Diabetes in a child takes a toll beyond the disease

A mother gives an insulin shot to her diabetic daughter with their family around them. When a child has diabetes, it affects the whole family. — Filepic

Every November, as we mark World Diabetes Day (on Nov 14), I’m reminded of the many children, adolescents and families I’ve met over the years who live bravely with diabetes every single day.

When most people hear the word “diabetes”, they think about sugar levels, insulin and diet – and they’re right, those are all important.

But there’s another part of the story that we often forget: the emotional and psychological journey that comes with this lifelong condition.

A quick look at diabetes

Diabetes in children comes mainly in two forms: Type 1 and Type 2.

Type 1 diabetes happens when the body’s immune system mistakenly destroys the cells in the pancreas that make insulin – the hormone that helps sugar move from the blood into the cells for energy.

Without insulin, sugar builds up in the blood, which can be life-threatening.

Symptoms can appear suddenly, e.g. urinating and drinking more than usual, feeling very tired, losing weight, or even vomiting and breathing rapidly in diabetes ketoacidosis, a life-threatening complication.

Type 1 diabetes can happen to any child – it’s not caused by eating too much sugar and it cannot be prevented.

Type 2 diabetes, once thought to affect only adults, is now appearing in adolescents and teenagers, especially those who are overweight or have a family history of the disease.

It develops more slowly and may cause symptoms just like type 1, or none at all for a while.

Type 2 diabetes is linked to insulin resistance, where the body still makes insulin, but doesn’t use it effectively.

Both types require long-term care and commitment, from checking blood sugar levels and watching food portions to balancing activity, insulin and other medications, and emotions.

When life changes overnight

I remember a seven-year-old girl I’ll call Amira.

She was brought to the hospital one night feeling tired and thirsty, with rapid breathing.

She was admitted to the ICU (intensive care unit) for diabetes ketoacidosis, requiring insulin infusion and fluids.

The next few days, her parents were taught how to give insulin injections, count carbohydrates and check blood glucose levels.

In 24 hours, their lives had changed completely.

Amira was brave, but she was also scared.

Insulin injections, adjustment in diet and blood glucose checks were daunting.

She asked why did it happen to her.

Her parents worried about how they would cope, the cost of supplies, and what would happen if her blood sugar dropped when she was at school.

Stories like Amira’s are common. 

A diagnosis of diabetes doesn’t just affect the child; it affects the whole family, including other siblings as the family focus shifts.

There’s the constant responsibility: remembering insulin doses, waking up at night to check blood sugar, and the fear of blood sugar highs and lows.

Over time, this can lead to “diabetes burnout” – a sense of emotional exhaustion and frustration.

This American teenager reluctantly hands her self-monitored blood sugar report to her doctor as she admits she had stopped testing herself for a week. The frustration of managing an incurable chronic disease can cause adolescents to act out in rebellion. — Los Angeles Times

Hidden costs

Diabetes care is expensive.

Even with public health support, families often face ongoing costs for insulin, glucose meters, test strips, continuous glucose monitoring sensors, and sometimes, insulin pumps.

Add clinic visits, diet adjustments and missed workdays for hospital appointments, and the financial strain can be significant.

But beyond the money, there’s an emotional cost.

Parents live with constant worry: “Did I pack enough snacks?” and “What if their sugar drops in class?”

Children may feel different from their peers or embarrassed about checking their blood sugar in public.

Teenagers, especially, may struggle with independence, and sometimes skip insulin doses or hide readings out of frustration.

These are not signs of weakness – they are human reactions to living with a 24/7 condition that never takes a holiday.

Mental and social support

That’s why mental health support is just as important as medical treatment.

Children and teenagers with diabetes are more likely to experience anxiety or depression.

Sometimes they feel guilty if their numbers aren’t “perfect”, or they become overwhelmed by the constant effort of self-care, leading to feelings of hopelessness.

What helps most is open communication.

Encourage children to talk about their feelings: the frustration, the fear, the boredom of routine.

Healthcare teams should ask not just “What’s your sugar level?”, but also “How are you coping?”

Families can request to speak with psychologists or counsellors familiar with chronic illness in children.

Even simple peer support – meeting others at a diabetes camp or online group – can be life-changing.

When a child sees someone on insulin injections, checking their blood glucose or wearing the same glucose monitor or pump, they realise they’re not alone and that diabetes is not something to be ashamed of.

Managing diabetes is a team effort involving parents, siblings, friends, teachers, school and community.

At home, small things matter: not blaming when numbers fluctuate (because they will), celebrating small successes and maintaining normal routines.

Siblings should be included in understanding what diabetes means, so they don’t feel left out or overly anxious.

Schools, too, must be supportive.

Teachers should know the signs of low blood sugar – shakiness, sweating, confusion – and understand that a child may need to snack during class or take short breaks.

Teachers and nurses at school should also be supportive in assisting a child with simple glucose checks or supervised insulin injections.

Friends who show kindness rather than curiosity or judgment can make a world of difference.

Any bullying in school must not be accepted.

On a broader level, community understanding helps reduce stigma.

Too often, people assume diabetes in children is simply caused by poor eating habits, which adds unnecessary guilt for families.

Public awareness campaigns and education in schools can help replace myths with empathy.

Living well

Despite the challenges, many children with diabetes go on to lead active, successful lives.

They can become athletes, doctors, artists, entrepreneurs and more.

The key is support, knowledge and a positive mindset.

As parents and professionals, we must remember that good diabetes care is not just about numbers on a screen; it’s about helping a child live confidently, enjoy friendships and dream big without fear.

This World Diabetes Day, let’s look beyond the needles and numbers.

Let’s remember the children who check their blood sugar before every meal, the parents who wake up in the middle of the night just to make sure their child is safe, and the families who juggle emotions, expenses and routines with quiet courage.

Diabetes may be a lifelong condition, but it doesn’t have to define a child’s life.

With compassion, community support, and attention to psychological and emotional well-being, we can help every child with diabetes not only survive, but truly thrive.

Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. For more information, email [e-mail]. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.