Treatments For

PEDIATRIC DIABETES

TYPE 1 DIABETES MELLITUS

The aim of treatment of Pediatric Type 1 Diabetes is to maintain normal blood glucose and HbA1c levels using insulin injections, diet modifications and maintaining healthy lifestyle. Maintaining normal blood glucose values and reducing glycemic variability helps to avoid long term complications of Type 1 Diabetes.

An individualised approach towards management of Type 1 Diabetes on a case to case basis includes;

Multiple Daily Insulin Injections ( Basal bolus Regimen)
Healthy diet plan including Carbohydrate counting
Regular Blood glucose monitoring
Preventing and managing hypoglycaemia/ Sick day rules
Emphasis on regular Physical activity

TYPE 2 DIABETES

Pediatric Type 2 diabetes, which is attributed to unhealthy lifestyle, is usually managed with a combination of diet advice and increased physical activity to maintain weight and Body Mass Index within normal range. Some children may need treatment with Insulin or oral medicines for control of blood glucose levels.

OBESITY AND METABOLIC SYNDROME

Preventive and treatment measures should be started as early as possible to prevent both the medical and psychological complications of obesity in children. Lifestyle changes result in dramatic improvement in BMI and reduce the risk for development of various complications. A combination of diet modification and activity are the two basic pillars for weight optimization. Children should be encouraged to adopt healthy eating behaviours and be physically active.

Management of Childhood obesity includes:

Identification of childhood obesity and associated metabolic syndrome

Adopting Healthy Lifestyle

Encouraging Healthy Diet

Enhancing Physical Activity

Limiting screen time

PEDIATRIC THYROID DISORDERS

PEDIATRIC HYPOTHYROIDISM

Both congenital and acquired hypothyroidism is amenable to therapy. When diagnosis is confirmed and treatment is started early, normal growth and development can be ensured. Compliance with medications results in optimum thyroid hormone levels which is beneficial in the long run.

PEDIATRIC HYPERTHYROIDISM

The mainstay of treatment in children with Hyperthyroidism (Graves Disease) is medications. Radioactive iodine therapy and rarely surgery may be advised in children who show poor response to oral medications.

GROWTH DISORDERS

The causes of growth failure in children could be varied. The treatment depends on the cause. Most children with poor growth (subnormal weight and/or height gain) benefit from improvement in diet and activity. Those with a physiological cause of short stature are only monitored. Those with growth hormone deficiency are amenable to therapy with growth hormone. When treatment is started early, the results are better.

PUBERTY DISORDERS

EARLY PUBERTY (PRECOCIOUS PUBERTY)

Identification of cause of early puberty is important to plan treatment. Not all children with precocious puberty require treatment. The goal of treatment is to prevent the production of sex hormones to prevent the early halt of growth, short stature in adulthood, emotional effects and social problems. If precocious puberty is caused by a specific medical problem, treating the underlying problem can often stop the progression of precocious puberty. In addition, medical treatment to block the hormones that cause puberty can be used to halt the progression of pubertal changes.

DELAYED PUBERTY

With delayed puberty or hypogonadism, treatment varies with the cause of the problem but may involve use of hormone replacement therapy as and when the need arises.

DISORDERS OF SEX DIFFERENTIATION

Management includes a rapid and organised evaluation to rule out the presence of an associated life threatening condition, decision regarding gender of rearing, planning regarding corrective surgery and hormonal treatment at the time of puberty.

ADRENAL DISORDERS

Disorders due to over functioning or under functioning of the adrenal gland can result in a spectrum of clinical manifestations many of which may be life threatening.

Conditions like congenital adrenal hyperplasia (CAH) and Addison disease need treatment with steroid medications with appropriate dose adjustments to ensure normal growth and development. Other important conditions like Cushing syndrome needs adequate evaluation for identification of cause of overfunctioning gland followed by appropriate treatment.

CALCIUM, VITAMIN D AND BONE DISORDERS

Disorders related to calcium, phosphorus and vitamin D require careful clinical evaluation for its diagnosis and management. Most of these conditions can be medically treated and managed if diagnosed in time.

SYNDROMES

Certain chromosomal syndromes like Turner syndrome, Noonan syndrome and Prader Willi syndrome present with multiple endocrine issues which needs regular health supervision, early preventive and treatment care for an overall good outcome.

METABOLIC

Disorders of sodium and glucose homeostasis in neonates and children pose a diagnostic challenge and often need a systematic and detailed evaluation to arrive at a diagnosis. Conditions like Congenital Hyperinsulinemic hypoglycaemia, Diabetes Insipidus and SIADH may need long term care with appropriate medications so as to have a favourable outcome in terms of growth and development.