Diabetes mellitus refers to the pathology of the endocrine system associated with a violation of the secretory function of the pancreas. As a result, the production of insulin is disrupted. This is a rather serious disease that is difficult to treat.
Diabetes mellitus in children can be types 1 and 2, based on which the 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 is manifested and diagnosed.
What is disease
Diabetes mellitus in children ranks second among all chronic diseases. The reasons for it 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 the disease. Sugar entering the body is broken down to the state of glucose, which acts as an energy base required for the normal existence of a person. It requires insulin to be absorbed.
This hormone is producedpancreatic cells, and if for some reason there is a violation of this function, 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 types 1 and 2. It is very important to understand why they occur, what are the signs and treatment of each type.
At the heart of type 1 diabetes in children is a dysfunction of the immune system, when the cells of the pancreas begin to be perceived as hostile and destroyed by their own immunity. This form of the disease is diagnosed quite often and is provoked by a genetic predisposition, as well as exposure to external factors. These include:
- infectious diseases;
- malnutrition;
- stress situations;
- accumulation of toxic substances.
If a child was born with diabetes mellitus, then the development of the disease and disruption of insulin production requires exposure to one or more 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, its jumps are observed. At this stage, the pancreas can still cope with the load, but when 85% of the cells die, the disease enters the active stage.
Often this leads to the fact that children are admitted to the hospital with a diagnosis of ketoacidosis or ketoacidosis.coma . This condition is characterized by the fact that the glucose level significantly exceeds the norm. It is simply impossible to completely cure autoimmune diabetes, however, proper observance of the doctor's prescriptions will help to avoid crises and premature destruction of the vascular system. A sick child must take insulin throughout his life.
For a long time, type 2 diabetes was considered a disease of the elderly, but teenagers are increasingly suffering from it. The essence of the disease lies in the fact that the pancreas produces insulin in sufficient quantities, but not all of it is perceived by the body. Most often, it occurs during puberty, since during this period hormones begin to inhibit tissue susceptibility to insulin. Among the main causes of the disease can be identified such as:
- overweight and obese;
- sedentary lifestyle;
- taking hormonal drugs;
- diseases of the endocrine system.
The risk of developing diabetes is especially increased with hereditary predisposition. The course of this type of disease is mostly asymptomatic and no special changes in the analyzes are observed. Treatment of diabetes mellitus in children is based on diet and the use of medications that lower blood sugar levels, as well as regulate the course of concomitant diseases.
MODY diabetes is mainly found in children under 10 years of age. The main reason for its occurrence is damage to cells at the genetic level. Mostlythis disease has an uncomplicated course, initially the child does without additional administration of insulin.
Neonatal diabetes occurs mainly in children under 6 months of age, is very rare and is hereditary.
Causes of occurrence
Diabetes 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;
- overeating;
- excessive weight;
- sedentary lifestyle.
The occurrence of diabetes mellitus 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 manifest itself immediately or after a few years. An increase in blood glucose in a woman during pregnancy is very dangerous. It is worth noting that it passes through the placenta very well and enters the baby's bloodstream, and since the needs of the fetus during this period are minimal, its excess accumulates in the subcutaneous fat. In this case, children are born with a large weight.
Eating a large amount of easily digestible carbohydrates puts a heavy strain on a child's insulin-producing cells. As a result, they deplete their reserves very quickly and stop working properly, which leads to a sharp decrease in insulin in the blood.
When a large amount of sugar enters the body, its excess is not excreted, but depositedin the form of fat. Fat molecules, the receptors responsible for processing glucose, are made immune. As a result, even with enough insulin, the amount of sugar in the blood does not decrease.
Inactive lifestyle leads to weight gain, which can lead to diabetes. With frequent colds, the immune system constantly produces antibodies aimed at fighting viruses and bacteria. As a result, it can begin to attack the body's own cells, in particular those that produce insulin. This leads to damage to the pancreas and a decrease in its quantity.
Main symptoms
Basically, diabetes mellitus in children develops in preschool or adolescence, when the child's physiological growth spurts occur. Since the body requires a lot of energy, clinical symptoms occur at this stage. Among the main signs of diabetes in children are:
- drastic weight loss;
- constant thirst;
- frequent urination;
- frequent feeling of hunger;
- dry skin, rashes and pustules;
- sweating, red coating on the tongue;
- headache, impaired consciousness.
The child begins to drink a lot of fluids, even in the cold season, and at the same time even gets up at night to quench his thirst. When a large amount of liquid is consumed, a lot of urine begins to be released, since an excess of sugar is excreted with it. In addition, bedwetting is common.
Among the main signs of diabetes in children is a sharp decrease in body weight, 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 worsens significantly. Since the baby's energy is reduced, he becomes lethargic, weak and gets tired quickly.
Diagnostics
If a disease is suspected, it is imperative to conduct a comprehensive diagnosis of diabetes mellitus in children, which includes:
- examination by a doctor;
- blood and urine tests for sugar;
- glucose tolerance test;
- biochemical blood control.
You need to be examined by a dermatologist, pediatrician, gastroenterologist, ophthalmologist, endocrinologist. Analyzes and tests help to determine the level of glucose in the blood and identify possible disorders. An ultrasound of the internal organs may be required.
Complex diagnostics will allow you to make a correct diagnosis and prescribe timely complex treatment, which includes a special diet, exercise, and, if necessary, insulin therapy is prescribed. A timely diagnosis will help to avoid a coma and death of a child.
Features of treatment
Treatment of diabetes in children largely depends on its type. Adequate therapy is prescribed by an endocrinologist. Treatment of diabetes implies adherence to such principles as:
- compliance with the hygiene of the mucous membranes and skin;
- sports;
- diet therapy;
- psychological support.
Replacement therapy is often used to treat type 1 diabetes in children. Since the cells of the pancreas produce insulin in insufficient quantities, it is necessary to replenish its amount in the blood. At the same time, 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 imperative to organize the proper nutrition of the child, since starvation is completely unacceptable. Snacks should also be taken between main meals.
Daily monitoring of blood glucose levels with the help of special glucometers is mandatory. You need to keep a special diary, which displays the food consumed per day, stressful situations, as they lead to an increase in glucose levels. This will allow the doctor to choose the right treatment.
Another type of treatment for type 1 diabetes is a pancreas transplant, as this will normalize well-being and get rid of the need for lifelong insulin.
With type 2 diabetes, it is imperative to treat the underlying disease. This will eliminate the main symptoms of the disease. Children with type 2 diabetes must follow a diet. In this case, the child in the body hasinsulin, however, you need to make sure that there are no sharp jumps in glucose.
It is important to completely eliminate easily digestible carbohydrates from the diet and limit the intake of all other types of them. In addition, the use of hypoglycemic drugs is required, in particular, such as Amaryl, Maninil, Diabeton. Liver support drugs are needed, such as Essentiale Forte N, and flaxseed 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. Taurine is prescribed to nourish the eyes. This amino acid has a hypoglycemic effect and also helps to nourish the retina. Children with diabetes cannot give up their habitual lifestyle, which is why parents should motivate them by their own example.
Using insulin
Treatment of diabetes mellitus largely depends on the stage at which it was diagnosed. If the child is in a state of coma or ketoacidosis, then the therapy is carried out in a hospital, where he is given droppers with solutions that help remove toxins from the body, restore the chemical composition of the blood, and also select the required dosage of insulin. For recovery, the use of droppers with glucose and insulin is indicated.
It is mandatory to follow a diet with diabetes mellitus in type 1 children, since the dosage of insulin largely depends on nutrition. The endocrinologist draws up a special menu, taking into account age, weight, severity of the coursedisease.
Since the treatment is carried out with insulin, it is worth considering that it can be of 2 types, namely bolus or basal. Short-acting insulin can be attributed to such as "Humulin Regulator" or "Humalog". In addition, you can use Russian-made products. Bolus insulin begins to work almost immediately, and the maximum period of action is approximately 4-8 hours. Designed to quickly assimilate carbohydrates that enter the body with food.
Long-acting insulin becomes active 30 minutes after injection and lasts for 20-30 hours. Basic funds include Ultratard-NM, Humulin-NPKh, Insuman Basal, VO-S.
Child needs to be taught how to properly use and store insulin. It is important that he is aware of the full responsibility for his he alth and understands the need for injections, since a person's life depends on it.
If the amount of insulin is incorrectly calculated, a state of hypoglycemia may develop. The decrease in sugar is not only due to an incorrectly calculated dosage. Eating low-carbohydrate foods and being physically active can contribute to this.
Calculation of bread units
Be sure to follow certain recommendations for children with diabetes, as this will prolong life and improve its quality. In Europe, the content of bread units is indicated on almost every product. This helps diabetics to easily find their own food.
You can independently calculate the bread units. All foods have a carb count. This amount must be divided by 12 and multiplied by the weight indicated on the package. The 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. To do 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 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. The device with special test strips is very convenient. However, their expiration date must be monitored. Expired strips can give errors that can be dangerous for a diabetic child.
Possible Complications
Complications of diabetes can be acute and late. Acute disorders can occur at any time during the illness and require immediate attention. Among them are:
- hyperglycemic coma;
- hypoglycemic coma;
- effect on internal organs.
Based onhyperglycemic coma is a lack of insulin. It develops gradually and at the same time there is drowsiness, weakness, increased thirst and urination. In addition, there may be abdominal pain, nausea and vomiting. In this case, you should immediately call an ambulance.
Hypoglycemic coma occurs with an overdose of insulin. It proceeds sharply, as the skin immediately becomes moist, the child is overexcited, his pupils dilate, and his appetite increases. In this case, you need to feed him or inject a glucose solution intravenously. Very often, children with diabetes are disabled, as they have impaired functioning of many internal organs. Among the late complications of the disease, it is necessary to highlight:
- ophthalmopathy;
- nephropathy;
- arthropathy;
- neuropathy;
- encephalopathy.
When diabetes is observed pathological damage to the organs of vision. 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 rapid change in mood, imbalance and depression. In addition, damage to the kidneys and nervous system can be observed. Complications are very dangerous, which is why you need to regularly treat, diet, and control blood sugar levels.
Disease prevention
So farthere 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-carbohydrate diet. In addition, you need to avoid stress, harden, use vitamin complexes.
It is important to conduct a preventive examination in a timely manner in order to notice possible violations in a timely manner.
