Diabetes mellitus in children: causes, diagnosis, symptoms and treatment
Diabetes mellitus refers to the pathology of the endocrinesystem associated with a violation of the secretory function of the pancreas. As a result, insulin production is disrupted. This is quite a serious disease, which is difficult to treat.
Diabetes mellitus in children can be 1 and 2 types,based on which, the appropriate treatment is selected, as well as diet. Parents are very important to know what factors can affect the development of the disease, how it manifests itself and is diagnosed.
What is the disease?
Diabetes mellitus in children ranks secondamong 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 split to the state of glucose, which acts as the energy base required for a person's normal existence. Insulin is required for its assimilation.
This hormone is produced by cells of the pancreas, and if for some reason there is a violation of this function, the glucose remains in its original state.
Types and forms
Depending on the cause of diabetes mellituschildren it is classified according to the type and form. First of all, the disease is divided into 1 and 2 type. It is very important to understand for what reasons they arise, what are the signs and treatment of each species.
The basis of diabetes in children of type 1 liesdysfunction 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 by external factors. These include:
- infectious diseases;
- stressful situations;
- accumulation of toxic substances.
If a child is born with diabetes, then forthe development of the disease and the violation of insulin production requires the impact of one or more of several external factors. In the latent stage, immunity cells destroy insulin producing tissues very slowly. In the morning, the sugar remains within the norm in the child, and after the consumption of food, his jumps are observed. At this stage, the pancreas can still cope with the load, but with the death of 85% of the cells the disease goes into the active stage.
Often this leads to the fact that children fall intoa hospital with a diagnosis of "ketoacidosis" or "ketoacidotic coma". This condition is characterized by the fact that the glucose level is much higher than normal. Completely cure autoimmune diabetes is simply not possible, but the proper adherence to the prescriptions of the doctor will avoid crises and premature destruction of the vascular system. A sick child should take insulin throughout life.
For a long time, type 2 diabeteswas considered a disease of the elderly, but more often it began to suffer from adolescents. 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, because during this period, hormones begin to inhibit the susceptibility of tissues to insulin. Among the main causes of the disease can be identified as:
- excessive weight and obesity;
- sedentary lifestyle;
- taking hormonal drugs;
- disease of the endocrine system.
The risk of developing diabetes is especially high.hereditary predisposition. The flow of this type of disease is mostly asymptomatic and there are no special changes in the analyzes. Treatment of diabetes in children is based on compliance with the diet and the use of medications that reduce blood sugar, as well as regulating the course of concomitant diseases.
Diabetes MODY is mainly found in children inage to 10 years. The main cause of its occurrence is cell damage at the genetic level. Basically, this disease has an uncomplicated course, initially the child does without additional insulin administration.
Neonatal diabetes is detected mainly in children up to 6 months of age, is very rare and has a hereditary nature.
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 distinguish:
- genetic predisposition;
- frequent colds;
- binge eating;
- excessive weight;
- sedentary lifestyle.
The emergence of diabetes in children canbe laid down at the genetic level, as the parents with this disease are already having a sick child. In this case, the disease can manifest immediately or in a few years. Very dangerous increase in blood glucose in a woman during pregnancy. It is worth noting that it passes very well through the placenta and gets into the bloodstream of the child, and since the fetal needs during this period are minimal, its excess accumulates in the subcutaneous fat. In this case, children are born with a lot of weight.
Eating large quantities of foodeasily digestible carbohydrates leads to a large load on the child's cells that produce insulin. As a result, they very quickly deplete their reserves and stop working normally, which leads to a sharp decrease in insulin in the blood.
When large amounts of sugar arethe organism does not excrete its surplus, but is deposited in the form of fats. The fat molecules of the receptors responsible for the processing of glucose are rendered unreceptive. As a result, even with a sufficient amount of insulin, the amount of sugar in the blood does not decrease.
A low-active lifestyle leads to an increaseweight, which can lead to the onset of diabetes. With frequent catarrhal diseases, immunity constantly produces antibodies directed to fight against viruses and bacteria. As a result, he can begin to attack his own body cells, in particular, and those that produce insulin. This leads to the defeat of the pancreas and a decrease in its number.
The main symptomatology
In general, diabetes mellitus in children develops inpreschool or adolescence, when physiological leaps of child growth occur. Since the body needs a lot of energy, at this stage, there are clinical symptoms. Among the main signs of diabetes in children can be identified as:
- sharp weight loss;
- constant thirst;
- frequent urination;
- frequent feeling of hunger;
- dry skin, rash and pustules;
- sweating, red bloom on the tongue;
- headache, impaired consciousness.
The child begins to drink a lot of fluid, evenin the cold season and even gets up at night to quench thirst. When a large amount of fluid is consumed, a lot of urine begins to stand out, as an excess of sugar is removed with it. In addition, bedwetting is often observed.
Among the main signs of diabetes mellituschildren need to highlight a sharp decrease in body weight, since glucose acts as the main source of energy. During the course of the disease, the amount of glucose that enters the cells decreases, and therefore, their nutrition worsens significantly. Since the baby has less energy, it becomes sluggish, weak, and gets tired quickly.
If you suspect a disease, it is imperative 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 control of blood.
You need to be examined by a dermatologist, pediatrician,Gastroenterologist, oculist, endocrinologist. Analyzes and tests help to determine the level of glucose in the blood and to identify possible violations. Ultrasound of the internal organs may be required.
Complex diagnostics will allow to delivercorrect diagnosis and prescribe timely complex treatment, which includes a special diet, exercise, and if necessary, insulin therapy is prescribed. A timely diagnosis will help avoid coma and death of the child.
Features of treatment
Treatment of diabetes in children depends on its type. Adequate therapy is prescribed by a doctor-endocrinologist. Treatment of diabetes involves the observance of such principles as:
- hygiene of the mucous and skin;
- playing sports;
- diet therapy;
- psychological support.
For the treatment of type 1 diabetes in childrenReplacement therapy is often used. 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 consumes all the sugar reserves, this will lead to energy starvation.
That is why, in addition to the use of drugdrugs, be sure to organize proper nutrition of the child, as fasting is completely unacceptable. Between main meals you should also do snacks.
Daily level control is a must.blood glucose with the help of special blood glucose meters. You need to keep a special diary, which displays the food consumed 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 type of treatment for diabetes mellitus type 1 is pancreas transplantation, as this will allow you to normalize your health and get rid of the need for lifelong insulin.
With type 2 diabetes, be sure to holdtreatment of 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 has insulin in the body, but care must be taken to avoid sudden surges in glucose.
It is important to completely eliminate from the diet.digestible carbohydrates and limit the consumption of all other types of them. In addition, the use of glucose-lowering drugs, in particular, such as "Amaryl", "Maninil", "Diabeton" is required. Medications are needed to maintain the liver, in particular, such as Essentiale Forte N, as well as linseed oil, which is a source of fatty acids.
To normalize microcirculation,The use of drugs such as Trental and Vasinit is shown. Vitamin complexes are also required. "Taurine" is prescribed to nourish the eyes. This amino acid has a hypoglycemic effect, and also helps nourish the retina. Children with diabetes cannot abandon their habitual lifestyle, which is why parents should motivate them with their example.
Diabetes treatment depends largely onthe stage at which he was diagnosed. If the child is in a state of coma or ketoacidosis, the therapy is carried out in a hospital where droppers are placed with solutions that help remove toxins from the body, restore the chemical composition of blood, and select the required insulin dosage. For recovery, the use of droppers with glucose and insulin is indicated.
Be sure to show adherence to a diet with sugardiabetes in children of type 1, since the dosage of insulin largely depends on nutrition. The endocrinologist makes a special menu, given the age, weight, severity of the course of the disease.
Since the treatment is done with insulin,it is necessary to take into account the fact that it is of 2 types, namely, bolus or basal. Short-acting insulin can be attributed to the Humulin Regulator or Humalog. In addition, you can use the tools of Russian production. 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 active30 minutes after the injection and acts for 20-30 hours. Ultratard-NM, Humulin-NPH, Insuman Bazal, VO-S can be attributed to the basic means.
The child must be taught to use correctly andstore insulin. It is important that he is aware of all the responsibility for his health and understand the need for the introduction of injections, since human life depends on it.
If the amount of insulin is incorrectly calculated,A state of hypoglycemia may develop. Reducing sugar is not only due to incorrectly calculated dosage. This can contribute to the consumption of food with a small amount of carbohydrates and excessive physical activity.
Calculation of bread units
Be sure to comply with certainrecommendations 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. It helps those who suffer from diabetes, without any problems to choose food for themselves.
You can independently calculate the grain units. All products indicate the amount of carbohydrates. This quantity should be divided by 12 and multiplied by the weight indicated on the package. A diet for children with diabetes mellitus implies a restriction of carbohydrate intake, since any errors can cause a deterioration in health.
Blood glucose control
A diabetic child needs constant monitoring.for blood sugar. For this you can use a special device - a blood glucose meter. Now there are many different options for such a product, so you can choose it based on your needs. Since this device is used often enough, it must be of high quality and reliable.
When a child is small, then to measure the levelglucose meter is used by parents, and when he grows up, he can use the device independently, so the design should be as simple as possible. Very convenient device with special test strips. However, the expiration date must be monitored. Overdue strips can give errors that can be dangerous for a diabetic child.
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.
The basis of hyperglycemic coma is lack ofinsulin. 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 must immediately call an ambulance.
Hypoglycemic coma occurs whenoverdose of insulin. It is acute, as the skin immediately becomes wet, the child is over-excited, his pupils dilate, his appetite increases. In this case, you need to feed it or enter intravenous glucose solution. Very often, children with diabetes mellitus are disabled, as they have a violation of the functioning of many internal organs. Among the late complications of the disease should be highlighted:
With diabetes mellitus observed pathologicaldamage to the organs of vision. This is manifested as a lesion of the optic nerves or a decrease in visual acuity. Also affects the joints, which is characterized by severe pain and restriction of their mobility.
Encephalopathy leads to mental changes andmood of the child, which is reflected in a rapid change of mood, imbalance and the occurrence of depression. In addition, there may be damage to the kidneys and the nervous system. Complications are very dangerous, which is why you need to regularly treat, follow a diet, and monitor blood sugar levels.
Prevention of disease
So far, there is no effective prevention of sugardiabetes 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, hardening, apply vitamin complexes.
It is important to conduct a preventive examination in a timely manner in order to promptly notice possible violations.