My Science School

Are you aware that vitamin D deficiency is prevalent in epidemic proportions all over the Indian subcontinent, including India? Estimates suggest that over 70% of the general population, both in urban and rural settings, and across socio-economic and geographic strata, have this deficiency. This, despite the fact that most of our country receives bountiful sunlight throughout the year, and our bodies possess the capability to create vitamin D from direct sunlight on the skin when outdoors.

The reason, obviously, is the more sedate lifestyle that most of us are now used to. Vitamin D deficiency isn't the only problem, as obesity too is getting bigger in India, with estimates suggesting that one out of every four people might now be overweight.

In a more connected world, we are more addicted to our devices than ever before. While these gadgets do make a lot of things easy and provide wholesome entertainment, they are also eating into all our leisure, making most of us couch potatoes. What's more, plenty of services that are now available to us on our smartphones get almost everything delivered to us on the doorsteps, making even those minor social excursions to go out and buy something unnecessary.

It is important to incorporate some form of digital minimalism into your lifestyle. By having a philosophy with which you operate on the digital landscape, you will be surprised by the amount of time you can create and peace of mind that you are able to enjoy.

Once you create some time for yourself, it would be good spending it on some form of exercise. Even though most of us do not end up becoming elite athletes, it shouldn't stop us from incorporating some of those best practices in our daily lives. Simple activities like walking, jogging, running, and cycling, too, come with a lot of benefits.

You can even bring in activities into your everyday commute. You can walk to your destinations if they are less than a couple of kilometres away. You can cycle around, always being mindful of vehicular traffic, even if you are going 5-10 km. You can even walk to the nearest bus stop and travel by public transport for longer distances. By doing these, you are not only leading a more active lifestyle, but you will also be reducing your carbon footprint, making for a greener planet.

The benefits of having a more active lifestyle are not limited to physical well-being. Research suggests that being physically active on a continuous basis also helps the emotional well-being of most individuals.

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With the incidence of diabetes in children on the rise, let's take a look at the types of diabetes, risk factors for the disease, prevention and diet.

India is already known as the world's capital of diabetes with its vast adult population having diabetes. And it's not a disease that just affects adult population. The incidence of diabetes in children is steeply on the rise with an increase of 3-5% per year.

Types of diabetes in children

"Type 1 diabetes is the most common form of diabetes and can affect children as young as 1 year of age. Childhood diabetes is on the rise with a worldwide estimate of 1 lakh children under 15 years likely to develop type 1diabetes. It develops due to a process called autoimmunity leading to permanent destruction of beta cells of the pancreas resulting in little or no insulin production. This gives rise to high blood sugar levels resulting in multiple short- and long-term damage to organs if untreated," says Dr. Namratha Upadhya, Pediatrician, Pediatric Endocrinologist, Aster RV Hospital, Bangalore.

Type 2 diabetes which was once regarded as a disease of adults is increasingly seen in children now, and result from a combination of genetic and environmental factors. Children born with low birth weight and who grow rapidly during childhood can be at increased risk. Lifestyle factors such as excessive consumption of high-fat and calorie-rich foods, pre-packaged, refined and processed foods, coupled with minimal physical activity, and increased amount of screen time lead to children becoming overweight and obese. This puts them at a higher risk of developing type 2diabetes over time. Studies have shown that early onset of type 2 diabetes in children tends to be severe and progress faster than in adults, she says. There are other rare forms of diabetes which may occur due to genetic defects in insulin production or action, and diabetes occurring in children with certain chronic diseases and taking medications for some other illness.

Drinking water

Symptoms of diabetes in children "The presence of high blood sugar indicates diabetes. More common symptoms include excessive urination, excessive thirst, and getting up multiple times to urinate in the night. Children who have been toilet trained may suddenly start bed wetting. Parents may note excessive tiredness, weakness and unintentional weight loss in their children," says Dr (Mrs.) Sumeet Arora, Consultant Pediatric and Adolescent Endocrinologist, Artemis Hospital, Gurgaon. Early identification of these symptoms helps with timely diagnosis of diabetes preventing severe complications, sickness and the need for an intensive care unit admission.

What parents can do

"It is necessary to get your child's blood sugars checked if you feel your child might have any of the symptoms of diabetes. Children with type 1 diabetes, once started on treatment, might temporarily go into a phase of low insulin requirement which is referred to as 'honeymoon' phase and some might mistake this phase to be a cure for diabetes. Omitting insulin without supervision by your doctor might lead to a serious consequence in the child," says Dr. Namratha. Hence it is necessary to get your child evaluated by a professional who can guide appropriately. "Parents need to inform school authorities by giving contact numbers of children's doctor and guardian," says Dr. Sobhana. Children with diabetes can lead a normal life with professional and family support. As parents, the best gift they can give to their child is by being role models themselves and lead by example, especially in adopting healthy eating practices, keeping oneself physically active and get your child checked if you feel your child is having symptoms of diabetes and also get your child screened for obesity.

Prevention/risk factors

 "There is no known prevention for type 1diabetes. It is an auto immune condition in which our immune system gets hyper activated for unknown reasons and destroy the insulin-producing cells. At present there are no established ways to prevent type 1 diabetes that can be used for children. However, research studies are ongoing towards finding medications to help prevent or delay onset of type 1 diabetes," says Dr Sumeet Arora Having a parent or sibling with type 1 diabetes puts an individual at a higher risk for developing type 1 diabetes.

 

Type 2 diabetes is a lifestyle-related disorder, where the body's insulin is unable to work properly causing a state of insulin resistance. Being overweight poor lifestyle and having family members with type 2 diabetes, put an individual at risk for this condition. A healthy lifestyle is essential to prevent type 2 diabetes," says Dr. R. Sobhana, Consultant Diabetologist Women Center by Motherhood Hospital. Coimbatore. With this condition on the rise in children, it becomes increasingly important to identify those at risk at an early stage, she adds. There are body mass index charts that can be used by paediatricians to determine if the children are at an overweight or obese stage. Strategies to target a normal BMI include dietary modifications and moderate to vigorous physical activity every day.

Diet

Keeping the intake of high calorie/ high sugar and processed food and sugary drinks to a minimum, adopting healthy eating practices, eating a rainbow every day (meaning consuming at least 5 different types of whole fruits and vegetables of different colours a day), consuming whole over refined foods, avoiding screen time during meals and engaging in any form of physical exercise for at least 30 minutes a day will help prevent diabetes in children..

Treatment

"Type 1 diabetes requires basal bolus insulin therapy via multiple daily dose injections or continuous subcutaneous insulin infusion via insulin pumps," says Dr. Sobhana. There has been significant advancement in insulin pumps that along with continuous glucose monitoring sensor are able to maintain near normal blood sugars with little intervention from the user. "Type 2 Diabetes can be effectively managed with dietary and lifestyle modifications along with metformin, GLPI receptor analogues and newer pharmacotherapeutic agents," says Dr. Sumeet Arora.

QUICK FACTS

• Childhood diabetes is on the rise with a worldwide estimate of 1 lakh children under 15 years of age likely to develop type 1diabetes.
• Early identification of symptoms helps with timely diagnosis, preventing severe complications, sickness and the need for a hospital admission.
• There is no known prevention for type 1 diabetes, which is an auto immune condition.
• A healthy lifestyle is essential to prevent type 2 diabetes.

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Researchers were quick to point out that there are no quick fix solutions for this limitation of the brain.

You might have noticed that on Occasions when you think hard about something, you end up feeling tired. You are able to understand when this happens after hard physical labour, but you are surprised when this happens after hard thinking as well. Rather than try to find why this happens, you would have most likely let it pass, trying to give yourself some rest as you already feel exhausted.

Researchers from the Pitie-Salpetriere University in Paris have probed this very question as to why intense cognitive thinking makes us feel mentally exhausted. Their results were reported in Current Biology on August 11. Brains, as opposed to machines, can't compute continuously. The researchers set out to understand what mental fatigue really is. They suspected the brain's need to release potentially toxic substances built-up from neural activity as the reason for tiredness and decided to look for evidence.

Brain chemistry monitored

Using magnetic resonance spectroscopy, they monitored the brain chemistry of two groups of people over the course of a day. While one group needed to think hard, the other had relatively easier cognitive tasks. The group doing hard mental labour showed signs of fatigue, including reduced pupil dilation. In technical terms, people in this group had higher levels of glutamate in synapses of the brain's prefrontal cortex.

Glutamate accumulation

Along with existing evidence, this supports the idea that further activation of the prefrontal cortex becomes more costly following glutamate accumulation. In effect, a mentally tough workday eventually leads to cognitive control becoming more difficult. Researchers were quick to point out that there are no quick fix solutions for this limitation of the brain. Rest and sleep is what is suggested as there is evidence to show that glutamate is eliminated from synapses during sleep.

Scope for future studies on the subject includes learning why the prefrontal cortex is particularly susceptible to glutamate accumulation and fatigue. Researchers believe that learning more about the markers of fatigue in the brain could help us plan our lives to avoid burnout, and may even predict recovery from health conditions like depression or cancer.

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