Diabetes in children. In order to function and perform its tasks, our body needs energy. The easiest way to obtain energy is to split a molecule of glucose (sugar) into components. This produces a large amount of energy, which is spent for the needs of the body. If there is a disruption in the processes of glucose recycling in the body, diabetes develops.
As sugar (glucose) comes to our body’s cells, where its transformation into energy happens, the body requires a kind of a mediator. This mediator is insulin, which is produced in special cells in the pancreas. These cells are called «islets of Langerhans». Insulin amount in our body is impermanent, it changes almost every minute. The process of food absorption leads to the production of insulin, but sleeping slows down its production. Some medications can also inhibit insulin production in the pancreatic cells.
When glucose comes to the body, its concentration in the blood initially rises sharply, which is a manifestation of the norm. After that, the insulin production in the cells of the pancreas begins. This promotes glucose uptake by the cells of the body and lowers blood sugar levels. As soon as the amount of sugar in the blood begins to decrease and reaches the norm (3,3 — 5,5 mmol/l) insulin production stops. The whole process takes about 2 hours.
Causes of diabetes
Diabetes mellitus is a chronic disease that poorly responds to treatment. There are 2 types of diabetes mellitus — type 1 and 2.
In diabetes mellitus type 1 or insulin-dependent diabetes, the cells that produce insulin are affected. This decreases the amount of insulin circulating in the blood, and sugar, which enters our body with food, remains in the blood and is not consumed.
In diabetes mellitus type 2 or non-insulin dependent diabetes, the body produces enough insulin, but the receptors, located on the cells, do not take insulin and do not absorb sugar from the peripheral blood.
There are many reasons for developing diabetes.
Very often children who have parents — diabetics have the same disease. Diabetes may manifest itself immediately after birth or after many years (20, 30, or 50 years). The number of cells that produce insulin is programmed in our DNA. If both parents have diabetes, there is 80% possibility that a baby will be born with the same pathology. Sugar increase in the blood of a pregnant woman is also very dangerous. Glucose easily passes through the placenta into the bloodstream of the fetus. The fetus doesn’t need much glucose, so its excess is deposited in the form of subcutaneous fat. Such babies are usually born with high birth weight — 5 kg and even more.
Eating large amounts of easily digestible carbohydrates (sugar, chocolate, flour products) leads to a large load on the pancreas cells that produce insulin. These cells rapidly deplete their reserves, which leads to insulin decrease in blood.
- Sedentary lifestyle
First, it leads to increase in body mass. Secondly, physical activity helps to strengthen the cells that produce insulin, which leads to lower blood sugar.
- Frequent colds
Our immune system fights infection by producing antibodies, which destroy viruses and bacteria. If you constantly stimulate the immune system, the interaction between the activation and oppression of the immune system impairs. When our body begins to produce antibodies, they — if do not find bacteria or viruses for destruction — begin to attack the body’s own cells, in particular, cells that produce insulin. This results in damage to the pancreas.
Symptoms of diabetes in a child
You can suspect your child has diabetes, if you observe some of the following symptoms.
- Unreasonable thirst (polydipsia)
The baby drinks much liquid, even in the cold season; the child often gets up at night to quench his thirst.
- Frequent urination (polyuria)
As a child consumes a large amount of liquid, the glucose draws in water, so the amount of urine formed is increased, and sugar may be found in the urine. In normal case, the child goes to the toilet about 6 times a day, and while diabetes the amount of urination is increased to 10−20 times. Bedwetting (enuresis) is very often observed among children, who have diabetes.
- Dryness of skin and mucous membranes
Fluid from the intercellular space of the skin and mucous enters the blood stream and then excretes with the urine.
- Weight loss
If your child’s body weight has decreased with no reason, it can be a sign of diabetes. Glucose is the main energy source for the body. While diabetes, the amount of glucose, entering the cells, is reduced, and hence the cells don’t get enough nutrition.
- Reduced visual acuity
If the amount of sugar in the blood increases, sugar excess begins to deposit in organs without turning into fat. Sugar accumulates mainly in kidneys, blood vessels and eye lenses. This leads to the clouding of the eye lens and vision deteriorates. Microangiopathy of retinal vessels can also develop. High level of glucose in the blood has a toxic effect, which leads to the destruction of the blood vessels of the retina and vision impairment.
- Weakness and fatigue
The child gets tired quickly as his body doesn’t get enough energy. For this reason, children with diabetes usually lag behind their peers in physical development. They often complain of tiredness and headaches at the end of the day.
Tests for diabetes
In order to clarify the diagnosis, it is necessary to test blood sugar levels. Normal fasting blood sugar level in children is 3,3 — 5,5 mmol/L. If the child’s fasting blood sugar level is 7.6 mmol/l and above, it indicates diabetes.
For specification of the diagnosis, it is necessary to conduct a glucose tolerance test. For this, blood from a finger is taken on an empty stomach, after that the child drinks 75 grams of glucose dissolved in water (children under 12 years drink half-dose — 35g). Re-analysis is done in 2 hours. During this time, the body must produce enough insulin to process glucose. If the glucose level in blood will be from 7.5 to 10.9 mmol/l, it can mean hidden diabetes. If glucose indicators in blood are equal to 11 mmol/l or more, then the doctor confirms the diagnosis of diabetes.
It is also necessary to conduct an ultrasound investigation of internal organs in order to study the pancreas to exclude the possibility of inflammation in it.
Treatment of diabetes in children
Treatment of diabetes depends on its type.
Treatment of diabetes type 1
For the treatment of diabetes mellitus type 1 (most common in pediatric practice, almost 98% of all cases) substitution therapy is used. As the cells of pancreas do not produce enough insulin, you must fill in for insulin in the blood. You should know that different insulin volumes are produced in different times in accordance with food intake. This is especially important in pediatric practice, as large insulin introduction can cause starvation of the body, as all the sugar in blood will be used up.
Our brain is the main energy consumer. If there isn’t enough energy for the brain to work, such a serious condition as a hypoglycemic coma may develop. This condition requires emergency medical care and, in some cases, even hospitalization in the intensive care unit. Therefore, in addition to insulin introduction, a child must eat enough food, fasting is not permitted. The child must eat vegetables and fruits between meals.
Daily monitoring of glucose levels in blood is required. You need to keep a diary, which keeps track of food, that the child eats, stressful situations and how they increase the glucose levels in the blood, and daily glucose levels. This diary will help the doctor decide on the right insulin dose.
The child must always have a chocolate candy in the pocket or bag. This is necessary to ensure that, even if a higher insulin dose is injected, and sugar blood levels are below acceptable standards, the child will be able to quickly raise glucose level and prevent the development of hypoglycemia. It is also necessary to keep to a diet with restriction of carbohydrates.
One of the methods of diabetes mellitus type 1 treatment is pancreas transplantation. As the decrease in the insulin level is connected with pancreas damage, pancreas transplantation can correct this condition.
Treatment of diabetes type 2
For the treatment of diabetes mellitus type 2, the main point is diet. In this case, the insulin in the body is present but it has no effect, therefore you should avoid sudden sugar levels raise.
Easily digestible carbohydrates (sugar, chocolate, flour products) should be either limited or completely excluded from the toddler’s diet. For this a special medicine concept was introduced — a bread unit. Bread unit is the amount of product that contains 12 grams of carbohydrates. One bread unit increases the blood sugar level by 2.2 mmol/L.
Bread units calculation
In Europe, almost every product is labeled with how many bread units it contains. It helps people with diabetes to lead a healthy life and to find foods that are right for them. Before purchasing, we can calculate the bread units in all products. If bread units are not written on the package, you can easily calculate them. On the labels, the amount of carbohydrates in 100 g of product is always shown. This number must be divided by 12, and then we’ll know how much bread units 100 g of the product contains. Then you must just recalculate the product weight that you have in the package.
So, if the pack with marshmallows indicated that 100 g of product contains 72 g carbohydrates, and the pack weighs 100 g and there are 3 pieces of marshmallow in it, then 72 is divided by 12, we get 6, and then we divide 6 by 3 and get 2. So one piece of marshmallow contains 2 bread units.
Children with diabetes are very disciplined, because they know that diet disruption almost always leads to deterioration.