Diabetes mellitus in children

The development of diabetes in children most often occurs rapidly, so it is so important to identify the disease in time and begin its treatment. Why can babies develop diabetes mellitus, how does this pathology manifest itself and is it possible to cure such a disease?

Causes of occurrence

The exact reasons why children develop type 1 diabetes are not yet known. The baby's immune system begins to attack the pancreas, destroying the cells responsible for the production of insulin.

The appearance of this type of diabetes in a child can be triggered by an infection of a viral genesis or a significant nervous shock.

Disease development

The disease begins with damage to beta cells, which are part of the pancreas. They are destroyed by the child's immune system, which leads to disruption of their function, which is to synthesize insulin. This hormone is involved in metabolic processes and is very important for carbohydrate metabolism.

Insulin acts as a key that opens cells, letting in glucose inside them, which serves as their energy substrate. Once glucose enters the cells, its level in the bloodstream decreases, which becomes a signal to reduce the secretion of insulin, and at the same time prevents the sugar level from dropping too much.

There is a constant feedback in the exchange of insulin and glucose. As soon as there is more glucose in the bloodstream, insulin levels rise simultaneously and vice versa.

In diabetes, insulin production decreases, resulting in persistently high blood sugar levels. In this case, the cells also suffer, since they receive less glucose.

Hereditary transmission of the disease

A child may inherit a tendency to develop diabetes, but this does not mean that he will necessarily get sick, even if close relatives have diabetes.

Who is most at risk of developing diabetes?

The risks of developing this pathology increase if:

There are people with diabetes in the baby's family.
The child has metabolic problems.
The birth weight was over 4500 grams.
The baby has reduced immunity.

Type II diabetes is at risk for children who are obese and other metabolic disorders.

Symptoms and Signs

A feature of diabetes in childhood is the rapid development of ketoacidosis, since the enzyme systems in the child's body are still immature, and toxic products are excreted slowly.

Within a few weeks after the first symptoms of diabetes, a child may develop a diabetic coma. That is why early detection of diabetes and timely treatment are so important.

You may suspect your baby has diabetes if:

The child often suffers from thirst, and especially asks for a drink in the evening.
The child has an increased appetite. It is difficult for him to endure long breaks between meals.
The kid lost weight dramatically.
He has frequent urination, and the child often goes to the toilet at night.
After eating, the condition may worsen.
The child may also have increased sweating and lethargy.
The child often has recurrent infections such as candidiasis, boils, skin infections.

In infants, who have difficulty detecting increased thirst and frequent urination, poor weight gain, restless behavior, and frequent diaper rash may suggest diabetes. The urine of children with diabetes can leave sticky stains on the floor and starch stains on diapers.

Severe symptoms for which a child should receive immediate medical attention for diabetes are:

Frequent episodes of vomiting.
Dehydration.
Strong weight loss.
Infrequent breathing, in which the child takes a noisy deep breath, followed by an increased exhalation.
The child is lethargic, disoriented in space, may lose consciousness.
Rapid pulse.
Acetone odor may come from the mouth.

Types

Type 1 diabetes is most common in childhood. Nevertheless, in recent years, the identification of type 2 of the disease in children over ten years old has become more frequent.

Both types of diabetes are characterized by intense thirst and excessive food intake, as well as polyuria. Moreover, the first type of diabetes has the following characteristic features:

The disease can begin at any age, even in infants.
The patient can have any body weight.
Hypertension, blood dyslipidemia, vaginal yeast infections in girls, and dark spots on the skin called acanthosis nigricans are very rare.
Antibodies to the pancreas are determined in the blood.

The second type has the following distinctive features:

Illness in childhood often begins in adolescents during puberty.
The patient is usually obese.
The disease is accompanied by an increase in blood pressure, the appearance of spots of acanthosis nigricans, thrush in girls, and changes in lipid metabolism in the blood.
Autoantibodies to the pancreas are not detected.

Diagnostics

Suspecting diabetes in a child, he is prescribed examinations that either confirm the diagnosis or exclude this pathology in the baby. Also, the diagnosis of diabetes is aimed at clarifying the type of disease, its stage and methods of treatment.

The first test that a child is prescribed is to determine the level of glucose in the blood. The test must be taken on an empty stomach and in the case of an increased rate, it is repeated, as well as with exercise.

To clarify the type of diabetes, blood is donated to detect antibodies to pancreatic cells, enzymes and insulin. The presence of antibodies confirms the diagnosis of type 1 diabetes.

Is it realistic to cure?

It is impossible to achieve a complete cure for diabetes in a child, but with the right approach to nutrition and drug therapy, you can achieve a long-term remission, which is called a "honeymoon". During remission, the child's condition improves significantly and daily insulin administration is not required.

What is the treatment?

Therapy for children with diabetes mellitus is aimed at ensuring normal development and growth, as well as preventing severe complications of the disease. The child is prescribed a diet low in carbohydrates. In the first type of diabetes, insulin injections are indicated, in the second, certain groups of drugs in tablets.

Blood sugar control

To keep your child's diabetes under control, blood glucose levels should be measured regularly, so buying a meter is a top priority. The sugar level will have to be measured daily four or more times a day. It is important to check the accuracy of the meter as it affects the treatment. Saving on this device and test strips for it threatens to treat complications of the disease in the future.

There are devices that monitor your glucose levels all day long. They are worn on a belt, and glucose is measured after a certain period of time through a needle inserted into the body. It should be noted that these devices have a rather large error and an ordinary glucometer is more accurate.

All measurements (their time and data obtained), as well as other circumstances (insulin administration, food intake, illness, physical activity, stress, etc.) should be recorded in a diary. This will help in monitoring and treating the baby.

Insulin injection

If a child has type 1 diabetes, insulin injections are a vital necessity for him. The use of the hormone by mouth is impossible, as it will be destroyed by enzymes in the stomach. So injections are the only option to get insulin into the bloodstream.

There are types of insulin that have a very quick effect, but after a few hours it stops. There are other types, the effect of which is smoother and more prolonged.

The hormone is injected using special syringes with a thin needle. Also, syringe pens have been developed, similar to conventional pens, but containing not ink, but insulin. There are also devices called insulin pumps. They are put on a belt, and a needle is inserted into the skin of the abdomen and fixed. This pump is programmed to deliver the hormone in small doses throughout the day.

Is life possible without insulin?

This question is of interest to all parents when detecting the first type of diabetes in their child. On their desire to avoid injections of the hormone, charlatans and scammers earn money. In reality, there are no drugs and procedures that could save a person with type 1 diabetes from insulin injections.

A low-carb diet can only reduce insulin requirements and achieve a long honeymoon — a period when blood glucose levels drop and treatment is not required.

Diet and nutrition

A low-carbohydrate diet for newly diagnosed children has a long honeymoon. The period without spikes in sugar levels stretches over months and even years. In children who have been suffering from diabetes for a long time, such a diet allows several times to reduce the required doses of insulin and stabilize blood sugar.

Nutritional features of a child with diabetes:

Preference is given to protein foods and foods with natural fats. The diet should be based on poultry, fish, eggs, cheeses, seafood, meat, butter, green vegetables, mushrooms.
Carbohydrate foods should be consumed in small doses, spread evenly throughout the day.
High-carbohydrate foods (sugar, bread, cereals, potatoes, fruits, juices and others) should be excluded.
You need to eat only when you feel hungry. In this case, the child should not starve, otherwise there is a high risk of breakdowns.
Overeating should be avoided, even if foods are allowed for diabetes.
It is advisable to plan the menu and not deviate from this plan.
You need to carefully read food labels to determine the percentage of carbohydrates and hidden sugar.
Products marked "low fat" and "dietary" are not recommended. In many of them, fats are replaced by carbohydrates.
All new foods should be tested by checking blood glucose 15 minutes and 2 hours after consumption.
The use of vitamin and mineral supplements is desirable.

Kindergarten and school

Kindergarten and school attendance can be problematic for children with diabetes and parents. Caregivers and teachers are usually poorly informed about diabetes and cannot feel the problem, but at the same time they are responsible for the health and life of the child while he is in the educational institution. Parents will have to talk a lot and explain all the nuances of the child's illness - to the director, class teacher, teachers (especially to the physical education teacher). Further, the situation should always be under their control.

A lot of difficulties are caused by the child's nutrition in the canteen and the introduction of insulin before meals. Inform kindergarten or school staff about what foods are prohibited for your child. You also need to decide where the child will be injected with insulin before meals - in the classroom, in the medical room, in another place.

Be sure to discuss with your child his actions in case of various unplanned situations at school. For example, what to do if the class is closed, and the food remains in the portfolio, or if the medical room is suddenly closed or the nurse is absent. The child should know what to do if, for example, he has lost his keys or is stuck in an elevator.

The child attending school should be gradually taught to take care of himself. He must understand what food is contraindicated for him, as well as how to act in case of hypoglycemia. Your child should always have fast-absorbing carbohydrate sources with them. Conflicts with classmates can also become a problem, as hypoglycemia can appear with stress.

Sports activities

Physical activity is very important for children with diabetes, especially when it comes to the second type. The child can be sent to sports sections and dances. But even with type 1, physical education brings many benefits to children and increases their quality of life. It is important not to forget that physical activity affects the glucose level, lowering it within 12-36 hours after exercise.

On the other hand, with sharp physical activity, sugar can rise. If a child with type 1 diabetes plays sports, they will need to use the meter more often.

Possible complications

The disease can be complicated by both acute conditions requiring immediate treatment (hypoglycemia, as well as ketoacidosis), and chronic changes in internal organs.

With frequent jumps in glucose levels, a child may develop:

Heart dysfunction.
Vascular pathology.
Neuropathies.
Kidney damage.
Retinopathy caused by impaired blood supply to the eyes.
Deterioration of the skin condition - peeling, itching, increased risk of infection.
Limb problems associated with impaired blood flow in the legs and nerve problems.

Controlling blood glucose levels helps prevent such complications. In addition, it is important to regularly visit an ophthalmologist and have urine and blood tests done in order to identify complications in the early stages.

Tips for parents

When your baby is diagnosed with type 1 diabetes, you will have to learn a lot of information about insulin administration to your baby. On the existing types of hormone, the calculation of the optimal dose and other nuances. This is extremely important to your child's life.
Also, parents should know how acute complications of the disease manifest themselves, what diet is right for their child when hospitalization may be needed.
Try to keep your child active by for example, doing physical education with him.
You will need to build relationships with educators and teachers, so that the child can attend childcare facilities on an equal basis with others.
If your child is on a low-carb diet, it is not necessary to inject him undiluted insulin from a syringe pen, as even one unit of the hormone may be too much.
Don't jump on the latest in diabetes care right away. as soon as they were released to the market. Do not test new insulins, measuring devices, drugs, or other innovations on your child. Wait at least two to three years to know for sure about all their benefits and nuances.
Encourage your child to find activities of interest and develop their abilities. Do not forbid him to go on excursions, circles, sports sections. Just think of a plan for each situation on how to deal with hypoglycemia.

Be especially careful when the child is approaching adolescence. During this period, psychological problems associated with the disease may appear. The child may start eating prohibited foods in secret or in a company so as not to stand out among friends. Situations when a child rebel against insulin shots and a low-carb diet is very dangerous for his health. Try to explain to him the consequences and outcomes of this behavior.

When is disability given to a child?

If a child is diagnosed with type 1 diabetes requiring treatment with insulin, then up to the age of 14, such a child is diagnosed with disability without a group. At the age of 14, a further decision is made regarding the determination of disability based on the course of the disease and the presence of complications.

Prevention

If your child has a genetic predisposition to type 1 diabetes, a low-carb diet can help prevent damage to the cells in the pancreas that make insulin.

You should also carefully introduce complementary foods, since excessively early feeding with cereals and cow's milk is attributed to risk factors for the development of the disease.