During a summer camp in Daisen, Tottori Prefecture, children screamed with excitement as they ran toward incoming waves at a beach. They were no different from other kids enjoying themselves except that they had diabetes.
Type 1 diabetes, previously known as juvenile diabetes because it often develops during childhood and adolescence, requires that patients monitor their blood glucose and self-administer insulin to keep it at a proper level.
Child patients are no exception in that they must thoroughly understand the disease but will not have to limit their physical activities as long as they can carry out self-management.
In Japan, somewhere between one and two of every 100,000 children are said to develop Type 1, in which the body does not produce insulin. More common is Type 2, in which insulin is produced but the body does not respond normally.
The Daisen camp, organized by a patients’ group that is part of a diabetes association in adjacent Shimane Prefecture, is intended to teach children with diabetes how to manage their condition without the assistance of their parents.
Similar events have been held across Japan by hospitals and patients’ associations.
The Daisen camp started in 1974. This year’s camp, the 45th held, ran for eight days and involved 27 participants.
Every day, participants checked their blood sugar as usual and received insulin injections. Since the children use a variety of medicines and insulin pens, many learned that different options were available to treat their condition.
The camp also held classes on various topics related to the disease, from the correct way to inject insulin to how to deal with low blood sugar. The children also received urine, eye and dental checkups as they learned about the medical complications Type 1 diabetes can cause.
But the camp was not just about learning. It also included athletics contests and recreational activities ranging from mountain climbing to ocean swimming.
Not all of the children were used to self-management, but there was plenty of medical support: This year’s camp attracted 59 doctors, 38 dieticians and cooks as well as 30 nurses and pharmacists. A total of 55 student volunteers from universities and elsewhere intent on careers in medicine also helped out.
“In the past, it was normal that diabetic children were not allowed to go on school excursions. More people now understand the disease, but nothing has changed about the fact that children have to take care of themselves without the help of others,” said Akira Takeda, a former adviser at Tottori Prefectural Central Hospital. “We want the children to know that, and that is why we have continued this event.”
Nearly 400 people have attended the event over the years, and some participants and their parents stay in touch even after it is over, providing an occasion to create friendships that may last a lifetime. It is also customary for participants to return to the event as assistants once they become university students.
Another key part of the program is nutritional guidance.
This year, by looking at a meal planning guide explaining about nutritional balance and calories for certain foods, children were asked to decide what they wanted to eat for dinner on the day of an athletics contest. Knowing how one’s blood sugar will change when certain foods are consumed is important for managing diabetes.
The children seem to be hungry for knowledge, even though what they are taught seems to include technical, rather than practical, content.
A 12-year-old junior high school student participating in the program for the third time said he had learned new things from each camp.
“The first time was tough, but fun. I was also able to do things I cannot usually do, such as mountain climbing,” he said, adding he signed up the second time not because of peer pressure, but because he wanted to learn more about nutrition.
The camp also enables trained medical staff to learn more about children with diabetes, said Kazuyoshi Murao, a doctor specializing in the disease at Tottori Prefectural Central Hospital.
Murao attends the camp every summer.
“(Ordinary medical staffers) hardly ever get a chance to spend a whole day together with children living with diabetes. The camp allows us to learn things we won’t notice if we just carry out medical examinations, such as what they usually have on their minds or their way of living,” he said.