Diabetes mellitus refers to the pathology of the endocrine system associated with a violation of the secretory function of the pancreas. As a result, insulin production is disrupted. This is a fairly serious disease that is difficult to treat.
Diabetes mellitus in children can be type 1 and 2, based on which, appropriate treatment is selected, as well as a diet. It is very important for parents to know what factors can affect the development of the disease, how it manifests itself and is diagnosed.
What is a disease?
Diabetes mellitus in children ranks second among all chronic diseases. Its causes are hidden in the violation of carbohydrate metabolism. To understand the factors that provoke the formation of diabetes, you need to understand what exactly is a disease. Sugar entering the body is broken down to a state of glucose, which acts as the energy base required for the normal existence of a person. Insulin is required for its absorption.
This hormone is produced by pancreatic cells, and if for some reason a violation of this function occurs, then glucose remains in its original state.
Types and Forms
Depending on the cause of diabetes in children, it is classified according to type and form. First of all, the disease is divided into type 1 and 2. It is very important to understand why they arise, what signs and treatment of each species are.
Diabetes mellitus in type 1 children is based on impaired functioning of the immune system, when pancreatic cells begin to be perceived as hostile and destroyed by their own immunity. This form of the disease is often diagnosed and is provoked by a genetic predisposition, as well as exposure to external factors. These include:
- infectious diseases;
- malnutrition;
- stressful situations;
- accumulation of toxic substances.
If the child was born with diabetes, then the development of the disease and impaired insulin production requires exposure to one or several external factors. In the latent stage, immune cells very slowly destroy insulin-producing tissues. In the morning, the child’s sugar remains within the normal range, and after eating food his jumps are observed. At this stage, the pancreas can still cope with the load, but when 85% of the cells die, the disease goes into the active stage.
Often this leads to the fact that children are hospitalized with a diagnosis of "ketoacidosis" or "ketoacidotic coma." This condition is characterized by the fact that the glucose level is significantly higher than normal. It is simply impossible to completely cure autoimmune diabetes, however, the correct observance of the doctor’s prescriptions will avoid crises and premature destruction of the vascular system. A sick child should take insulin throughout his life.
For a long time, type 2 diabetes was considered a disease of the elderly, but adolescents began to suffer more and more from it. The essence of the disease is that the pancreas produces enough insulin, but not all of it is perceived by the body. Most often, it occurs during puberty, since during this period hormones begin to inhibit the susceptibility of tissues to insulin. Among the main causes of the disease can be identified such as:
- overweight and obesity;
- sedentary lifestyle;
- taking hormonal drugs;
- endocrine system diseases.
The risk of developing diabetes with a hereditary predisposition is particularly increased. The course of the disease of this type is mainly asymptomatic and there are no special changes in the analyzes. Treatment of diabetes in children is based on diet and the use of medications that reduce blood sugar and regulate the course of concomitant diseases.
MODY diabetes is mainly found in children under 10 years old. The main reason for its occurrence is cell damage at the genetic level. Basically, this disease has an uncomplicated course, initially the child does without additional insulin.
Neonatal diabetes is detected mainly in children under 6 months of age, is very rare and has a hereditary nature.
Causes of occurrence
Diabetes mellitus is a chronic disease that is very difficult to treat. There are several reasons for its development, among which it is necessary to highlight:
- genetic predisposition;
- frequent colds;
- binge eating;
- overweight;
- sedentary lifestyle.
The occurrence of diabetes in children can be laid down at the genetic level, since parents with this disease already have a sick child. In this case, the disease can occur immediately or after a few years. It is very dangerous to increase blood glucose in a woman during pregnancy. It is worth noting that it passes very well through the placenta and enters the bloodstream of the baby, and since the fetus needs are minimal during this period, its excess accumulates in the subcutaneous fat. In this case, children are born with a lot of weight.
The consumption of large amounts of easily digestible carbohydrates in food leads to a large load on the baby's cells that produce insulin. As a result, they very quickly deplete their reserves and cease to function normally, which leads to a sharp decrease in blood insulin.
When a large amount of sugar enters the body, its excess is not excreted, but is deposited in the form of fats. The molecules of fat receptors responsible for the processing of glucose are made immune. As a result of this, even with a sufficient amount of insulin, the amount of sugar in the blood does not decrease.
A low lifestyle leads to weight gain, which can lead to diabetes. With frequent colds, the immune system constantly produces antibodies aimed at combating viruses and bacteria. As a result of this, he can begin to attack his own cells, in particular those that produce insulin. This leads to damage to the pancreas and a decrease in its amount.
The main symptoms
In general, diabetes in children develops in preschool or adolescence, when physiological growth leaps occur in a child. Since the body needs a lot of energy, then at this stage there are clinical symptoms. Among the main signs of diabetes in children can be identified such as:
- sharp weight loss;
- constant thirst;
- frequent urination
- frequent hunger;
- dry skin, the appearance of a rash and pustules;
- sweating, red plaque on the tongue;
- headache, impaired consciousness.
The child begins to drink a lot of liquid, even in the cold season, and even gets up at night to quench his thirst. When you consume a large amount of liquid, a lot of urine begins to be released, since an excess of sugar is excreted with it. In addition, bedwetting is often observed.
Among the main signs of diabetes in children, a sharp decrease in body weight should be highlighted, since glucose acts as the main source of energy. With the course of the disease, the amount of glucose entering the cells decreases, which means that their nutrition is significantly deteriorated. Since the baby has a reduced amount of energy, he becomes lethargic, weak and quickly tired.
Diagnostics
If you suspect a disease, it is necessary to conduct a comprehensive diagnosis of diabetes in children, which includes:
- examination by a doctor;
- blood and urine tests for sugar;
- glucose tolerance test;
- biochemical blood control.
It is necessary to undergo examination by a dermatologist, pediatrician, gastroenterologist, optometrist, endocrinologist. Tests and tests help determine the level of glucose in the blood and identify possible abnormalities. Ultrasound of the internal organs may be required.
Comprehensive diagnostics will make it possible to make a correct diagnosis and prescribe timely comprehensive treatment, which includes a special diet, physical exercises, and if necessary, insulin therapy is prescribed. A timely diagnosis will help to avoid a coma and the death of a child.
Treatment features
The treatment of diabetes in children largely depends on its type. Adequate therapy is prescribed by an endocrinologist. Diabetes treatment implies adherence to principles such as:
- hygiene of the mucous membrane and skin;
- playing sports;
- diet therapy;
- psychological support.
For the treatment of type 1 diabetes in children, replacement therapy is often used. Since pancreatic cells do not produce enough insulin, you need to replenish its amount in the blood. In this case, it is necessary to take into account the peculiarity of glucose production in accordance with food intake, since if the body uses up all sugar reserves, this will lead to energy starvation.
That is why, in addition to the use of medications, it is necessary to organize the proper nutrition of the child, since fasting is completely unacceptable. Snacks should also be taken between main meals.
Mandatory is the daily monitoring of blood glucose using special glucometers. You need to keep a special diary, which displays the consumed food for the day, stressful situations, as they lead to an increase in glucose levels. This will allow the doctor to choose the right treatment.
Another treatment for type 1 diabetes is transplantation of the pancreas, as this will allow you to normalize your health and get rid of the need for lifelong administration of insulin.
With type 2 diabetes, it is necessary to conduct therapy for the underlying disease. This will eliminate the main symptoms of the disease. Children with type 2 diabetes should follow a diet. In this case, the child has insulin in the body, but you need to make sure that there are no sudden jumps in glucose.
It is important to completely eliminate easily digestible carbohydrates from the diet and limit the intake of all other types. In addition, the use of sugar-lowering drugs, in particular, such as Amaril, Maninil, Diabeton, is required. Medicines are needed to support the liver, in particular, such as Essential Forte N, as well as linseed oil, which is a source of fatty acids.
To normalize blood microcirculation, the use of drugs such as Trental and Vazinit is indicated. Vitamin complexes are also required. To nourish the eyes, Taurine is prescribed. This amino acid has a hypoglycemic effect, and also helps to nourish the retina. Children with diabetes cannot give up their usual lifestyle, which is why parents should motivate them with their own example.
Insulin use
The treatment of diabetes largely depends on what stage it was diagnosed with. If the child is in a state of coma or ketoacidosis, then the therapy is carried out in a hospital setting where droppers are placed with solutions that help to remove toxins from the body, restore the chemical composition of the blood, and the required dosage of insulin is selected. For recovery, the use of droppers with glucose and insulin is indicated.
Be sure to follow a diet with diabetes in children of type 1, since the dosage of insulin largely depends on nutrition. The endocrinologist makes a special menu, taking into account the age, weight, severity of the course of the disease.
Since treatment is carried out with the help of insulin, it is worth considering that it is of 2 types, namely, bolus or basal. Short-acting insulin can be attributed to such as "Humulin Regulator" or "Humalog". In addition, Russian-made products can be used. Bolus insulin begins to act almost immediately, and the maximum period of action is approximately 4-8 hours. It is intended for the rapid absorption of carbohydrates that enter the body with food.
Long-acting insulin becomes active 30 minutes after the injection and lasts for 20-30 hours. The basic funds include Ultratard-NM, Humulin-NPH, Insuman Bazal, and VO-S.
The child needs to be taught how to properly use and store insulin. It is important that he is aware of all responsibility for his health and understands the need for injections, as human life depends on this.
If the amount of insulin is incorrectly calculated, then a state of hypoglycemia may develop. Sugar reduction is not only due to improperly calculated dosage. Food intake with a small amount of carbohydrates and excessive physical activity can contribute to this.
Calculation of bread units
Be sure to follow certain recommendations for children with diabetes, as this will extend the life and improve its quality. In Europe, almost every product indicates the content of bread units. This helps those with diabetes to choose their own food without any problems.
You can independently calculate the bread units. All foods have carbohydrates. This amount must be divided by 12 and multiplied by the weight indicated on the package. Diet for diabetes in children implies a restriction of carbohydrate intake, since any errors can provoke a deterioration in well-being.
Blood glucose control
A diabetic child needs constant monitoring of blood sugar. For this, you can use a special device - a glucometer. Now there are many different options for such a product, so you can choose it based on your needs. Since this device is used quite often, it must necessarily be of high quality and reliable.
When a child is small, the glucometer is used by parents to measure glucose levels, and when he grows up, he can use the device on his own, so the design should be as simple as possible. Very convenient device with special test strips. However, the expiration date must be monitored. Expired strips may cause errors that can be dangerous for a diabetic child.
Possible complications
Complications of diabetes can be acute and late. Acute disorders can occur in any period of the disease and require immediate assistance. Among them are:
- hyperglycemic coma;
- hypoglycemic coma;
- effect on internal organs.
Hyperglycemic coma is based on a lack of insulin. It develops gradually and at the same time drowsiness, weakness is observed, thirst and urination intensify. In addition, there may be abdominal pain, nausea and vomiting. In this case, you must immediately call an ambulance.
Hypoglycemic coma occurs with an overdose of insulin. It proceeds sharply, since the skin immediately becomes wet, the child is overexcited, his pupils dilate, his appetite increases. In this case, you need to feed him or introduce an intravenous glucose solution. Very often, children with diabetes are disabled, as they have a malfunction of many internal organs. Among the late complications of the disease, it is necessary to highlight:
- ophthalmopathy;
- nephropathy;
- arthropathy;
- neuropathy
- encephalopathy.
In diabetes mellitus, pathological damage to the organs of vision is observed. This manifests itself in the form of damage to the optic nerves or a decrease in visual acuity. Joint damage also occurs, which is characterized by severe pain and limitation of their mobility.
Encephalopathy leads to a change in the psyche and mood of the child, which is expressed in a quick change of mood, imbalance and the onset of depression. In addition, kidney and nervous system damage may be observed. Complications are very dangerous, which is why you need to regularly treat, follow a diet, and also monitor blood sugar.
Disease prevention
While there is no effective prevention of diabetes in children, however, to prevent the occurrence of the disease in a child with a genetic predisposition, you need to follow a low-carb diet. In addition, you need to avoid stress, conduct hardening, apply vitamin complexes.
It is important to conduct a preventive examination in a timely manner in order to notice possible violations in a timely manner.