Diabetes occurs in two forms; Type 1 and type 2 diabetes mellitus. Type 1 diabetes mellitus (T1DM) is the deficiency of insulin in the body, whereas type 2 diabetes mellitus (T2DM) occurs due to the body’s inability to respond effectively to insulin in the blood. T1DM is most common in children. The main causes of diabetes are a combination of various environmental and genetic triggers (Deiner, 2012, p. 372).
Saudi Arabia has one of the highest diabetes prevalence rates in the world. A five-year research determine that Saudi Arabia has an adult (30-70 years) diabetes prevalence rate of 23.7%. The prevalence rate in females is 26.2% whereas that of men is 23.7%. The study had a sample of randomly selected 17232 Saudi residents and had a response rate of 98.2% (Al-Nozha et al, 2004, p. 1603-1610). However, the prevalence rate of childhood diabetes is significantly lower.
Research on childhood diabetes using a sample of 110 children determined that genetic factors play a critical role in onset of diabetes in Saudi children. The research determined that in 28% of the cases first-degree family medical history was positive for T1DM, 35% for T2DM and 14% for both T1DM and T2DM. 67% of the patients presented symptoms of diabetes in the form of diabetic ketoacidosis (Salman et al, 1991, p. 176-178).
A nationwide research helped to determine the prevalence and trend of childhood diabetes in Saudi Arabia. The sample for the study was 14,000 randomly selected households. Researchers surveyed 45,682 children and adolescents of ages 0-19 years, from 11,874 of the 14,000 households. Of the children surveyed, 50 had T1DM, representing a ratio of 109.5 per 100,000 children, with the ratio of females to males being almost equal (24 females and 26 males). Prevalence of diabetes varied depending on the region, with the central region having the highest prevalence, and the eastern region having the lowest prevalence (Al-Herbish et al, 2008, p. 1285-1288).
Incidences of childhood diabetes have been on the increase over the past decades. Incidences of childhood diabetes in Eastern Saudi Arabia have increased from 27.52/100,000/year to 36.99/100,000/year. The study used Saudi aged less than 15 years that received care at Saudi Aramco Medical Service Organization. Of the total patients, 40% of the males and 55% of the female had diabetic ketoacidosis (Abduljabbar et al, 2010, p. 413-418).
A study on the prevalence of T1DM in Eastern Province determined that the mean age of diagnosis as 9.0 years, with the onset of symptoms prior to diagnosis being 12.5 days. The basis of the research was clinical and laboratory data. From the research, ketoacidosis occurred in 77% of the patients (Kulaylat & Narchi, 2001, p. 43-47). A different study on the clinical symptoms of T1DM in Al-Madina province showed that the onset of symptoms prior to diagnosis was 17.1 days. Clinical presentation of childhood T1DM in the region was via polydipsia, polyuria, and weight loss. 55.2% of the children had Ketoacidosis (Al Magamsi & Habib, 2004, p. 95-98). The two studies show that prevalence and onset of various clinical symptoms varies from one region to another.
A seven-year research determined that there is a close relationship between the age of the children and the severity of the disease prior to admission in hospital. The study focused on children between the ages of 0-5 years and children who were more than 5 years old. The study used children admitted to Aseer Central Hospital as the sample. The research determined that parents presented younger children to the hospital later than older children, when the children were already in a state of diabetic ketoacidosis (Al-Fifi, 2010, p. 87-90). This demonstrates the importance of educating parents on the symptoms of diabetes to facilitate early detection.
Diabetes treatment regimens strive to maintain metabolic control to levels that are as near as possible to normal levels. Metabolism determines the glycosylated haemoglobin assay (HbA1c) – a measure of blood glucose level (O’Donohue, 2009, p. 86). A study on children and adolescents attending King Abdul-Aziz University Hospital, determined that patients had a mean HbA1c of 9.4±2.4%. However, only 31.4% of the patients had levels of HbA1c that were satisfactory according to the American Diabetes Association Guidelines (Al-Agha, Ocheltree & Hakeem, 2011, p. 202-207). This necessitates the promotion of physical exercises to improve metabolic control in children.
Presence of T1DM in the body makes the body produce autoantibodies to counter the disease. The three major antibodies that the body produces are insulin autoantibodies (IAA), islet cell antibodies (ICA), and glutamic acid decarboxylase antibodies (GAD). A study that used a sample of 98 children from Riyadh who had T1DM showed that ICA is the predominant antibody in children under the age of six years. The study also determined that there was a close association of the presence of GAD and ICA in the absence of IAA, with the presentation of severe clinical symptoms (Al Alwani et al, 2012, p. 31-33). Findings of the research would help improve diagnosis of childhood T1DM.
Childhood diabetes places a greater burden on parents. Mothers of the children bear the greatest burden, as they are the primary caregivers. The disease makes mothers of the children be prone to physical, financial, and social stress. The study used a sample of randomly selected 125 mothers of diabetic children from 10 hospitals in Riyadh (Felimban & Salih, 2000, p. 63-68).
Diabetes is one of the major chronic ailments facing the children in Saudi Arabia. The prevalence of diabetes varies with the region. This necessitates more research on reasons on why certain regions have lower prevalence rates. Findings of the research would provide insights that would help in curbing diabetes and improve the health of Saudi children.
References
Abduljabbar, MA, Aljubeh, JM, Amalraj, A Cherian, MP. 2010. Incidence trends of childhood type 1 diabetes in eastern Saudi Arabia. Saudi Medical Journal. 31(4), 413-418.
Al Alwan, I, Bin Dajim, N, Jawdat, D, Tamimi, W, Al Ahmdi, R, Albuhairan, F. 2012. Prevalence of autoantibodies in children newly diagnosed with type 1 diabetes mellitus. Journal of Biomedical Sciences. 69(1), 31-3.
Al Magamsi, MS & Habib, HS. 2004. Clinical presentation of childhood type 1diabetes mellitus in the Al-Madina region of Saudi Arabia. Pediatric Diabetes. 5, 95-98.
Al-Agha, A, Ocheltree A, & Hakeem, A. 2011. Metabolic control in children and adolescents with insulin-dependent diabetes mellitus at King Abdul-Aziz University Hospital. Journal of Clinical Research in Pediatric Endocrinology. 3(4), 202-207.
Al-Fifi, SH. 2010. The relation of age to the severity of Type I diabetes in children. Journal of Family & Community Medicine. 17(2), 87-90.
Al-Herbish, AS, El-Mouzan, MI, Al-Salloum, AA, Al-Qurachi, MM, Al-Omar AA. 2008. Prevalence of type 1 diabetes mellitus in Saudi Arabian children and adolescents. Saudi Medical Journal. 29(9), 1285-1288.
Al-Nozha, MM, Al-Maatouq MA, Al-Mazrou, YY, Al-Harthi, SS, Arafah, MR, Khalil, MZ,… Al-Mobeireek, A. 2004. Diabetes mellitus in Saudi Arabia. Saudi Medical Journal. 25(11), 1603-1610.
Deiner, P. 2012. Inclusive early childhood education: Development, resources, and practice. Belmont, CA: Cengage Learning.
Felimban MA, Salih MA. Stress in mothers of diabetic children in Riyadh city, Saudi Arabia. Journal of Family & Community Medicine. 7(1), 63-68.
Kulaylat, NA & Narchi, H. 2001. Clinical picture of childhood type 1 diabetes mellitus in the Eastern Province of Saudi Arabia. Pediatric Diabetes. 2(1), 43-47.
O’Donohue, WT. Behavioural Approaches to chronic disease in adolescence: A guide to integrative care. Spring Street, NY: Springer.
Salman H, Abanamy A, Ghassan B, Khalil M. 1991. Childhood diabetes in Saudi Arabia. Diabetic Medicine. 8(2), 176-178.