Children's diabetes, its causes and features have long attracted the attention of the scientific community. In recent years, the frequency of such cases has increased compared to previously established. Childrenās name is the first type of diabetic disease. If he appears in his teens, this is called a juvenile event.
Relevance of the issue
In total, there are more than 150 million people in the world of victims of both types of diabetes. In our country, the official number of patients is about 2.5 million, and this is only among the adult population. About the same number of people suffer from a pre-diabetes condition. In reality, there are many more purely ill people. The incidence of diabetes among minors is increasing. For 100 thousand children, previously, there were approximately 0.7 patients, today the frequency has increased to 7.2.
Diabetes affecting people of different age groups is a disease caused by malfunctioning of the endocrine system. In the case of type 1 diabetes mellitus or in the second type of disease, in different age groups, in a word, under any conditions, a disease is a condition in which glucose levels increase in the circulatory system. The state of hyperglycemia may appear due to a genetic predisposition, concomitant diseases, and external factors. In diabetes, lipid metabolism is disrupted, the processes of metabolism of carbohydrates and proteins are disrupted. This disease adversely affects the performance of the liver, kidneys, heart, and vascular system.
Children's: features
Juvenile type 1 diabetes mellitus is called juvenile, because most often an insulin-dependent type of disease is detected in people younger than 30 years of age. In most cases, the diagnosis is made in childhood or adolescence. Such a disease is explained by hereditary factors and the influence of the external environment. The root cause is a decrease in the generation of the pancreas, a hormone necessary for the life of the body - insulin. Perhaps a complete cessation of the processes of insulin production. The reason for this is the death of Langerhans cells. Cell death can be triggered by the invasion of a viral agent, the presence of toxic antigens in the diet. Particular risks are associated with the production of nitrosoamine from the external environment. Stress can play a role.
Can a child get sick?
To assess the risks of developing diabetes in childhood, it is necessary to analyze the characteristics of the condition. According to doctors, the greatest risk is getting sick if there are diabetics among close relatives. The probability inherent in such a case is not yet known exactly - different figures cite different figures. Some observations show that insulin-dependent diabetic disease is inherited from the mother with a probability of 3-7%, from the father - with a risk of about one tenth. If both parents are sick, the risk of developing diabetes in a child reaches 70%.
If blood relatives are sick with diabetes, one must take into account the child's belonging to a risk class that forces close monitoring of the condition. It is necessary to monitor the health of the baby, conduct preventive procedures, preventable infectious diseases, monitor nutrition. A very important factor is the observance of a healthy lifestyle, including adequate physical activity and diet.
About risks and reasons
Doctors, identifying the causes of childhood diabetes, determined the dependence of the risk of developing the disease on a personās weight. However, this is important not only for children, but also for adults. On average, 90% of diabetics with a second type of disease are overweight. It is believed that severe obesity indicates an approaching 100% risk of getting sick. Every ten extra pounds increases the risk of a diabetic disease and the occurrence of other pathologies by 10 times.
An equally significant cause of childhood diabetes is infection with a variety of viruses. There is a higher risk of getting sick if the child has rubella, has smallpox, and has contracted hepatitis. To some extent, the likelihood of developing diabetes increases even because of the familiar and seemingly fairly safe flu. Infections are the starting mechanism that triggers autoimmune reactions. If immunological abnormalities occur, infection leads to a severe outcome. Of particular difficulty is the fact that it is very difficult to detect immunological abnormalities in a child on time, so it is problematic to assess the risks inherent in a particular case in advance. In most modern children, the flu does not provoke diabetes, but if there is excess weight, if close relatives suffer from a diabetic disease, then the probability of getting sick is very high.
Diseases and their consequences
The causes of childhood diabetes include pathologies that affect the endocrine gland. All such diseases adversely affect the state of beta cells. In particular, pancreatitis, that is, a pathological condition in which an inflammatory focus appears in the pancreas, is very dangerous. Children's age does not protect against the risk of oncology, which can also be localized in the pancreas. You can get injured due to which beta cells lose their ability to work. There is a danger of poisoning the body (chemical compounds, drugs). More often, such diseases haunt people of an older age group, but no one is protected from dangers, especially if there are favorable factors.
Juvenile and childhood diabetes in a girl can occur with polycystic ovary. Risk factors include puberty and a negative genetic predisposition. The lower the childās physical activity, the greater the risk of getting sick. Additional deterioration due to excess weight.
Metabolic syndrome
This term has recently been used by doctors, but it is of particular concern in terms of juvenile, childhood diabetes. The syndrome is a personās condition in which overweight is combined with insulin resistance. This condition occurs when the hormone content in the body is normal, but the tissues consume less sugar from the circulatory system. Insufficient glucose utilization provokes the activity of pancreatic beta cells, which causes new insulin portions to be released, and a state of hyperinsulinemia. Often the situation is exacerbated by high blood pressure, dyslipidemia. The last term conceals a condition in which the circulatory system deviates from the norm, the fat content increases.
Studies by American doctors have shown that metabolic syndrome in type 1 diabetes is present in 4.2% of all adolescents. More often this condition is detected in males. Impairment of glucose susceptibility with excess weight was detected in 21% of the studied adolescents. In our country, no similar studies were conducted to assess the frequency of the phenomenon, but a registry of patients was kept in the capital region. From the data of this registry it is known that in 1994 the first type of diabetic disease occurred in 11.7 out of 100,000 children, a year later the figure increased to 12.1.
Recognition difficulty
One of the main problems of the disease is the difficulty in identifying symptoms of childhood diabetes. Manifestations are diverse, non-specific, often lead to a false diagnosis of other pathologies. If the disease appears in a very young child, the hidden stage is short-lived, parents only notice the activation of drinking and the frequency of urination, including nightly. Some have urinary incontinence. A sharp change in appetite can occur - some lose it, others are constantly hungry. The child loses weight, is lethargic, does not play, refuses to walk. Symptoms are nonspecific, often doctors and parents do not notice them, and there are no vivid manifestations. At some early stages of a diabetic disease, skin disorders (eczema, fungus, boils) appear. There is a high risk of periodontal disease.
If in time the symptoms of childhood diabetes did not attract attention, it was not possible to identify the pathology, at some point the patient's condition will sharply become worse. Then ketoacidosis will be observed, the patient will be thirsty, the skin and mucous membranes will become dry. If the child is old enough to describe his condition, he complains of headache, weakness in the body, drowsiness. The child may vomit, feel sick, the harder ketoacidosis, the more often the breath. Inhalations become deep, noisy. If you sniff, you can smell the acetone coming from the patientās body. The child may lose consciousness, there is a chance of falling into a coma. Without emergency qualified assistance, there is a risk of death.
Symptoms and features
The first and second types of diabetic disease in minors manifest themselves in different ways. In the case of the first type, overweight is rare, but in the second case, an average of 85% of patients are observed. A sign of childhood diabetes of the first type is considered to be a rapid increase in symptoms, not characteristic of the second type of disease. In the insulin-dependent form, ketoacidosis is observed in a large number of patients, and in the second variant of the course, on average, every third has ketonuria and ketoacidosis in the mild course. In individuals with the first type of disease, a burdened genetic background is observed in 5% of the first or second line of relatives; in the case of the second type, burdening is observed in 74-100% of patients.
With the first type of disease, cases of immune pathologies are not uncommon. In the second case, insulin resistance, high blood pressure, ovarian polycystosis, dyslipidemia are observed.
In adolescence, with the second type of diabetic disease, the clinical picture gradually worsens, but this progress is rather slow. Typically, the first signs are polydipsia, polyuria, urinary incontinence at night, foci of itching of the skin, genitals. The child quickly and often gets tired.
How to find?
In the case of type 1 childhood diabetes, the prognosis for life is directly determined by how quickly the diagnosis was made. If no one notices the disease, ketoacidosis occurs, the condition worsens sharply, but the patient does not receive help, the prognosis is extremely unfavorable. If the disease has been identified and determined, control measures have been developed, the patient has been trained for them and the importance of following the recommendations has been explained, it will be possible to maintain the body in good condition. Of course, this is quite inconvenient for the child himself, imposes certain restrictions on everyday life, but does not lead to dangerous consequences.
To determine the disease in time, you need to check the presence of sugars in the circulatory system. This method is the most effective - if necessary, you can evaluate whether glucose tolerance is impaired, whether there is a diabetic disease. The normal concentration of sugars on an empty stomach for a person is about 3.5-5.5 units. If the study of urine taken in the morning shows the content of sugar, acetone, ketone bodies, if there is an excess of blood sugar, it is necessary to contact a qualified specialist for testing. The analysis is called a glucose tolerance test.
Test Features
Screening for childhood diabetes requires proper preparation. For three days, the child is prescribed a normal diet, without restricting the intake of carbohydrates in the body. Sample material is taken in the morning, on an empty stomach. The child is given sugar syrup, then blood sugar is checked: one hour and two hours after taking the liquid. If the state of health is good, after an hour, the indicators increase to 8.8 units, but not more. After two hours, the maximum is another one less. For many, two hours after drinking, the concentration of sugar in the blood returns to its original level.
If glucose is fixed in an amount of 15 or more units in whole blood or in a sample from a vein, a glucose tolerance test is not needed - only an initial study is sufficient to confirm the diagnosis. In the case of overweight and burdened by heredity, manifestations of insulin resistance, it is necessary to check the concentration of sugars in the circulatory system twice a year. This systematic practice begins at the age of 10. It is important to regularly show the child to an endocrinologist, specialists in the kidneys, an ophthalmologist, as well as an orthopedist, a neurologist.
Features and Diagnostics
In some cases, additional studies are required to confirm childhood diabetes. Sometimes a check of the content of glycated hemoglobin is indicated. In some cases, a fairly accurate idea of āāthe condition can be obtained by detecting the level of C-peptide or proinsulin, glucagon. The child can be referred for ultrasound or fundus examination. In some cases, microalbuminuria is studied. The need for such studies is determined by highly specialized doctors.
If parents have diabetes, they should check the childās genetics. This will allow you to timely assess the risks inherent in a particular case and establish the disease, if it is still secretive.
What to do?
There are several strategies for treating childhood diabetes. It is necessary to eliminate the manifestations of the disease, take control of the metabolic processes in the body, and prevent the occurrence of complications. The main idea of āāthe therapeutic course is to achieve a high standard of living for the patient. Do not count on a complete cure. At the moment, diabetes is one of the chronic pathologies that can be controlled, but which cannot be completely eliminated.
As part of the treatment of childhood diabetes, they choose the right diet and teach the child to independently control their blood sugar. Dosed physical activity is indicated. Special diabetes schools operate in which children are taught basic rules of behavior, and parents are told how to monitor the child so that it is safe. Currently, there are quite a few such schools, but they are mainly located in large cities. In the capital, the first such institution appeared in 1989. Those in need go through an initial educational course, in a year or two - a repeated one, which allows them to consolidate the material.
No drugs
All methods of combating childhood diabetes are divided into medications and drugs that are not included. The classic representative of the latter is diet food. It is necessary to exclude from the diet carbohydrates that are easily absorbed by the body. They are found in abundance in jam, chocolate, sugar and honey are prohibited. If possible, reduce the amount of foods containing saturated fats. Calories received by the body, only half should be provided with carbohydrates in food. Proteins normally account for about 15%, fats - up to 35%. Children under the age of one year develop a diet based on whether the child eats natural milk, receives artificial nutrition or mixed. The best option is to preserve natural nutrition until one and a half years of age.
To correct childhood diabetes, it is necessary to reduce the weight of the patient. It is important to convey to the child the importance of self-monitoring of glucose in the body. It is recommended at home to teach the patient how to use strips to evaluate sugar in urine and blood. If a child has been sick for more than five years, it is important to introduce a constant pressure test into everyday life. They regularly take urine and blood tests, and visit the doctorās office, checking blood vessels. It is important to visit your optometrist regularly to notice retinopathy on time. A dentist and ENT doctor should be visited twice a year.
About drugs
In the case of the first type of diabetic disease, you must first introduce proper nutrition, balance physical activity. They resort to medicines if non-drug approaches do not give an effect. In childhood, medications are not prescribed, if possible. In the second type of disease, it is necessary to take drugs that reduce the concentration of sugar in the body. Usually prescribed tablets. Addiction to them, as shown by observations of adult patients, is observed approximately 10-15 years after the start of admission. After this, it is necessary to switch to synthetic insulin for injective administration.
Features of childhood illness
As observations show, in most children with the first type of diabetic disease, after clarifying the diagnosis and selecting the appropriate treatment, regression is observed. This usually takes from a couple of weeks to twice as much time, less often - several months. The need for insulin increases over time. Puberty is accompanied by a restructuring of the internal secretory systems, a change in hormonal levels. Usually during this period, diabetes is labile. It is necessary to very carefully monitor the patient's condition. Then the course of the disease stabilizes again.