Nearly 70,000 children under 15 suffer from diabetes (Nov 14 is Diabetes Day)

Five-year-old Krati Dhawan often complained of abdominal pain and even lost weight. She underwent a series of tests for stomach infection, which tested negative. It was only after the girl's mother said her daughter was drinking a lot of water and urinating frequently that she got blood-sugar tests done which confirmed type 1 diabetes.

Krati, who had to be immediately put on insulin - which if not started could have pushed her into coma - is not the only one.

An increasing number of children are developing diabetes, with up to 90 percent of all childhood diabetes being type 1, where children are dependent on insulin for survival.

"Most children with type 1 diabetes are not diagnosed on time. The awareness levels about the disease are not as high as they should be, a common assumption being that diabetes affects adults and not children," I.P.S Kochar, paediatric adolescent endocrinologist and diabetologist at Indraprastha Apollo Hospital, told IANS.

According to Richa Chaturvedi, diabetologist and endocrinologist at Pushpawati Singhania Research Institute (PSRI) Hospital, though there has not been an increase in type 1 diabetes among children in India, type 2 diabetes has recorded an increase, which she attributes to rising childhood obesity.

Chaturvedi said it was also because children were having a "high caloric diet, junk food, there is a lot of inactivity, less outdoor games and more of indoor games".

"Around 70,000 children under the age of 15 suffer from type 1 diabetes. Another 40,000 have been diagnosed with type 2 diabetes and this figure is growing by five percent each year.

"Sixty-eight percent urban children don't exercise regularly. Obesity is also a common factor. Nearly nine percent of adolescents between nine and 18 years of age have more abdominal fat," Chaturvedi said.

Diabetes describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both.

While type 1 is an autoimmune disease where children are dependent on insulin for survival, type 2 is due to insulin resistance and is seen in obese children with a family history of diabetes.

According to the Diabetes Foundation of India, about 50.9 million people in India suffer from diabetes, and this figure was likely to go up to 80 million by 2025, making it the 'Diabetes Capital' of the world.

Manoj Chadha, consultant endocrinologist at Hinduja Hospital in Mumbai, told IANS that type 1 diabetes in children was in large majority, with certain pockets in the south and the northeast reporting equal incidence of both types in children.

Listing a few symptoms, Chadha said: "Excessive urine, thirst and hunger, unexplained weight loss and fatigue are some of the common symptoms. All of these occur due to insulin deficiency."

Anup Misra, chairman of the Fortis C-DOC centre of excellence for diabetes and metabolic diseases, said: "Diabetes is beginning to appear much earlier in life in India, meaning that chronic long-term complications are becoming more common."

"There is a 100 percent rise in diabetes in the age group of 20-40 years," he said, adding that many patients were below 20 years.

Abhishek Kulkarni, paediatric and adolescent endocrinologist at the Jaslok Hospital and Research Centre in Mumbai, said the diet of children with type 1 diabetes should have age appropriate calories with normal proportions of carbohydrates, fats and proteins.

Experts said only type 2 diabetes can be prevented with a healthy lifestyle, exercise and avoiding obesity.

While type 1 diabetes can be well managed and detected early, the experts all unanimously called for greater awareness levels.

"The society and government should promote healthy lifestyle through advocacy and legislation, if required," Ajay Kumar Ajmani, senior consultant, endocrinology, at BLK Super Specialty Hospital, told IANS.

He said schools and teachers can also adopt a few measures like focussing on the quality of canteen food, replacing junk food with light, healthy food and also giving preference to outdoor games.