When blood glucose signicantly increases above normal range i.e. fasting blood sugar more than 126mg/dl & after food blood sugar (pp) above 200 mg/dl) is called diabetes. (In normal persons the blood sugar remains in normal range in empty stomach & even after the food. Normal level of blood sugar in fasting condition is 70 to 110 milligram & after food it should be below140 milligram deciliter. ) 

Thus criteria for the, diagnosis of diabetes is: 
1) Fasting Blood Sugar more than 126 mg. /dl. 
2) Post prandial (P.P.) Blood Sugar more than 200 mg./dl.

RISK OF TYPE-II DIABETES TO CHILDREN & OTHER FAMILY MEMBERS:

If one parent has Non-Insulin Dependent Diabetes risk of developing diabetes to children is 36% i.e. one out of 3 children will develop diabetes. If both parents have diabetes then 75% of their children will become diabetic (i.e. if they have four children then 3 out of four will become diabetic). If one brother or sister has diabetes risk to other siblings is 33% i.e. one out of every 3 will become diabetic

If parent has Type-1 Diabetes i.e. insulin dependent diabetes then risk to offspring is very little.

So based on detail data of diabetes patient & his family history, we may be able to tell them about the risk of diabetes to their children.

SYMPTOMS OF DIABETES

The classical symptoms of diabetes are excess thirst, excess urination, weight loss inspite of good eating, weakness, fatigue, leg pain, easy fatigability, decreased vision, recurrent itching deposition of whitish deposits & fissuring on glans pennis & foreskin in men, itching in & around vulva, difficulty in healing of wound so that wound may not heal for long time. Sometimes patient may have sugar for long time without their knowledge & they manifest directly with various complications of diabetes. Thus patient may directly present with complications of diabetes as burning & numbness in feet (nerve involvement), chest pain or breathlessness (heart involvement), decreased vision (eye involvement), selling over feet or body (kidney involvement) etc.

Remember many patients with Diabetes are asymptomatic i.e. they have no symptoms & they are diagnosed only when they go for routine blood sugar test during routine investigations for some other problem, then it was found that their blood sugar is high. Sometimes patient’s blood sugar may become too high leading to coma (Diabetic ketoacidotic coma due to high blood ketone, Ketone is an acid which is produced when blood sugar becomes very high due to severe insulin deficiency.

WHY DIABETES OCCURS (CAUSES)

Diabetes in adult is known as type 2 Diabetes, maturity onset diabetes or non insulin dependent diabetes. This usually occurs after the age of 30 year. This type of diabetes occurs due to decreased secretion of insulin as well as decreased effect of insulin (already less produced) in body i.e. insulin resistance. Thus diabetes in adults occurs due to twin defect namely insufficient insulin production in the body as well as what ever insulin is being produced works less meaning insulin is less effective in lowering the blood sugar (i.e. less ineffective also known as insulin resistance).

This less insulin production & less insulin effectiveness may be due to following causes: 
1) Hereditary factors: There are two type of inherited defect in gene of the persons with diabetes as: 
      a) First one is defect in genes of insulin producing cells so that their insulin producing beta cell (in pancreatic gland) is not able to secrete enough insulin so that less insulin is produced i.e. insulin deficiency. 
      b) The second hereditary defect, there is inherited defect in insulin molecule or its working mechanism so that what ever insulin is being produced is not very effective in lowering the blood sugar level because either insulin itself is defective or their body organs are inherently resistant to secreted insulin action i.e. insulin resistance.
Thus glucose reaching in blood from intestine is not utilized by body & sugar concentration in blood keeps on increasing to higher than normal resulting in diabetes. The above mechanism is the cause of diabetes in vast majority of patients.
2) Many drugs as steroids, growth hormone, diuretics taken for longer times leads to decreased insulin secretion & makes insulin less effective causing drug induced diabetes.
3) Many toxins as insecticides found in many food items may damage insulin secreting glands.
4) Many hormone disorders, as excess of Cortisol hormone, growth hormone, hyper aldosteronism etc decreases insulin secretion & lead to diabetes.
5) Chronic alcohol use may lead to pancreatic damage leading to insulin deficiency & diabetes.
6) Diabetes during pregnancy occurs due to release of certain hormone during pregnancy which decreases the effect of insulin secreted from pancreas leading to diabetes. The diabetes which develops during pregnancy is called Gestational Diabetes.
7) Latent Diabetes
8) Borderline diabetes
9) Impaired Fasting Glucose
10) Impaired Glucose Tolerance

There are following types of diabetes in children: 
1) Type I (i.e. Insulin dependent diabetes mellitus): Type I diabetes is also known as Insulin dependent Diabetes. It occurs at young age often below 25 yr. of age due to destruction of insulin forming beta cells in pancreas by a particular type of viral infection. These viruses infect the pancreas & then damaging insulin forming beta cells leading to total deficiency of insulin hormone so that blood sugar rises. Such children are dependent on insulin injection for their survival. If they miss insulin injection for few days then their blood sugar level reaches very high & they may go in coma. Some times ketones appear in blood & urine (called as diabetic keto-acidosis). This may be sometimes life threatening also.
2.) Type II i.e. Non Insulin Diabetes of young (NIDDY): This usually occurs in obese children with positive family history. In such children diabetes is initially controlled on tablets, later insulin may be required by some.
3.) MRDM (Malnutrition related Diabetes
4) Fibrocalcific Pancreatic Diabetes (FCPD)
5) Drug induced: steroid induced
6) Auto-antibody induced.
7) Secondary diabetes
In Children after investigating the type of Diabetes appropriate treatment should be prescribed.