue insulin costs around Rs 3000 and may last up to 4 weeksgtgt Insulin delivery syringes cheapest pens moderate pumps Rs 6 lakh plus R30000 monthly maintenancegtgt When lifesaving drugs enter the National Essential Medicines List prices drop mdash for example Lantus fell from Rs 1200 to Rs 640 per 3 ml cartridge after inclusionBlueCircle Foundation survey 2025gtgt 99237 of Type 1 diabetics cannot afford Libre 1 continuous glucose monitor CGM costing around R5500gtgt Libre Pro R2300 has been discontinued forcing users to buy expensive versiongtgt CGM sensors last only 14 days meaning R11000 monthly outofpocket costgtgt Alternative 10ndash12 fingerprick tests daily which is painful and risky for manyTYPE 1 vs TYPE 2 DIABETESType 1 Diabetesgtgt Age at onset 6 months and oldergtgt Family history less than 1037gtgt Insulin secretion decreasedabsentgtgt Insulin sensitivity normalgtgt Insulin dependency permanentgtgt Obesity population prevalencegtgt DKA commongtgt Beta cell antibodies usually presentgtgt Cpeptide undetectable lowType 2 Diabetesgtgt Age at onset Usually pubertalgtgt Family history 30ndash5037gtgt Insulin secretion variablegtgt Insulin sensitivity decreasedgtgt Insulin dependency episodic initiallygtgt Obesity 9037gtgt DKA raregtgt Beta cell antibodies usually negativegtgt Cpeptide normalhighSource AIIMS NagpurWHAT INDIA NEEDS POLICY GAPS amp SOLUTIONSRepresentation picistock1 States like West Bengal Chhattisgarh and Rajasthan provide free insulin and run government clinics for Type 1 diabetes mdash Maharashtra needs similar support2 Lack of structured support systems subsidies free insulin supply patient education and mental health services increases longterm risk3 Integrate Type 1 diabetes care into primary healthcare expand training for health workers4 Conduct widespread awareness campaigns for early detection and destigmatisation5 Provide psychological counselling for children and caregivers6 Improve access to affordable insulin technologies CGMs pumps7 Mandate insurance coverage for Type 1 diabetesNovemberNational Diabetes Awareness Month