Did chicken pox trigger my children's diabetes As the number of patients DOUBLE in ten years, one mother's alarming story
23:17 GMT, 30 April 2012
23:17 GMT, 30 April 2012
Jen Mackenzie has lived with type-1 diabetes since she was four, and is only too well aware of the symptoms of the disease.
So when her normally vibrant two-year-old daughter, Erin, suddenly seemed drained of all energy, it raised alarm bells.
‘Erin had also wet the bed twice that week — her nappy and the mattress were totally sodden,’ says Jen.
Double blow: Jen Mackenzie with Erin, Harriet and Faith. Erin and Harriet both have diabetes
‘I knew excessive urination was a symptom of diabetes, and I lay in bed thinking: “Please don’t let her be diabetic.” ’
The next day Jen took her toddler to the GP and mentioned her worry about diabetes.
Yet rather than give Erin a simple blood test to check her blood sugar levels, the doctor made Jen feel as though she was wasting her time, and sent her away ‘with a flea in her ear’.
‘I stood in the reception sobbing — Erin was clearly not right, she was really lethargic and quiet,’ says Jen, 35, who is a full-time mother to her three daughters — Erin, now five, Faith, six, and Harriet, nine.
The receptionist called the surgery nurse, who gave Erin a blood test.
Jen’s hunch was right — not only was Erin’s blood sugar raised, a key sign of type-1 diabetes, but she also had raised levels of ketones, a sign her insulin level was so low her body was producing the dangerous toxic by-product.
‘The GP apologised. There was no malice in what she had done — I just don’t think she could fathom that this toddler could be old enough to have type-1 diabetes,’ says Jen, who lives in Folkestone, Kent, with her husband, Stuart, 37, a loft insulator.
Erin was taken to hospital and remained there for five days while doctors stabilised her blood sugar and insulin levels.
To help manage their condition, Jen, Erin and Harriet have insulin pumps, small mobile phone-shaped devices worn on a belt, which supply a continuous stream of insulin
Much has been made recently of the rise in type-2 diabetes, with the number affected doubling since 1996, to 2.8 million.
Yet there has also been a worrying surge in type-1 diabetes — like type-2, figures have also doubled in the past ten years, to 400,000.
‘And most of that rise has been among the under-fives,’ says Dr David Dunger, a paediatric diabetologist, who is based at Cambridge University.
Indeed, the incidence of type-1 diabetes is rising at a rate of 4 per cent a year, according to a report issued by JDRF (Juvenile Diabetes Research Foundation), the type-1 diabetes research charity, Diabetes UK, and drug manufacturer Sanofi.
Type-1 and 2 diabetes are linked to problems with the hormone insulin, produced in the pancreas, and crucial for controlling blood sugar.
But while type-2 is linked to obesity, and usually develops later in life, type-1 is an auto-immune condition, which means the body’s immune system mistakenly attacks the cells that produce insulin (the average age of diagnosis for type-1 is 14).
So while type-2 can usually be managed with lifestyle changes and drugs, those with type-1 need insulin tablets or injections every day for life.
The other main difference is the cause — while it’s clear type-2 is on the rise as a result of the obesity epidemic, medics don’t understand why type-1 is increasing.
‘Cases of type-1 diabetes have risen above the projected increases since the Sixties,’ says Naveed Sattar, professor of metabolic medicine at the Institute of Cardiovascular and Medical Sciences at Glasgow University.
‘It desperately needs more research.’
One theory is that children today have less exposure to childhood illness and germs, which affects the development of their immune system.
Because it is exposed to fewer harmful agents, it over-reacts and starts attacking the body by mistake.
Some believe childhood infections such as mumps or measles trigger this immune system malfunction in those with a genetic susceptibility to type-1 diabetes.
‘There have also been associations made with stomach bugs such as gastroenteritis,’ says Dr Dunger.
Another theory is that a lack of exposure to vitamin D, formed when sunlight hits the skin, could be a cause — especially as cases of type-1 diabetes are high in Northern Europe. Obesity among children may also be partly to blame.
Jen believes her daughters' condition may have been triggered by genetic susceptibility combined with a bout of chicken pox
‘The idea is this puts an extra strain on the pancreas,’ says Professor Sattar.
Yet worryingly, despite the significant rise in numbers, many GPs are still failing to suspect a child has type-1 diabetes when they have symptoms such as excess urination, thirst, fatigue and unexplained weight loss.
‘A lot of noise has been made about children being diagnosed with type-2 diabetes, but not much about those with type-1 diabetes, even though there are far more of them (around 26,000, compared with 1,000 who have type-2),’ says Dr Dunger.
‘By the time they are diagnosed, 30 per cent of children have early-stage ketoacidosis.’
This means the body has started to break down fat and protein, producing ketones, which are toxic and can lead to kidney damage.
In the longer term, high levels of glucose in the blood can damage blood vessels and organs.
A diagnosis of type-1 diabetes reduces life expectancy by an average of 20 years (less than half that for type-2 diabetes) because of the complications it can cause.
‘It is a horrible condition and you can never step away from it,’ says Dr Dunger.
Jen understands the difficulties more than most.
For eight days after Erin’s diagnosis, Jen’s eldest child, Harriet, then five, was also diagnosed as diabetic.
‘I was devastated,’ says Jen. ‘I know how much type-1 diabetes impacts on your life — the blood tests every few hours, the daily insulin, having to think about what and when you eat.
‘I was also surprised because I’d been told any child of mine would have, at best, a 2 per cent risk of developing the condition.’
Jen believes her daughters’ condition may have been triggered by genetic susceptibility combined with a bout of chicken pox, because both were recovering from the infection when they developed symptoms.
To help manage their condition, Jen and her two daughters have insulin pumps, small mobile phone-shaped devices worn on a belt, which supply a continuous stream of insulin.
However, the amount of insulin pumped in has to be modified and checked by Jen according to what the girls eat and how active they are.
Every day, the girls go to school with a bag with extra insulin, an extra pump, their blood test kit and a hypo kit (to provide sugar in case their blood sugar drops).
‘It is relentless — I have to check their blood sugar levels every two or three hours at night when they are asleep — more if they have had a bug,’ says Jen.
‘One of us has a hypo (low blood sugar) every day.
'Last week, Harriet’s speech started to slur and her eyelids grew heavy.
'We had to force-feed her jelly beans to get her blood sugar up again.’
Of course, Jen worries about the future for her girls.
‘I pin my hopes on someone finding a cure, so they won’t always have to think about their diabetes before anything else,’ she says.
JDRF, 020 7713 2030; jdrf.org.uk; Diabetes UK Careline: 0845 120 2960, diabetes.org.uk