The prevalence of type 1 diabetes is on the increase among young children, however when it comes to the treatment of this disease, children are 'not small adults' and their care needs to be better tailored to their age and developmental stage, experts have warned.

According to a team in Limerick, type 1 diabetes only accounts for 5-10% of all cases of diabetes, with type 2 accounting for the majority of the rest. However, 'diabetes in childhood is usually type 1'. In fact, it is one of the most common chronic illnesses seen in childhood, with an estimated 3,000 young people under the age of 16 currently living with the condition in Ireland, including 270 aged less than five years.

Dr Orla O'Leary and diabetes nurse specialist, Anne Quinn, of Midwestern Regional Hospital Limerick, along with Prof Clodagh O'Gorman of the University of Limerick, said that children with this condition 'need to be appropriately managed in the context of their family from the onset of the disease'. This requires commitment from the patient, his/her family and medical staff.

"It also requires diabetes education to be provided to teachers, babysitters, grandparents and other responsible adults who play a key role in the life of the child. Children are not small adults and this is key in understanding the management of childhood diabetes," they said.

They pointed out that children with type 1 diabetes 'tend to be sicker' at presentation than adults and have a shorter duration of symptoms. Healthy children with the disease also tend to be admitted to hospital more frequently than healthy adults with the disease.

They emphasised that the management of type 1 diabetes in children should be carried out by a multidisciplinary team, which includes a paediatric diabetes nurse specialist, a paediatric endocrinologist, a diabetes dietician, a paediatric psychologist and a medical social worker.

Furthermore, the management of this disease in young people needs 'continuous attention', including ongoing education on diet and exercise. For example, because a child's nutrition requirements change constantly, 'ongoing pediatric diabetes dietary education is essential'.

The experts said that the management of type 1 diabetes in young children 'is not universal', and should therefore be tailored to each individual child depending on their age and development.

"The management of type 1 diabetes in children is complex and adult management strategies cannot be applied. Every child is different and managing the condition involves a multidisciplinary approach and constant education and support," they insisted.

They added that one of the biggest problems facing children with type 1 diabetes is that the long duration of their illness puts them at high risk of long-term complications. As a result, the experts said, multidisciplinary care and education for the child and their family 'should begin on the day of diagnosis'.

The Limerick team made their comments in the Irish journal, Diabetes Professional.