Wishart Medical Centre

Diabetes & Asthma Clinics

Diabetes Mellitus

Diabetes is a chronic condition characterized by increased levels of sugar in the blood. It is caused by the inability of the pancreas to produce the hormone insulin, which is responsible for maintaining normal levels of sugar in the blood, or the insensitivity of the body to the amount of insulin produced. There are two types of diabetes:

  • Type 1 diabetes: The pancreas produces little or no insulin, and diabetes develops when the body’s immune system destroys the pancreas cells. It is also called insulin-dependent diabetes or juvenile-onset diabetes as it is commonly seen in children.
  • Type 2 diabetes: The pancreas usually produces normal levels of insulin, but the body becomes resistant to the hormone. It is associated with inactivity, obesity and genetic factors. Also called adult-onset diabetes, it occurs mainly in adults, but is becoming more common in children because of the increase of childhood obesity.

The common symptoms of diabetes mellitus are increased thirst, frequent urination, extreme hunger, weight loss, fatigue, blurred vision and frequent infections. When your child is suspected of having diabetes, your doctor confirms the diagnosis through blood tests.

Effective treatment can prevent long-term damage to other organs such as the heart (cardiovascular problems), nerves, kidneys, eyes, feet and skin, which can be life-threatening. Treatment involves lifelong management of blood sugar levels with healthy eating, exercising, oral medications and insulin. In the course of treatment, your child may develop hypoglycaemia (low blood sugar) as a result of skipping a meal, excess physical activity or injecting excess insulin, or alternately, hyperglycaemia (high blood sugar) by overeating or not taking enough insulin. These complications should be managed by adjusting your child’s food and insulin intake and activity level.

As your child grows, his/her treatment plan will change. A new meal plan may be advised, and a change in medication and a different type of insulin may be prescribed. Diabetes mellitus management should be a constant collaboration between you and your child’s doctor.


Asthma is a respiratory condition in which the airways of the lungs (breathing passages) narrow and swell, often in response to an allergen. This disease affects people of all ages, but usually starts in childhood.

Air in the lungs travel through small airways called bronchial tubes. When the airways are clear, air moves in and out of the lungs easily. An asthma attack constricts the airways and interferes with the normal breathing process.

The common signs and symptoms of asthma include:

  • Frequent cough
  • Wheezing sound heard during breathing
  • Shortness of breath and coughing
  • Feeling of tightness in the chest
  • Pain in the chest

As people experience asthma attacks they learn to recognize specific triggers that contribute to these attacks and try to stay away from them. There are individual triggers for each person. Children exposed to certain triggers become highly sensitive which causes the lungs and airways to swell up and produce mucus. Some of the triggers include the common cold, weather changes, physical activity, and air pollutants such as smoke, dust mites, animal dander, and pollen.

Asthma can be difficult to diagnose. Your doctor will ask about the frequency of your symptoms and order some tests to rule out other conditions. A lung function test (spirometry) is done to measure the amount of air exhaled. Allergy skin testing may be helpful to identify allergens in people with asthma. In younger children the diagnosis is done based on the information provided about symptoms because lung function tests will be inaccurate before 6 years of age.


You must know as much as you can about asthma, its triggers, and how to recognize and avoid them. Avoiding the triggers and with the right medication, an asthmatic can have a perfectly normal life.

Treatment of asthma includes prevention of symptoms and treatment of progressive asthma attacks. Your allergist may also prescribe two main types of medications, long- term control medications and quick- relief medications. Long-term medications that can be taken every day help reduce airway inflammation and prevent the asthma symptoms. Quick-relief medications provide rapid relief from symptoms during an asthma attack.

Inhaled short- and long-term control medications are used by inhaling measured amounts of the medication through inhalation devices. The most common is the metered dose inhaler that uses a chemical propellant to carry the correct dose of medication out of the inhaler. Dry powder inhalers (DPIs) do not use propellants but need a stronger and faster inhalation. A nebulizer is a type of inhaler that delivers medications in a fine mist through mouthpieces or masks.


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