Diabetes in children and adolescents

Diabetes in children: symptoms, diagnosis, treatment, prevention

Diabetes in children is a serious chronic disease. Below you will find out what his symptoms and signs are, how to confirm or refute the diagnosis. Effective treatment methods are described in detail. This information will allow you to protect your child from acute and chronic complications. Read how parents can provide their children with normal growth and development. Also study ways to prevent it - how to reduce the risk of childhood diabetes mellitus (DM) if one of the parents is sick.

In many cases, diabetes can keep a stable, regular sugar without daily insulin shots. Learn how to do it.

Diabetes in children is the second most common chronic disease. It causes more problems than high blood sugar in adults. Because it is difficult for a child who has an impaired glucose exchange to psychologically adapt and take a worthy place in the peer collective. If a child or teenager has type 1 diabetes, then all family members have to adapt. The article describes what skills parents need to master, in particular, how to build relationships with school teachers and the administration. Try not to be deprived of the attention and their other children, who were lucky to stay healthy.

The content of the article:

The treatment of diabetes in children has short-term and long-term goals. The closest goal is to ensure that the diabetic child grows and develops normally, adapts well to the team, and does not feel defective among healthy peers. The strategic goal from childhood should be to prevent severe vascular complications. Or at least move them back to adulthood as late as possible.

To control diabetes well, you need to transfer a sick child to a low-carbohydrate diet as soon as possible.

Symptoms and signs

Symptoms and signs of diabetes in children tend to grow rapidly over a period of weeks. Below they are described in detail. If you notice unusual symptoms in your child - take him to the doctor, take the tests. If someone you know has a blood glucose meter, you can simply measure sugar on an empty stomach or after a meal. Read also the article "Norms of blood sugar". Ignore the symptoms should not be - they themselves will not pass, and it will only get worse.

Signs in children:
Constant thirstChildren who are ill with type 1 diabetes, but have not started treatment yet, experience constant thirst. Because when sugar is high, the body pulls water out of the cells and tissues to dilute the glucose in the blood. A child may drink an unusually large amount of pure water, tea, or sugary drinks.
Frequent urge to urinateThe liquid that the diabetic drinks in excess must be removed from the body. Therefore, he will go to the toilet more often than usual. He may need to go to the toilet from the lessons several times during the day. This will attract the attention of teachers and classmates. If the child started writing at night, and before his bed was dry, this is an alarming sign.
Unusual weight lossThe body has lost the ability to use glucose as an energy source. Therefore, it burns its own fat and muscle. Instead of growing and gaining weight, the child on the contrary loses weight and weakens. Weight loss is usually sudden and fast.
Chronic fatigueA child may feel constant lethargy, weakness, because he cannot convert glucose into energy due to a lack of insulin. Tissues and internal organs suffer from a shortage of fuel, send alarming signals, and this causes chronic fatigue.
Severe hungerThe body can not normally absorb food and get enough. Therefore, the patient is always hungry, despite the fact that he eats a lot. However, it happens and vice versa - appetite falls. This is a symptom of diabetic ketoacidosis - an acute complication, life-threatening.
Visual impairmentIncreased blood sugar causes dehydration of tissues, including the lens of the eye. This may be manifested by fog in the eyes or other visual impairment. However, the baby is unlikely to pay attention to it. Because he still does not know how to distinguish between normal and impaired vision, especially if he cannot read.
Fungal infectionsIn girls with type 1 diabetes, thrush can develop. Fungal infections in infants cause severe diaper rash, which disappears only when the blood sugar can be reduced to normal.
Diabetic ketoacidosisAcute complication that carries a threat to life. Its symptoms are nausea, abdominal pain, fast intermittent breathing, the smell of acetone from the mouth, fatigue. If you do not take action, the diabetic will faint and die, and this can happen quickly. Diabetic ketoacidosis requires emergency medical care.

Unfortunately, in Russian-speaking countries, type 1 diabetes usually begins with the fact that the child is in reanimation with ketoacidosis. Because parents ignore the symptoms - they hope that it will pass by itself. If time to pay attention to the warning signs, measure blood sugar and take action, then you can avoid the "adventures" in the intensive care unit.

See your doctor as soon as you notice at least some of the symptoms listed above. Diabetes in children is a serious illness, but not a disaster. It can be well controlled and guaranteed to prevent complications. The child and his family can lead a normal life. All disease control activities take no more than 10-15 minutes a day. There is no reason to despair.

The reasons

The exact causes of type 1 diabetes in children and adults are not yet known. The immune system is designed to kill dangerous bacteria and viruses. For some reason, it begins to attack and destroy the beta cells of the pancreas, which produce insulin. Genetics largely determines the predisposition to type 1 diabetes. A postponed viral infection (rubella, flu) is often the trigger for the onset of the disease.

Insulin is a hormone that helps glucose molecules penetrate from the blood into cells that use sugar as fuel. Insulin is produced by beta cells located on the islets of Langerhans of the pancreas. In a normal situation, a lot of insulin is quickly released into the blood after eating. This hormone acts as a key that unlocks the doors on the surface of cells through which glucose penetrates.

Thus, the concentration of sugar in the blood decreases. After this, insulin secretion by the pancreas decreases, so that the glucose level does not fall below normal. The liver stores sugar and, if necessary, saturates the blood with glucose. If there is little insulin in the blood, for example, in a person's fasting state, glucose from the liver is released into the blood to maintain a normal sugar concentration.

The exchange of glucose and insulin is continuously regulated on the basis of feedback. But after the immune system has destroyed 80% of the beta cells, the body can no longer produce enough insulin. Without this hormone, sugar cannot penetrate from the bloodstream into the cells. The concentration of glucose in the blood rises, which causes the symptoms of diabetes. Meanwhile, the tissues are starving without getting fuel. This is the mechanism for the development of type 1 diabetes in adults and children.

A 6-year-old baby unsuccessfully suffered a cold, got sick with type 1 diabetes, began to lose weight inexplicably and eventually lost consciousness from ketoacidosis. In resuscitation, he was rescued, discharged, prescribed to prick insulin ... as usual. Then my mother found the site Diabet-Med.Com and transferred her son to a low-carbohydrate diet.

A child with type 1 diabetes maintains a stable, normal sugar due to proper diet. Insulin prick is not necessary daily.

Unfortunately, after two weeks my mother had a "dizzy with success."

The pancreas, weakened by diabetes, does not cope with the load of carbohydrates. Therefore, sugar rises. After another 3 days, the child’s mother stopped filling out the diary and getting in touch with Skype. Probably nothing to brag about.

See also:
  • How insulin regulates blood sugar: detailed scheme

Prevention

No methods of preventing diabetes in children have proven effectiveness. Prevent this serious disease today is impossible. No vaccinations, pills, hormones, vitamins, prayers, sacrifices, conspiracies, homeopathy, etc., help. Children of parents with type 1 diabetes can be genetically tested to determine the risk. You can also take blood tests for antibodies. But even if antibodies in the blood show up - still nothing can be done to prevent the disease.

If one of the parents, brothers or sisters is sick with type 1 diabetes - think about transferring the whole family to a low-carbohydrate diet in advance, for prevention. This diet protects beta cells from destruction by the immune system. Why this is happening is still unknown. But the effect is, what thousands of diabetics have already seen.

Currently, scientists are working to create effective methods of preventing diabetes in children. Another important area is to try to keep some beta cells alive in patients who have recently been diagnosed. To do this, you need to somehow protect the beta cells from attacks of the immune system. If your child's genetic testing showed a high risk or antibodies were detected in the blood, he may be asked to participate in clinical studies. This should be treated with caution. Because the new methods of treatment and prevention that scientists are experiencing can do more harm than good.

Proven risk factors for type 1 diabetes in children:
  • Family history. If a child has one of his parents, brothers or sisters, he suffers from insulin-dependent diabetes, then for him the risk is increased.
  • Genetic predisposition. Genetic testing can be done to determine the risk. But this is an expensive procedure and, most importantly, a useless one, because there are still no effective methods of prevention.
Estimated risk factors:
  • Viral infections are often a trigger for the onset of type 1 diabetes. Dangerous viruses - Epstein-Barr, Coxsackie, rubella, cytomegalovirus.
  • Low levels of vitamin D in the blood. Studies confirm that vitamin D calms the immune system, reducing the risk of insulin-dependent diabetes.
  • Early introduction of cow's milk in the diet. This is believed to increase the risk of type 1 diabetes.
  • Drinking water contaminated with nitrates.
  • Early start of baby feeding with cereal products.

Most of the risk factors for type 1 diabetes cannot be eliminated, but some are under parental control. Do not rush to start feeding the baby. It is recommended that the baby eat breast milk only for up to 6 months. Artificial feeding is believed to increase the risk of insulin-dependent diabetes, but this has not been officially proven. Take care to provide clean drinking water. Do not try to create a sterile environment to protect the child from viruses - it is useless. Vitamin D can be given only in consultation with the doctor, its overdose is undesirable.

Diagnostics

Diagnostics is performed to answer questions:
  1. Is the baby sick with diabetes?
  2. If the exchange of glucose is disturbed, what kind of diabetes is it?

If the parents or doctor notice the symptoms of diabetes described above, then you just need to measure the sugar with a glucometer. It is not necessary to do on an empty stomach. If there is no home glucometer, take a blood sugar test in the lab, on an empty stomach or after a meal. Learn blood sugar rates. Compare with them the test results - and everything will become clear.
Unfortunately, in most cases, parents ignore the symptoms until the child loses consciousness. An ambulance arrives. Doctors with a trained eye determine diabetic ketoacidosis and carry out resuscitation. And then it remains only to determine what type of diabetes. To do this, blood tests for antibodies.

Finding out what type of diabetes a patient has is scientifically called conducting a “differential diagnosis” between type 1 and type 2 diabetes, as well as other rare types of this disease. Type II in children in Russian-speaking countries is rare. It is usually diagnosed in adolescents with overweight or obesity, aged 12 years and older. Signs of this disease are growing gradually. The more common first type usually causes acute symptoms immediately.

In type I, antibodies can be detected in the blood:
  • cells of the islets of Langerhans;
  • glutamate decarboxylase;
  • tyrosine phosphatase;
  • to insulin.

They confirm that the immune system attacks the pancreatic beta cells. In type 2 diabetes, these antibodies are absent in the blood, but often there is a high level of fasting insulin and after eating. Also, in the second type, tests in a child show insulin resistance, i.e., the sensitivity of tissues to the action of insulin is reduced. In most young patients with type 2 diabetes, this disease is diagnosed as a result of blood and urine tests during examination due to other health problems. Also, a burdened heredity can be a reason to undergo an examination (clinical examination) if someone from close relatives has a disturbed glucose exchange.

Approximately 20% of adolescents suffering from type 2 diabetes, complain of strong thirst, frequent urination, loss of body weight. Their complaints correspond to the usual acute signs of type 1 diabetes. To make it easier for doctors to determine which type of disease, the following table will help.

How to distinguish type 1 diabetes from type 2 diabetes in children and adolescents:
Sign of
Type 1 diabetes
Type 2 diabetes
Polydipsia - an unusually strong, unquenchable thirst
Yes
Yes
Polyuria - an increase in the amount of daily urine
Yes
Yes
Polyphagy - excessive food intake
Yes
Yes
Strengthening in infectious diseases
Yes
Yes
Diabetic ketoacidosis
Yes
Available
Random diagnostics
Uncharacteristic
Is common
Age of onset
Anyone, even chest
Often the period of puberty
Body mass
Any
Obesity
Acanthosis nigricans
Seldom
Usually
Vaginal infection (candidiasis, thrush)
Seldom
Usually
High blood pressure (hypertension)
Seldom
Usually
Dyslipidemia - poor cholesterol and blood fat levels
Seldom
Usually
Autoantibodies in the blood (the immune system attacks the pancreas)
Positive
Negative
The main differences:
  • body weight - is obesity or not;
  • antibodies in the blood;
  • blood pressure is elevated or normal.

Acanthosis nigricans are special dark spots that can be between the fingers and toes, the armpits and the back of the neck. This is a sign of insulin resistance. Acanthosis nigricans is observed in 90% of children with type 2 diabetes, and rarely with type 1 diabetes.

Treatment

Treatment of diabetes in children is the measurement of glucose in the blood several times a day, insulin injections, keeping a diary, a healthy diet and regular physical activity. It is necessary to control the disease every day, without breaks for weekends, holidays or holidays. After a few weeks, the child and his parents become experienced. After that, all therapeutic measures take no more than 10-15 minutes a day. And the rest of the time you can lead a normal life.

Read the main article on “Treatment for Type 1 Diabetes.” It contains step-by-step instructions written in plain language.

Configure that diabetes revealed in childhood is forever. Probably, sooner or later treatment will appear that will allow you to refuse to follow a diet and daily insulin shots. But when it happens - no one knows. Today, only charlatans can definitively cure your child from diabetes. They lure money from their parents - this is half the trouble. As a result of the use of charlatan methods, the course of the disease in children worsens significantly - this is a real tragedy. Before the revolution in the treatment of diabetes still need to live. And it is desirable that until this time the child did not develop irreversible complications.

A child grows and develops, the circumstances of his life change. Therefore, treatment has to be changed frequently, and specifically - to specify the dosage of insulin and the menu. If your child has diabetes - try to understand the methods of dealing with the disease no worse than the "average" endocrinologist. Doctors should train the parents of sick children, but in practice they rarely do this. So learn by yourself - read the Diabet-Med.Com website or the original English-language materials of Dr. Bernstein. Every day, write information in a diary. Thanks to this, you will soon understand how a child's blood sugar behaves, how he reacts to insulin shots, different foods and physical activity.

See also:
  • How type 1 diabetes in a 6-year-old child is controlled without insulin - a success story
  • How to treat colds, vomiting and diarrhea in diabetes
  • Vitamins in diabetes - play a third-party role, do not get carried away with dietary supplements
  • New methods of treating diabetes - beta-cell transplantation and others

Blood sugar control

Sugar should be measured at least 4 times a day, and even more often. This means that you often need to pierce your fingers and spend considerable money on test strips for the meter. First of all, read how to check your meter for accuracy. Then make sure your device is accurate. Do not use a blood glucose meter that is lying, even if the test strips are cheap because it will make all the treatment useless. Do not save on test strips, so that you do not have to go broke on the treatment of complications.

You should know that in addition to blood glucose meters there are still devices for continuous monitoring of glucose. They are worn on the belt, like an insulin pump. A patient with diabetes lives with such a device. The needle is continuously inserted into the body. The sensor measures blood sugar every few minutes and transmits data so that you can plot a graph. Devices for continuous monitoring of glucose give a significant error. Therefore, they are not recommended for use if you are trying to control the disease in a child well. Ordinary glucometers are more accurate.

Frequent sugar measurements are the only effective way to control diabetes in children. Write in the diary the time of each measurement, the result obtained and the attendant circumstances - what they ate, how much and what insulin was pricked, what physical activity was, infectious diseases, stress.

Do not use information that is stored in the memory of the meter, because the surrounding circumstances are not recorded there. Keep a diary, do not be lazy! Try to take blood for measurements not from fingers, but from other sites on a skin.

A device for continuous monitoring of glucose in combination with an insulin pump is like an artificial pancreas. Now such devices are being developed, but they have not yet become widely accepted. Subscribe to the Diabet-Med.Com e-mail newsletter to keep up with the news. Do not grab new devices, drugs, types of insulin, as soon as they appear on the market. Wait at least 2-3 years until they are tested by a wide community of diabetics. Do not make your child the object of questionable experiments.

Insulin injections

Any person with type 1 diabetes should be given insulin shots in order not to die. Unfortunately, if you take insulin by mouth, the enzymes in the stomach destroy it. Therefore, the only effective method of administration remains injections. Some types of insulin lower the sugar quickly, but stop acting after a few hours. Others operate smoothly for 8-24 hours.

Treatment of diabetes with insulin is a lot of information. You will need to carefully read the articles for a few days to figure it out. You can prick all the time the same dose of insulin, but it does not allow good control of the disease. It is necessary to learn to calculate the optimal dosage before each injection in terms of blood sugar and nutrition. There are ready-made mixtures of several different types of insulin. Dr. Bernstein does not recommend their use. Also, if you have been given free insulin Protafan on a benefit, it is better to switch from it to Levemir or Lantus.

Insulin syringes, pens and pumps

Most often for injections of insulin using special syringes or syringe pens. Insulin syringes have special fine needles so that the injection does not cause pain. A pen is similar to a regular ballpoint pen, only its cartridge is filled with insulin, not ink. If you have transferred a child to a low-carbohydrate diet, do not give him insulin syringe pen. Even 1 U of insulin may be too high a dose. Insulin will need to be diluted. Drain it from the handle into the dilution tank, and then dilute the insulin with a syringe.

An insulin pump is a mobile phone-sized device. The pump contains a reservoir with insulin and an electronic control device. From it comes a transparent tube, which ends with a needle. The device is worn on the belt, while the needle is stuck under the skin on the abdomen and secured. The pump is programmed to supply insulin often in small portions suitable for the patient. In the West, insulin pumps are often used to control diabetes in children. However, these devices are very expensive. Compared with conventional syringes, they have other disadvantages. For more, read the article "Insulin Pump: Pros and Cons."

Treatment without insulin

Treating children without insulin is a topic that interests most parents whose child has recently become ill. Can type 1 diabetes be cured without insulin? Rumor has it that a medicine has long been invented to cure diabetes in children and adults forever. Many parents of sick children believe in conspiracy theories. They believe that the authorities know the miracle cure for autoimmune diabetes, but they hide it.

Officially, the magic tool does not yet exist. No pills, surgeries, prayers, raw foods, bioenergy, and any other treatment methods do not allow people with diabetes to refuse insulin shots. However, if you immediately transfer the patient to a low-carbohydrate diet, then the honeymoon period can be extended significantly - for many months, several years, and theoretically, even for a lifetime.

Charlatans promise to cure diabetes in a child without insulin

In order for a child with type 1 diabetes to live well with normal blood sugar without daily injections, he must strictly follow a low-carbohydrate diet. With a high probability, this diet will keep the sugar consistently no higher than 4-5.5 mmol / l. However, the diet must be strictly followed. You can not even eat fruit, and even more, other prohibited foods. This is often difficult for the patient and other family members.

A low-carbohydrate diet does not give an opportunity to refuse insulin shots to children and adults who already have a long experience of type 1 diabetes and who later learned about this method of treatment. In such patients, it lowers the daily dosage of insulin by 2-7 times, stabilizes blood sugar levels and thus improves the course of the disease. If a diabetic goes on a low-carbohydrate diet immediately after the onset of the disease, then his honeymoon is extended for many months, for several years or even for a lifetime. In any case, you need to measure sugar several times every day. Also have to prick insulin during a cold and other infectious diseases.

Physical activity

Every person needs regular physical activity. Children with diabetes - all the more. Exercise treats type 2 diabetes, but does not eliminate the cause of type 1 disease. Do not try to stop autoimmune attacks on beta cells of the pancreas by physical exertion. However, physical education improves the quality of life. Dance lessons and some kind of sport will benefit. Try to engage with him.

In people with severe type 1 diabetes, physical activity affects blood sugar in a complex way. Usually it lowers it, and the effect can be felt 12-36 hours after the end of the workout. However, sometimes heavy exercise increases sugar. It is difficult to adapt to this. When doing sports, you need to measure sugar with a glucometer more often than usual. Nevertheless, physical education brings many times more benefits than troubles. Especially, if it is possible to control diabetes in a child well with the help of a low-carbohydrate diet, without insulin shots at all or with minimal doses.

Skills that parents need to learn

Parents of a diabetic child are responsible for it. Caring for him requires a lot of time and effort. Teaching someone from outsiders to replace you is unlikely to succeed. Therefore, one of the parents may need to be with the child all the time.

The list of skills that parents need to master:

  • Determine the symptoms and take urgent measures for acute complications: hypoglycemia, severely elevated sugar, ketoacidosis;
  • Measure blood sugar with a glucometer;
  • Calculate the appropriate dosage of insulin, depending on the performance of sugar;
  • Make insulin shots painlessly;
  • Feed a suitable meal, encourage it to follow a diet;
  • Maintain physical activity, jointly engage in physical exercise;
  • Build relationships with school teachers and the administration;
  • Competently act in the hospital during hospitalization for diabetes or other diseases.

Acute complications of type 1 diabetes in children are increased sugar (hyperglycemia, ketoacidosis), reduced sugar (hypoglycemia) and dehydration. Each child has symptoms of acute complications in different ways. Some children become lethargic, others - excited, capricious and aggressive. What are the typical symptoms of a child - parents should know, as well as all those with whom he communicates during the day, especially school personnel.

See also:
  • Hypoglycemia: Symptoms and Treatment
  • Diabetic ketoacidosis

The period of “honeymoon” (remission)

When a patient with type 1 diabetes begins to receive insulin injections, his health usually improves significantly after a few days or weeks. This is called the honeymoon period. At this time, the level of glucose in the blood can be normalized so that the need for insulin completely disappears. Blood sugar is kept stable normal without insulin injections. Doctors always warn children and their parents that the honeymoon period is not for long. Honeymoon does not mean that diabetes was cured. The disease only temporarily receded.

If, after diagnosis, the child quickly goes on a low-carbohydrate diet, the honeymoon phase will last a long time. It may take several years. Theoretically, the honeymoon can be extended for life.

Read more:
  • Why do you need to eat less carbohydrate in diabetes?
  • Honeymoon in type 1 diabetes and how to extend it
  • How to reduce blood sugar and stably maintain it normal

Diabetic child at school

As a rule, in Russian-speaking countries, children with diabetes go to a regular school. This can be a problem for themselves, as well as for those around them. Parents should be aware that:

  • teachers are virtually illiterate with diabetes;
  • your special problems, to put it mildly, do not interest them much;
  • on the other hand, if something bad happens to the child, the school staff is responsible, even criminal.

If you choose a normal school and also apply the “carrot and stick” approach to its employees, then the parents will most likely be able to ensure that everything is normal with a diabetic child at school. But this will have to try, and then all the time to control the situation, do not let it drift.

Parents need to discuss the situation in advance with the class teacher, the school principal, and even with all the teachers who teach them to the child. Particularly noteworthy is the physical education teacher and trainer of the sports section, if you attend such classes.

Nutrition and insulin shots

An important issue is the food in the school canteen, as well as insulin shots before meals. Employees of the dining room should be aware of what food you can give to your child, and what you can not. The main thing is that he himself should know well and feel "in his own skin" how much illegal foods cause him harm.

Where will the child do an insulin injection before eating? Right in the classroom? In the nurse's office? In some other place? What if the nurse's office is closed? Who will track what dose of insulin a child has collected in a syringe or pen? These are issues that parents and school authorities need to solve in advance.

Work with your child on an emergency plan for school, as well as on the way to and from school. What if the bag with food was closed in the classroom? What to do if classmates are bullied? Stuck in the elevator? Lost your apartment key?

It is important that the child finds a class of interest. Try to develop his abilities. It is undesirable to prohibit a child to go in for sports, go on excursions, clubs, etc. In each of these situations he must have a plan on how to prevent hypoglycemia or quickly stop her symptoms.

Emergency situations at school

Do not rely too much on the teachers and the school nurse. A child of school age should be trained to take care of himself. You should consider different situations with him in advance and develop an action plan. At the same time, the main task is to stop hypoglycemia in time, if it occurs in order to prevent loss of consciousness.

Children with diabetes should always carry with them a few pieces of sugar or other sweets that are quickly absorbed. Sweet drinks are also suitable. When the child goes to school, sweets should be in the pockets of the jacket, coat, school uniform, and an additional portion in the briefcase.

Bullying children over weak and defenseless peers is a problem. Children with diabetes are at risk of suffering severe hypoglycemia as a result of stress, fights, and also if classmates hide their briefcase, which contains backup sweets. It is important for parents to make sure that their child’s physical education teacher is adequate.

Watch the video: Preventing Type 2 Diabetes in Kids (December 2019).

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