We know you sometimes have burning questions that can best be answered by a pharmacist. Our feature, Ask Your Pharmacist, seeks to address some of those issues. Send your questions to healthandwealth@jamaicaobserver.com.

Question: Can children really get diabetes? Is it not an old people disease?

Answer: There are two main types of diabetes. Type 1 diabetes is an autoimmune disease where the body attacks the cells of the pancreas. This is the most common type of diabetes in children. There is no known cause for type 1 diabetes. It just happens. Because the body attacks the pancreatic cells, the body cannot make insulin so the child has to take insulin injections every day to process the carbohydrate in the food that he/she eats.

Type 2 diabetes is often associated with older people, but it is getting more prevalent in children. Type 2 diabetes is a lifestyle disease that is largely linked to the decisions that we make on a day-to-day basis. One of the major contributing factors to the increasing cases of type 2 diabetes in children is the rapid rise in childhood obesity. Childhood obesity can be directly linked to poor diets and lack of physical activity. Another risk factor is our race. Black people, even children, are more at risk for type 2 diabetes. If children have close relatives with type 2 diabetes of if their mothers had diabetes during pregnancy, they are at increased risk. For some reason, adolescent girls are more prone to getting type 2 diabetes than adolescent boys. Also, premature babies or those born with low birth weights are more at risk of developing type 2 diabetes.

How can we prevent children from getting type 2 diabetes? It is important to ensure that children are eating healthy diets and getting enough physical activity. We live in a convenience age where fast food and processed foods are the norm. From very early, children are given juice boxes and processed snacks that contain loads of sugar, salt, and empty calories. Eating red and processed meats are also linked to childhood type 2 diabetes. Children are also exposed to a lot of screen time from very early and are not given adequate encouragement to go outside and engage in physical play. We have to change this paradigm.

The American Academy of Paediatrics advises that babies should not be given any type of juice before one year old. Breastmilk, infant formula, and minimal amounts of water after six months should provide adequate hydration for the baby. Introducing juice from early allows the child to develop a preference for sweets that may lead to the formation of poor dietary habits. After one year, parents should promote water as the drink of choice for children.

From the time solid foods are introduced to babies at around six months, parents should encourage the child to eat healthy foods. Parents should offer a variety of fruits, vegetables, and whole grains instead of offering processed foods that are packed with added sugars, salt, saturated fats, and empty calories. Parents shouldn’t serve large portion sizes and force children to finish all the food on their plate. Serve sensible portions and if the child says he/she is full, do not force them to finish the food. Parents should try to provide more home-cooked meals as opposed to buying food from restaurants. More often than not, home-cooked meals are healthier and preparing meals at home helps you to control the ingredients to incorporate more healthy choices. If children help make healthy meals, they might be more inclined to eat them, so get them involved! It would also be beneficial to eat at the dining table instead of in front of the TV. Sitting in front of the TV promotes mindless eating, where you just keep picking at food, and before you know it, a whole container of ice cream is done. If you share out a portion and sit at the table, then you will just consume that portion.

Parents should encourage children to go outside and play instead of sitting in front of an electronic device all day. Better yet, make it a family affair. The lifestyle choices that can help prevent type 2 diabetes in children can do the same for adults.

So, if children get type 2 diabetes, what treatment options are there? Lifestyle modification will be the first intervention for children who get type 2 diabetes. If lifestyle modifications do not control the blood sugar sufficiently, the child may be put on Metformin (a pill taken orally) or insulin (an injected medication). Treatment for type 2 diabetes is lifelong and this can be difficult for children. The earlier a child has diabetes, the earlier they will have end organ damage. This means there will be serious, often permanent damage to organs such as the eyes, kidneys, heart, blood vessels and nerves. Early diagnosis and treatment will help to minimise or delay end organ damage.

So, to answer your question: yes, children can get diabetes and it is becoming more prevalent! Apart from type 1 diabetes that cannot be prevented, poor lifestyle choices are contributing to an increasing number of children having type 2 diabetes. Parents have a responsibility to cultivate healthy lifestyle choices in their children from early. It definitely takes more time and effort to cook healthy meals and to go outside and engage in physical activity, but it is totally worth it.

Novia Jerry Stewart, MSc, RPh, is a pharmacist who specialises in diabetes care. She may be contacted for diabetes care coaching sessions at diabetescarepharmacist@gmail.com