Experts concerned by rising cases of Type 1 Diabetes in children

A mother checks her daughter's diabetes by monitoring her blood glucose. [Getty Images]

Christine Njoki, 12 years old, was taken ill just a year after the government declared Covid-19 a pandemic in 2021.

When schools were reopening after the end of pandemic lockdowns, Njoki started having malaria-like symptoms and felt weak.

Njoki’s mother, Mary Nyokabi, explains that when her daughter was taken to Ngala Special School for First Term opening, all was well until sometime in February 2021, when she was contacted by the school and told that her daughter seemed unwell.

She had to leave Naivasha, where she worked on a flower farm, to go and pick Njoki and take her to Nakuru Level 5 hospital.

Her husband and her elder sister went to the school and rushed the minor to the hospital where she was treated for stomach issues, severe vomiting, and chest problems.

Nyokabi arrived at the facility later when her daughter was being discharged but appeared too weak to go home.

“When I got to the hospital due to her condition, I asked the doctor in charge to admit her and take time to examine what exactly was the problem. I had to stay with my child in the wards to wait for the diagnosis,” says Nokabi.

The doctor then decided to test Njoki’s sugar level because she was taking a lot of water and vomiting at the same time. That is how she was diagnosed with Diabetes type 1. Tests revealed that the girl’s sugar level was too high.

Another patient, nine-year-old Asili Thiram was a normal child at birth, according to her mother, Zainab Adams.

In 2021, at the height of the Covid-19 pandemic, Thiram’s mother fell ill leading to her admission to the Nakuru Level 5 Hospital for nearly one week.

Together with her elder sister, Thiram would occasionally visit her mother at the hospital. But because of her age, she would be barred from entering the facility.

Thiram began feeling weak and inactive as days went by, even after her mother was discharged.

Initially, her mother assumed that the girl had been affected by her being in hospital.

Days later Thiram started being weak and had symptoms similar to malaria, when her mother, Zainab, decided to seek medical help from a nearby dispensary.

“When I was discharged I was told that Thiram was not eating well, she was weak and was only taking a lot of water. I took her to the nearby hospital thinking that she had developed malaria or typhoid because she used to take a lot of water, especially at night,” said the mother.

Adams says that her child’s body was weak, she had no appetite and would take water both day and night and would urinate a lot at night.

The mother of four says when she took her for specialised treatment at the Nakuru Referral Hospital, she was told her child had developed Diabetes type 1.

According to Gladys Chesire, a Diabetes Nurse at Nakuru Level 5 Hospital under the programme ‘Changing Diabetes in Children’, there has been a significant spike in Diabetes type 1 - which is common in children.

“Having practised as a diabetes nurse for children for over 10 years, there has been a significant rise in Diabetes Type 1 which is common in children. For example, we would go for two to three months before registering new cases before Covid-19 but after the pandemic, we are admitting alarming 10 new patients every month,” says Chesire.

Chesire admits that the disease has become too common lately, posing symptoms of malaria and typhoid, which causes misdiagnosis, thus hindering early detection and treatment for young patients.

“You find that most of the patients who come here under this programme are being misdiagnosed. By the time they come to our facility, we have no option but to admit them due to their deteriorating conditions caused by misdiagnosis,” she adds.

Although it has not been confirmed, scientists have found out that before the pandemic, the incidence rate of childhood Type 1 Diabetes was already increasing by about three per cent a year.

A recent study found that there was a 27 per cent rise in the rate during the first year of the pandemic, compared to before Covid-19.

In the second year of Covid-19, the rate was up about 14 per cent compared to pre-pandemic levels.

Researchers say regardless of the cause, more resources and support may be needed for the growing number of children, some as young as 11 months old, to 15-year-old teens affected by Type 1 Diabetes.

According to Dr Bernard Gwer, a paediatrician and diabetes specialist, Type 1 Diabetes occurs when insulin-producing cells in the pancreas are mistakenly destroyed by the body’s immune system.

It affects both children and adults, but the causes are not fully known, hence there is currently no cure for it.

“People with the condition have to closely monitor their blood sugar level and take insulin to control it because their body cannot do this automatically,” he adds.

Experts say it is unclear what has triggered the surge in cases. Dr Gwer has urged people to look out for the symptoms of Type 1 Diabetes.

They include tiredness, thirst, needing to use the toilet more often, and weight loss or increasing thinness - collectively known as the four Ts.

“Knowing these signs and getting an early diagnosis and swift treatment can be life-saving,” he says.

“You are trying to process that your child is going through this. You’re being taught all these scientific facts about the condition...to keep them alive. If you don’t do it, you know, there are severe consequences,” Dr Gwer says.

Future studies that examine long-term trends could be needed to disentangle the impact of the pandemic from natural fluctuations in the incidence of Type 1 Diabetes over time, as well as establish the range of factors that could be behind any apparent rise, Dr Gwer reiterates.

Health officials are now calling for more partners to join in the fight against the disease and ensure affected children get the required support.

Dr Gwer says so far, they have more than 335 children in their care who are receiving training on how to check their sugar levels and inject themselves with provided insulin.

About half a million Kenyans may have Type 1 Diabetes, yet 60 per cent of them have never been tested. Out of the remaining 40 per cent, half of them may have tested but do not have access to the required medication.

“We have set structures to sustain these programmes. We have trained community healthcare providers, children and their parents so that they may be able to know how to manage themselves through the programme changing diabetes in children,” the medic says.

Dr Gwer adds that the reason they are training the minors on self-injecting the insulin is because at some point, they will go to boarding schools and they may be required to take care of themselves and manage their conditions.

“Insulin is a key drug for these children. Without it, there is a high risk of losing their lives for lack of insulin injection,” says the specialist.

The children need daily insulin injections and in some cases double injections from two different types of insulin, one at night and the other during the day.

He adds that without insulin, the sugar in the blood circulation damages body organs such as the eye capillaries and kidneys, and prevents wounds from healing.

He, however, says that there are programmes for children with Type 1 Diabetes, where they all meet in camps, play together, and understand that there are others too facing the same conditions.

Some of the counties with higher cases of type one diabetes include Kitui, Marsabit, Homa Bay, and Lamu.