Box 3:  Definitions used in this section

Long-term conditions – chronic diseases for which there is currently no cure, and which are managed with drugs or other treatment

Asthma – a condition of the lungs characterised by coughing, wheezing, chest tightness and breathlessness

Diabetes mellitus – the most common form of diabetes, caused by a relative deficiency of the hormone insulin causing a high level of sugar to be found in the blood and urine. Throughout this chapter, the use of the term ‘diabetes’ relates to diabetes mellitus

Epilepsy – a condition that affects the brain and causes repeated seizures (fits)

Asthma and respiratory conditions

A family history of atopy (allergic diseases such as asthma and eczema) is a strong individual risk factor for developing asthma, as is the presence of other atopic conditions in the child themselves. Boys are more likely to develop prepubertal asthma, but girls with prepubertal asthma are more likely to continue to have asthma in adolescence. 6

Smoking during pregnancy increases the risk of asthma in children; second-hand smoke can also trigger asthma attacks in those with the condition. 7

Epilepsy

Risk of epilepsy is higher in those with a family history of the condition. Epilepsy can also be caused by damage to the brain from injury, infections and other diseases (such as a stroke), substance misuse and problems with oxygen deprivation at birth. 8 Children with learning difficulties are also at increased risk (see the forthcoming report, ‘Health and wellbeing needs of adults with learning disability in the City and Hackney’).

Diabetes

The majority (95%) of diabetes affecting 5-19 year olds is type 1 diabetes (an autoimmune condition), but most diabetes affecting the adult population is type 2 (or lifestyle-related). However, the prevalence of type 2 diabetes in children is increasing, linked to rising levels of childhood obesity. 9

Risk of type 1 diabetes has a strong genetic component, with no specific behavioural/environmental risk factors identified. Risk of type 2 diabetes also has a strong genetic component, with other risk factors including low birthweight, poor early childhood nutrition, poor diet, excess body weight, smoking and low physical activity. South Asian populations are at higher risk of diabetes. 10

References

  1. British Thoracic Society, Scottish Intercollegiate Guidelines Network, “British guideline on the management of asthma: A national clinical guideline,” 2016.
  2. British Thoracic Society, Scottish Intercollegiate Guidelines Network, “British guideline on the management of asthma: A national clinical guideline,” 2016.
  3. National Clinical Guideline Centre, “The Epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care,” 2012.
  4. “More than 500 children and young people have Type 2 diabetes,” Diabetes UK, 15 June 2016. [Online]. Available: https://www.diabetes.org.uk/About_us/News/-More-than-500-children-and-young-people-have-Type-2-diabetes/. [Accessed August 2016].
  5. World Health Organisation, “Global Report on Diabetes,” 2016.
  6. British Thoracic Society, Scottish Intercollegiate Guidelines Network, “British guideline on the management of asthma: A national clinical guideline,” 2016.
  7. British Thoracic Society, Scottish Intercollegiate Guidelines Network, “British guideline on the management of asthma: A national clinical guideline,” 2016.
  8. National Clinical Guideline Centre, “The Epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care,” 2012.
  9. “More than 500 children and young people have Type 2 diabetes,” Diabetes UK, 15 June 2016. [Online]. Available: https://www.diabetes.org.uk/About_us/News/-More-than-500-children-and-young-people-have-Type-2-diabetes/. [Accessed August 2016].
  10. World Health Organisation, “Global Report on Diabetes,” 2016.