Determination, not disability, marks life with diabetes

The Central Board of Secondary Education (CBSE) recently announced that children with Type1 diabetes will now be placed under the category of persons with disabilities (PwD).

These students will be asked to fill up the forms for classes X and XII exams under this category. Last year, however, the board permitted insulin-dependent students taking classes X and XII board exams to carry sugar tablets, chocolate, candies and water bottles inside the centre.

Commenting on the same, Dr Sanjay Kalra - Consultant Endocrinologist, Bharti Hospital Karnal and Vice President, South Asian Federation of Endocrine Societies, said, using the word 'disability' for children with Type 1 diabetes is most inappropriate.

"As per the standard dictionary definition, disability (noun) is a physical or mental condition that limits a person's movements, senses, or activities. Diabetes is not one of the 21 disabilities listed under Rights of Persons with Disabilities Act, 2017. The word 'disability' runs counter to modern diabetes care philosophy, which encourages self-confidence and self-esteem."

"Type 1 diabetes (T1DM) is not a disability. However, uncontrolled or poorly managed T1DM is certainly a disability. Management of T1DM entails immense self -discipline in every sphere of life, including meal patterns. Ideally, a 3+3 meal pattern [3 meals, 3 snacks] is advised to children living with DM. Long periods without meals may lead to neuroglycopenia [low glucose levels in brain] and compromise mental function in children. The issue becomes even more pronounced in children with low body weight, as their glucose stores are lower. Therefore, we strongly support the provision for sugar/meal breaks during exams."

Dr. Kalra further said, "Children with DM face multiple challenges and demands, and their health care providers and family members work hard to create a sense of self-worth in them. We strongly suggest using the descriptor 'children of determination' not only for children with DM, but for all children with so-called 'disability'."

Living with diabetes is a challenge irrespective of one's age, but young kids and teens often face more difficulties dealing with it. But it is a challenge that can be overcome with determination. Children living with diabetes should be helped in attaining a normal physical, mental, emotional, and social growth and development.

To do this, parents and kids should aim for the goal of keeping blood sugar levels as close to normal as possible. In general, kids with type 1 diabetes should do the following and also remember that getting diagnosed with diabetes does not, in any way, indicate an end to a normal life.

• Take insulin as prescribed

• Eat a healthy, balanced diet, paying special attention to the amount of carbohydrates in each meal and the diabetes meal plan

• Check blood sugar levels several times a day

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