Quantcast
Latest Stories

Changing Diabetes

Insulin therapy for children and pregnant women

By

Not too long ago, the common type of diabetes in children and teens was type 1, a chronic condition in which the pancreas produces little or virtually no insulin. Today, no thanks to obesity brought on by physical inactivity and unhealthy eating habits, more and more young individuals are developing type 2 diabetes, the more common form that occurs when the body becomes resistant to the actions of insulin apart from not making enough insulin.

Aside from the multi-organ damage caused by long-term uncontrolled diabetes, pediatric patients are also at risk of retardation in normal growth parameters such as height, weight and height velocity. Children and teens with type 1 diabetes require insulin therapy. Insulin therapy ensures catch-up growth and helps children with diabetes achieve mean growth and development rates similar to their peers.

Type 2 diabetes may be controlled with intensive diet and structured exercise. In the past, if lifestyle modification alone is unable to control type 2 diabetes, then oral antidiabetes medications will be added. More recent guidelines recommend early initiation of oral agents and even insulin therapy together with lifestyle changes if blood glucose targets are not achieved within 3 to 6 months.

Diabetes in pregnancy can either be preexisting (type 1 or type 2) or gestational diabetes, which is first recognized only during pregnancy. The placenta, during pregnancy, produces hormones that impair the actions of insulin. The placenta is a structure that develops at the inner side of the uterus during pregnancy and provides oxygen and nutrients to the growing baby and removes waste products from the baby’s blood.

Pregnancies of women with diabetes are considered high-risk for both the mother and the baby. Uncontrolled diabetes puts a woman at risk of various complications, such as pregnancy-induced hypertension (preeclampsia and eclampsia), premature labor leading to emergency cesarean section, obstructed labor, maternal infection and blood clots. The baby is at increased risk of excessive birth weight that may require a cesarean section, pre-term birth, respiratory distress syndrome, jaundice (yellowish discoloration of the skin and sclerae of the eyes), hypoglycemia (low blood sugar) shortly after birth (which can provoke seizures) and even fetal death.

More researches of longer duration are needed to confirm that oral drugs are as safe and as effective as injectable insulin to control diabetes in pregnant women. Insulin therapy is the treatment of choice for diabetes in pregnancy. Insulin is injected under the skin, usually with a fine needle and syringe or via an insulin pen.

Insulin therapy provides more predictable and flexible blood glucose control with the capability of adjusting doses in relation to the patient’s diet, activity and illness. With optimal blood glucose control, the risks of complications to both mother and baby are significantly reduced.

Many types of insulin are available. Endocrinologists and other physicians who take care of patients with diabetes, will prescribe the insulin or combination of insulins that is best for a child, adolescent or pregnant woman with diabetes. Insulin detemir is a long-acting insulin analog that is safe and proven to control blood glucose in adults and children 2 years and older with type 1 diabetes and adults with type 2 diabetes. It is also the first and only long-acting insulin analog with a randomized clinical trial showing the safety and efficacy of this insulin in pregnancy without increasing the risk of harm to the unborn child.

DIABETES TRIVIA

CONTEST: What type of diabetes develops during pregnancy? E-mail your answer to changingdiabetesph@gmail.com and get the chance to win a prize! Congratulations to Annielyn dela Cruz! Your correct answer to the question in the Aug. 3, 2013 column was chosen as this week’s winner in the Diabetes Trivia Contest. You will receive an e-mail on how to claim your prize.

Dr. Nemencio A. Nicodemus Jr. is an endocrinologist and an associate professor at the University of the Philippines-College of Medicine and Ateneo School of Medicine and Public Health. The “Changing Diabetes” column commemorates the 92nd anniversary of insulin’s discovery. It aims to increase awareness on diabetes prevention, diagnosis and management. Novo Nordisk supports “Changing Diabetes.” Headquartered in Denmark, Novo Nordisk is a global healthcare company with 90 years of innovation and leadership in diabetes care. For questions or comments, e-mail changingdiabetesph@gmail.com.


Follow Us


Follow us on Facebook Follow on Twitter Follow on Twitter


Recent Stories:

Complete stories on our Digital Edition newsstand for tablets, netbooks and mobile phones; 14-issue free trial. About to step out? Get breaking alerts on your mobile.phone. Text ON INQ BREAKING to 4467, for Globe, Smart and Sun subscribers in the Philippines.

Tags: Children , diabetes , health and wellness , insulin therapy , pregnant women



Copyright © 2014, .
To subscribe to the Philippine Daily Inquirer newspaper in the Philippines, call +63 2 896-6000 for Metro Manila and Metro Cebu or email your subscription request here.
Factual errors? Contact the Philippine Daily Inquirer's day desk. Believe this article violates journalistic ethics? Contact the Inquirer's Reader's Advocate. Or write The Readers' Advocate:
c/o Philippine Daily Inquirer Chino Roces Avenue corner Yague and Mascardo Streets, Makati City, Metro Manila, Philippines Or fax nos. +63 2 8974793 to 94
Advertisement
Advertisement

News

  • What Went Before: Malacañang allies alleged involvement in pork scam
  • Timeline: Napoles tell-all
  • 12 senators on Napoles ‘pork’ list, says Lacson
  • Napoles surgery in Makati hospital successful
  • Save the queen? Aide takes fall for Enrile, Gigi Reyes
  • Sports

  • Mixers trim Aces; Painters repulse Bolts
  • Donaire junks Garcia as coach, taps father
  • ’Bye Ginebra: No heavy heart this time
  • UAAP board tackles new rules
  • Baguio climb to decide Le Tour de Filipinas
  • Lifestyle

  • The best flavors of summer in one bite, and more
  • Homemade yogurt, bread blended with pizza, even ramen
  • Visiting chefs from Denmark get creative with ‘ube,’ ‘ buko,’ ‘calamansi,’ mangoes
  • Salted baked potatoes
  • A first in a mall: Authentic Greek yogurt–made fresh in front of diners
  • Entertainment

  • Return of ‘Ibong Adarna’
  • Practical Phytos plans his future
  • In love … with acting
  • From prison to the peak of success
  • ‘Asedillo’ location thrives
  • Business

  • This time, BIR goes after florists
  • Philippine Airlines to stop shipment of shark fins
  • PH banks not ready for Asean integration
  • Stocks down on profit-taking
  • Banks allowed to use ‘cloud’
  • Technology

  • ‘Unlimited’ Internet promos not really limitless; lawmakers call for probe
  • Viber releases new design for iPhone, comes to Blackberry 10 for the first time
  • Engineers create a world of difference
  • Bam Aquino becomes Master Splinter’s son after Wiki hack
  • Mark Caguioa lambasts Ginebra teammates on Twitter
  • Opinion

  • Editorial cartoon, April 24, 2014
  • Talking to Janet
  • Respite
  • Bucket list
  • JPII in 1981: walking a tightrope
  • Global Nation

  • PH seeks ‘clearer assurance’ from US
  • China and rivals sign naval pact to ease maritime tensions
  • What Went Before: Manila bus hostage crisis
  • Obama arrives in Tokyo, first stop of 4-nation tour
  • Believe it or not: Filipinos love US more than Yanks
  • Marketplace